Pulse rate and chest compressions

Thanks for the input everyone.
 
STXmedic said:
If that's exactly what he said and there was no misunderstanding, your paramedic needs to go back to school.
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bahaha :lol: :rofl:

The only time I've seen an adult with pulses get compressions is when the only way we could get a pulse was by doppler, it was under 10 BPM and unobtainable BP. He was refractory to every other intervention so we started chest compressions, push dose pressors, a drip or 6 and then he went to the cath lab where he later died.

This was in-hopsital though, not prehospital. My thought was hold the CPR do do everything else but the ERP who I respect had a good explanation as to his reasoning.
 
Percussion pace em' :rofl:

I actually did it once. It worked. No joke

Robb said:
bahaha :lol: :rofl:

The only time I've seen an adult with pulses get compressions is when the only way we could get a pulse was by doppler, it was under 10 BPM and unobtainable BP. He was refractory to every other intervention so we started chest compressions, push dose pressors, a drip or 6 and then he went to the cath lab where he later died.

This was in-hopsital though, not prehospital. My thought was hold the CPR do do everything else but the ERP who I respect had a good explanation as to his reasoning.
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Did they float a wire?
 
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Chase said:
Percussion pace em' :rofl:

I actually did it once. It worked. No joke



Did they float a wire?
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For a transvenous pacer? Not when I was there, this hospital at the time didn't have a super aggressive interventional cardiology program but they've got a new lead cardiologist and things are a lot different now.
 
Robb said:
For a transvenous pacer? Not when I was there, this hospital at the time didn't have a super aggressive interventional cardiology program but they've got a new lead cardiologist and things are a lot different now.
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Yep. Any EMP or CCP should be able to do it. It is just like placing a central and floating a swan. No special skills required. I am all for early transvenous pacing. Definitive treatment.
 
Chase said:
Yep. Any EMP or CCP should be able to do it. It is just like placing a central and floating a swan. No special skills required. I am all for early transvenous pacing. Definitive treatment.
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Knowing the changes that have been made in pretty sure he'd have gotten one now. He seemed like a good candidate for ECMO but I'm not sure if that hospital has the capabilities or not.

I've always wondered about that call and if we'd have gone to the TC which has not capabilities if it would've had a different outcome. I watched him go from walky talky to basically dead over the course of 40 minutes. Nothing I did would work. Pretty helpless feeling I'm not going to lie.
 
Brandon O said:
Really?

How do you know? Pulses?
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Art line. After a temporary pacer wire was pulled out of the pacemaker terminal and patient was in Ventricular standstill. A couple hits on the chest corresponded with small tracings on the arterial waveform.
 
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Chase said:
Art line. After a temporary pacer box wire was pulled out and patient was in Ventricular standstill.
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I can count how many patients I've paced on one hand. Every. Single. One. Someone at the hospital disconnected the limb leads, even after I repeatedly said "No one touch any of my monitor cables, no one touches them except me."

D/C the limb leads and the pacer goes kaput. So frustrating. Every time we were able to get capture back either on my monitor or swap to the ER's crash cart quickly, thank goodness.
 
Chase said:
Art line. After a temporary pacer wire was pulled out of the pacemaker terminal and patient was in Ventricular standstill. A couple hits on the chest corresponded with small tracings on the arterial waveform.
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Couldn't that be artifact from you whacking him?
 
Brandon O said:
Couldn't that be artifact from you whacking him?
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Don't burst my bubble. :rofl: I wouldn't think a hit in the center of the chest would cause artifact in a radial art line. But it's possible, probably likely, it was artifact.
 
I do hate to be a bubble burster... this kind of thing is just an old issue from the TCP pacing world. "Is it working?" "Eh... who knows."
 
I'm not exactly sure I know what y'all are talking about
 
Ive started compressions on a post arrest patient who we had lost again and gotten back, watch him go from HR of 80 to brady 60-50-40 and we started compressions at about 30-40...dude was 5 seconds from coding, cardiac output was kaput, difference between waiting for him to code and starting then...probably close to 0..

lost story short, I have absolutely done compressions on adults with a pulse.
 
You folks are spurring me to get a DNR tag to add to my two dog tags already.
 
mycrofft said:
You folks are spurring me to get a DNR tag to add to my two dog tags already.
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My gift to you will be boot-method of CPR. You're grumpy enough that you'll just spring back to life if I just threaten to use it on ya... because you'll probably try chasing me down the street! :rofl:
 
Oh, the time-immemorial "precordial jump".
 
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