My first code

[BEorP]

The CPR protocol in the hospital is compressions are continous once the ETT is in place, 1 2 3 4 5 bag was bagging every five seconds. I counted it in my head, we dont have the ResQPods yet. I wish we did, those are so freakin cool!

ILCOR guideline is 8-10 breaths per minute when there is an advanced airway. And what is so "cool" about the ITD?

 

[MissTrishEMTB08]

Uhhhm... We were taught, and still are taught, that once every 5 to 6 seconds with an ETT tube. THat is how my instructor and the hospital staff do it. Thats how I do it.

I think ResQPods are pretty cool. They have a light that flashes when you ventilate and a valve that keeps air where its supposed to be. What isnt cool about them?

 

[MissTrishEMTB08]

We as in my class. Thats how I go by, is what Im taught in my class.

 

[BossyCow]

I guess the patient didnt realize that once you do CPR shes supposed to wake back up like in them movies! You know.. cough a few times, moan, then pop up like nothin ever happened and go runnin into the sunset with the doc.

Yeah, I call this "Baywatch CPR"

 

[BEorP]

I think ResQPods are pretty cool. They have a light that flashes when you ventilate and a valve that keeps air where its supposed to be. What isnt cool about them?

Could you please explain to me how it actually works in terms of keeping "air where its supposed to be"?

 

[upstateemt]

http://orlandohealth.com/media/media_news_details.aspx?NewsID= 138


ResQPOD helps Code Team at ORMC

Date : 06/15/2006
Media Contact : Sabrina Childress
321.841.8748
sabrina.childress@orlandohealth.com

ORLANDO, Fla. (June 15, 2006)

Restarting a heart after cardiac arrest is top priority for the Code Team at Orlando Regional Medical Center (ORMC). The ResQPOD? Circulatory Enhancer is a new device being used during cardiopulmonary resuscitation (CPR) to help the team of nurses, respiratory therapists and doctors restore an efficient flow of blood and oxygen to the heart, brain and other organs — with the hope of increasing survival and improved quality of life. “During basic CPR, a rescuer may use a portable respirator and hands to compress the blood to the heart and lungs to stimulate breathing and heartbeat which moves blood and oxygen to the brain,” said Terry Suarez, RRT, life support coordinator, Orlando Regional, and training coordinator for the Orlando Regional Healthcare American Heart Association Training Center. A challenge with CPR is the possibility of delivery of too much air, too often, making the compressions less effective. ResQPOD is designed to reduce the chances and improve the quality of CPR, bringing new hope of more lives saved. “ResQPOD, shaped similar to a cylinder, is a control valve that attaches to a bag mask valve respirator or a mask to help decrease the pressure in the chest to improve blood flow to the heart during decompression phase of CPR,” said Suarez. “Then with each compression, more blood will be pumped out to the brain and other vital organs.

Imagine the heart is a sponge, this device helps fill up the sponge faster for the next squeeze. ResQPOD also flashes a light signal, to help clinicians maintains proper breathing rate and speed of compressions.” While it is estimated that more than 95 percent of cardiac arrest victims die before reaching the hospital, death from cardiac arrest is not inevitable. “CPR alone can double a victim’s chance of survival until more advanced care can be given,” said Suarez. “In the hospital setting, our Code Team always seeks ways to improve patient outcomes. In its winter 2005 guidelines for CPR and emergency cardiac care, the American Heart Association released new evidenced based guidelines that list Impendence Threshold Devices (ITD), such as ResQPOD, as a Class IIa device. We look forward to adding ResQPOD to our continued efforts in quality care for heart patients.”

 

[BEorP]

Thanks, upstate. I have a full understanding of how the ITD works, but I was wondering if the OP did. It frustrates me to see an EMT who calls something "cool" and may or may not have an understanding of what it actually does.

 

[upstateemt]

Since she is a new EMT perhaps you could show her a bit more tolerance. We all started somewhere.

 

[MikeRi24]

to the OP: welcome to the wild and crazy emotional roller coaster that is EMS. Like others have said, usually after a couple rounds of drugs if you're not getting anything then its a lost cause. It also depends on the hospital and the doctors there at the time. For example, I know in my area that Hospital A generally is more willing to worke a code longer than Hospital B, and at Hospital C, you are lucky if you even get into a room before the doc calls it, and so on. Being in the ambulance is a little different. Do you have pts that will be talking to you one minute and you're doing compressions on them the next. I've had it happen. But most of the time, you don;t know these people, they're already down when you get to them, and you'll never see them again in a half hour. You just do your job and thats it. You start to become numb to the whole death and sympathy for the pt after a while. Is that kinda sad? Yeah I guess but really after a while it just becomes part of your job. I've worked with some people are frantic as can be and rushing around trying to get stuff done as afast as they can when working a code and they just make everything so chaotic. My current partner has been a medic for quite some time and has been a fire chief for even longer, and when we work a code he's as calm as can be (I think he gets more excited over eating his lunch lol), does what he needs to do and thats it.

2 Things to take away from this that I think might help you, because I know they helped me a LOT:
#1 It's not your emergency, its not your arm thats cut off and bleeding, its not you that coding, so why bother getting all excited about it? If you're freaking out, the other people working with you will freak out, and the pt will freak out and then everything is a mess. if you're calm, you will find it a lot easier to do what you need to do.
#2 In the world of EMS, you wear many different hats: EMS worker, psychologist, counselor, taxi driver, maybe some days your just someone for that old lady who has no one to talk to and is lonely. But above all, the one hat that you can never put on is God.

 

[MissTrishEMTB08]

Thanks, upstate. I have a full understanding of how the ITD works, but I was wondering if the OP did. It frustrates me to see an EMT who calls something "cool" and may or may not have an understanding of what it actually does.

Sorry. I wasnt aware you were the "How it Works" police. Jeez louise.

 

[teehehe]

Thanks, upstate. I have a full understanding of how the ITD works, but I was wondering if the OP did. It frustrates me to see an EMT who calls something "cool" and may or may not have an understanding of what it actually does.

You're right. In order to call something "cool" you must demonstrate complete understanding of the device in question. I guess that means I can't call NASA's spacecrafts "cool" anymore because I'm not a rocket scientist. <_<

 

[BossyCow]

And I suppose I can't describe Sean Connery as "Sexy" because I'm not sleeping with him.

 

[Ridryder911]

I don't care how many codes you have worked, how long you've been in Emergency Medicine or what your pedigree is. This is the most callous insensitive load of smoke I have ever heard from anyone in health care. In the absence of a DNR, regardless of the present response to therapy, you work them til the end with your full attention and ability PERIOD. You do not lose your focus and you darn sure dont relax.
I wonder how many lawsuits and review boards you would face if the families of your patients ever came to hear you refer to their loved ones as a waste of time...

Save the jokes until after the pt is declared or the shift is over.

Obviously, you are not a professional provider and rather still in the embryo of EMS and medicine. You still think and believe what you see on t.v. as being actual and real. Get over yourself and your self righteousness of what you think medicine is like and than what it truly is. Not all of us get excited and teary eyed every time there is a sick person. The reason is because it is my job, a job that I do take extremely serious and do extremely well with great results and damned fine care.. Remember, take your job serious not yourself..

A monkey can perform a code. It is an obviously a cookbook steps. Obviously you do not even understand litigation...your patients cannot get any worse.. their dead!

P-l-e-a-s-e get a taste of reality. Do you really think that there is not practical jokes performed during surgeries on a daily basis or their not listening to rock music during a heart transplant? ... Geez. get over yourself. Your naivety is grossly obvious.

You are in a world of trouble if you think everything is dealt with seriousness. As well, you will be a short timer not realizing your own limitations and how to deal with them. Either you will learn this is the "normal" reaction of most or not be able to "deal" with the day to day workings. I have seen many not "deal" with the work and attempt to be serious all the time, they don't last long either in the profession or in life.

It is called "black humor or gallow humor" as well. It is well documented as a stress relief by the American Psychological Association as a coping mechanism for those in EMS and those that perform in stressful environments. We find things funny most do not. The reason there is few litigation's is because attorneys/judges understand and have it too. Don't believe me, just go into a judges chambers and hear the jokes being made. As well, humor may be called inappropriate to some but is NOT negligible. Where you may see it as tasteless, I see being over sympathetic to patient as disgustingly if one loose their objectivity. There is a BIG difference of being empathetic and sympathetic. Please leave the sadness and tears to the family and allow me to do what I am supposed to do.. take care of patients. Life does go on.

I highly suggest to see and listen to Steve Berry's lecture of humor in EMS. Yet again, I doubt that you would understand.

In regards to the Res-Q-Pod. The metro EMS near me have been using them for about 3 years. It started with big results and was the new next thing.. problem is now the numbers have changed and really do not see any evidence of outcome changes.

Personally, these have been out long enough, we should had seen some major difference in numbers and at >$100 a unit an expensive toy. Again, arguably if one can really increase ATP per ventilation.

I believe we will see it go to the waste side as a nice idea in theory but did not work out.

R/r 911

 

[firecoins]

Do you really think that there is not practical jokes performed during surgeries on a daily basis or their not listening to rock music during a heart transplant? ... Geez. get over yourself. Your naivety is grossly obvious.

R/r 911

Thats odd! I have seen rock music played during orthopedic surgery.

 

[mikie]

Thats odd! I have seen rock music played during orthopedic surgery.

Seen or heard?

 

[MMiz]

This thread, like many, has strayed from the original topic. You're welcome to start a new thread to discuss the multitude of issues discussed in this thread. If you continue with this thread, please keep the discussion on topic.

 

[firecoins]

Seen or heard?

watched them hit play on an ipod that played music. I heard that. You hear waht I am saying or did you just see my post?

 

[mikie]

watched them hit play on an ipod that played music. I heard that. You hear waht I am saying or did you just see my post?

touchée good sir. what's next, surgeons playing Guitar-Hero during surgery?

[sorry to interrupt the thread!]

 

[MissTrishEMTB08]

Wow Rid. Your post came off as really condescending.

 

[KEVD18]

Wow Rid. Your post came off as really condescending.

you'll get used to that....