First Full arrest

[CALEMT]

"...well damn, that sucked..." then again, I think that's a problem. It's one thing to be emotionally detached, which is an important quality to have - it's quite a different thing to be cold and indifferent.

So what you're implying is that after every full arrest when I have the feeling of "damn that sucks for him/her glad it wasn't me" makes me cold and indifferent? Don't get me wrong I'm not cold hearted or indifferent, I just don't let my emotions dictate my actions while at work and I sure as hell don't let my emotions affect me as a provider.

 

[jwk]

No one said anything about it being OK for a person to "be emotional and let it affect them". I don't know where you got that from.

But just telling a newbie "codes are easy, you just follow ACLS" is pretty shortsighted and supports the "technician" mindset that so many on here are constantly complaining about.

So what you're implying is that after every full arrest when I have the feeling of "damn that sucks for him/her glad it wasn't me" makes me cold and indifferent? Don't get me wrong I'm not cold hearted or indifferent, I just don't let my emotions dictate my actions while at work and I sure as hell don't let my emotions affect me as a provider.

As I mentioned previously, Remi is a little less blunt than I am.

I don't let my emotions dictate my actions - never have in the 40 years I've been in healthcare. Maybe we're a lot alike and just arguing to argue. But there are certainly patients that are more stressful than others. My first arrest as a new EMT decades ago was a five year old child out in the middle of BFE. It's quite stressful to realize you're very likely not going to be able to do squat for this child. One of my last was a 19yr old girl in profound respiratory distress that arrested on the way to the hospital. We coded her for three hours (no thumpers back then - it was all old-fashioned CPR) in the ER until it was determined she'd had a massive PE likely due to her concomitant smoking and BCP use. That significantly affected everyone involved from ER doc to EMT.

I find it quite odd that people think that arrests shouldn't be stressful to a certain extent because there is usually an expectation that something can be done, but again, we have different perspectives and different responsibilities. Do A, do B, do C, do D, repeat as necessary is not the norm in my world. I assume most patients on whom you run a code, with some exceptions, have already arrested. That is not the case in my business. My patients are all quite alive when they come to me, although some are already in deep trouble from sepsis, trauma, etc. I sometimes have patients with nearly all the "H's and T's" at the same time. I know what to do - I don't hesitate - but that doesn't mean it's not stressful.

 

[Chewy20]

Dude once their heart stops it's stopped. Do CPR, shock if in correct rhythm, pump them full of fluid, epi and get bicarb onboard, maybe some narcan if indicated, maybe some amio. What other magic things do you have going for you at work? What are your differentials and what can you do for them? I'm honestly curious. It's sounding like maybe you are not in the field anymore? So maybe you have some different things to add. I am not familiar with arrests in a hospital besides getting to cath lab for STEMI. What things do you have at your disposal that your protocols are just "suggestions"?

Yes I am very good at detaching myself from the emotional part of this job. Yet I still do my job. I guess I should quit. Because if you are able to walk away after an arrest without saying "damn that sucked", well then, you're cold and the devil.

Quit making blanket statements. Everyone is different with how they handle crap or don't handle crap. You have yet to argue how an arrest in the field is difficult medicine. I'm a basic and would be able to do the ALS side in my sleep, and I can't say that for other medical calls. Maybe from the "lack of options" field providers have. But like it or not, field providers are pretty limited nationwide.

if you want I can take back my blanket statemtent about these calls not being stressful to make a couple of you feel better.

 

[triemal04]

As I mentioned previously, Remi is a little less blunt than I am.

I don't let my emotions dictate my actions - never have in the 40 years I've been in healthcare. Maybe we're a lot alike and just arguing to argue. But there are certainly patients that are more stressful than others. My first arrest as a new EMT decades ago was a five year old child out in the middle of BFE. It's quite stressful to realize you're very likely not going to be able to do squat for this child. One of my last was a 19yr old girl in profound respiratory distress that arrested on the way to the hospital. We coded her for three hours (no thumpers back then - it was all old-fashioned CPR) in the ER until it was determined she'd had a massive PE likely due to her concomitant smoking and BCP use. That significantly affected everyone involved from ER doc to EMT.

I find it quite odd that people think that arrests shouldn't be stressful to a certain extent because there is usually an expectation that something can be done, but again, we have different perspectives and different responsibilities. Do A, do B, do C, do D, repeat as necessary is not the norm in my world. I assume most patients on whom you run a code, with some exceptions, have already arrested. That is not the case in my business. My patients are all quite alive when they come to me, although some are already in deep trouble from sepsis, trauma, etc. I sometimes have patients with nearly all the "H's and T's" at the same time. I know what to do - I don't hesitate - but that doesn't mean it's not stressful.

There might be a difference in perspective that you're ignoring. As an AA, the resuscitation you attend will almost always be someone that started out alive in your presence (unless you're going to floor codes), then died, and the expectation is that you will resuscitate them. Compare this to the average paramedic who will only rarely have people die in front of them, have abysmal resuscitation rates and doesn't have the expectation that the patient will, or should survive.

Might explain some of the differing views.

 

[CALEMT]

Yes I am very good at detaching myself from the emotional part of this job. Yet I still do my job. I guess I should quit. Because if you are able to walk away after an arrest without saying "damn that sucked", well then, you're cold and the devil.

Quit making blanket statements. Everyone is different with how they handle crap or don't handle crap. You have yet to argue how an arrest in the field is difficult medicine. I'm a basic and would be able to do the ALS side in my sleep, and I can't say that for other medical calls. Maybe from the "lack of options" field providers have. But like it or not, field providers are pretty limited nationwide.

This. Why/ how does it make me "cold and indifferent" when I can walk away from any call with the mindset of "damn that sucked". I don't get emotionally involved with any calls... well kids being the only exception. If I was emotionally moved by every call chances are I would have committed suicide or gotten out of this career field by now. I don't understand why we all should be emotional about the calls we run.

Chewy is right. Everyone handles things differently, I can work a arrest on a 15 year old and be perfectly fine if the pt is terminated in the field while you may be sobbing your eyes out in the ambulance (not a personal attack, just a ex.). But just because I don't shed a tear or I'm not emotionally moved by the call certainly doesn't make me a bad provider. Even when I worked BLS IFT doing the renal rodeo you know how many "regulars" we had that died? Quite a few, yeah it sucked because you built a rapport with them but at the end of the day I'm not going to let to affect me. Life goes on, if you spent all your time dwindling on all the people you've lost in the field or in the ER it would drive you clinically insane.

As far as full/cardiac/ what ever people call it yeah its stressful for some people running one for the first time. Why? Because its the first real "legit" high intensity call that a newbie can run. My first full arrest I wasn't even a EMT, I was a 16 year old fire explorer doing compressions on a 50 year old male who collapsed while riding a bike. We transported to the hospital where he was called 5 minutes later. Let me tell you, my adrenaline was through the roof and I will admit I had the deer in the headlights look for the first minute, then a regained composure and remembered what I was taught and followed the medics directions. Up until then all I ran was the run of the mill chest pain and difficulty breathing. But even at 16 it didn't emotionally bother me, why? Because life goes on and I'm still here roaming this earth.