Mouth To Mouth Question

chadwick

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I worked a cardiac arrest on a 2-3 month old child today. I am used to running on a BLS truck that has all 3 sizes of BVM's in the bag but our ALS bag only has an adult so I ended up wiping the mouth off and giving two quick breaths when I scooped the baby up and ran to the ALS truck while doing compressions. My question is, there was a pool of fluid under the head and when I gave my breaths I noted that it tasted like vomit. Should I document that in my run sheet? I think if I go to court later on it may be important to have that in my run sheet. And yes I checked my truck and made sure it had the required equipment when my shift started, I should have remembered and grabbed a BVM but I did forget. This is my first infant code and I don't make a habit of not having what I need at a scene. Any input on including this in my narrative would be greatly appreciated.
 

Shishkabob

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What would vomit have to do with going to court?

Anyhow, note that vomit was in the airway if it was, but not that something "tasted"like vomit.
 

MMiz

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I would think that you'd want to put all of that in your run report. Even at this point you could always add a supplemental narrative.

If you tasted vomit then you need to make sure that the patient did not have any communicable diseases.

Lastly, I don't need to tell you what to do in the case of mouth to mouth, you already know what to do, but I've heard suggestions of using gauze pads or dressings as a CPR barrier in cases where one wasn't readily available. Nothing is 100%, including a CPR mask, but it's better than nothing.
 
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chadwick

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It just feels to me like it needed included, my paramedic called it an unknown fluid in her run sheet which just seems too vague. I have to do a run sheet also because its our policy here.

MMiz, I have seen the gauze used on TV before, that was in the bag (smacks self in head). They are sending him for autopsy so the coroner will let us know, he is a good guy.
 
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MMiz

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It just feels to me like it needed included, my paramedic called it an unknown fluid in her run sheet which just seems too vague. I have to do a run sheet also because its our policy here.

MMiz, I have seen the gauze used on TV before, that was in the bag (smacks self in head). They are sending him for autopsy so the coroner will let us know, he is a good guy.
I would not write "tasted like vomit" on the run report. I'd probably write "Arrived to find 3 month old baby xxx with what appeared to be a pool of emesis under the patient's head."

The reality is that it is an unknown fluid, and you have no way of easily determining whether or not it was actually emesis or another substance. It's like a patient that looks drunk, smells drunk, and sounds drunk. We still can't say that the patient is drunk, but instead can only record our assessment, observations, and data.
 
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chadwick

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I am just going to say unknown fluid. I can't say what it is for sure but I have an educated guess.
 

Aidey

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Your policy is that everyone does their own independent report? Yikes, talk about potential for contradicting statements.
 
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chadwick

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Each responding unit has to do a report. My partner and I are the BLS crew today, we have to document everything up until ALS arrived as a response.
 

18G

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When the ALS chase unit comes from the hospital and BLS from the FD they each have to do their own report. Around here they are different entities.
 

l_one

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Documentation

Document. Everything.

Seriously, my instructor drilled this into us over and over. You don't want to make diagnosis but objectively document everything (yes, tedious).

Example: you probably shouldn't say "it was vomit" but you can say "unknown substance which had an odor(and/or taste) of vomit".
 
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Jay

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What was the underlying cause of the arrest? Was it secondary to choking (which would explain the emesis)? Did the kid make it?

Just curious on the background.

Bottom line is two things:

(1) Everything gets documented. Always. No exceptions.

(2) When it comes to kids the rules change, I would have done the same thing out of reflex. whether or not the administration of rescue breaths w/o proper BSI technique is in protocol or even morally or ethically called for is another post all its own.
 
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