medic417
The Truth Provider
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Absolutely; count to five, insert scalpal.
As always, the trick is knowing when to do it.
(And how to RSI them first)
Wow you are letting us do the easy stuff.
question regarding CPR / saves ALS or BLS
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Wow you are letting us do the easy stuff.
firetender
Community Leader Emeritus
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Getting up and walking away? Not on my shift. Wheeled away, yes, to ER, ICU, the Floor then home. And you're talking JUST CPR, yes?
I actually had a couple saves as an EMT, arriving to find pulseless and apneic patients on scene, and with nothing more than CPR (yes, including mouth-to-mouth; it was THAT long ago!) they made it to the ER with pulses, BPs and breathing on their own.
There are many, many ways to die, and many many things that trip the heart out of action. There are just as many things that can trick the heart BACK into action; we just haven't figured them out yet. Just look at all the things we used because we THOUGHT they worked, and then we found out they didn't. (I present as Exhibit "A" Sodium Bicarb.)
Just because we've figured out SOME stuff that works doesn't mean we know it all. What I'm saying is I've seen hearts come back to life after the administration of a thing or things that never, ever should have worked.
That's significant though, because when you really look at it, the only fact that made a difference was that YOU were there and you tried something!
IMHO in order to stick with the profession, it really helps to view yourself as an agent of something much greater than yourself in action. And I'm not even talking "God" here. It's even broader and more inclusive than that! It involves the essence of healing, the movement to understand and facilitate it and the growing realization that it is a living, dynamic thing.
If you really look at it, that's all healing has ever been; an aspect of evolution. We just happen to be in the biz at this particular time of it.
And I'm not sure if you realize that you are still at the very infancy of a profession that completely revolutionized our understanding of healing. Thanks for being here!
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You want to save lives?
CPR training to the public free of charge, remove the stigma associated with "getting involved" and public access to AED's.
Bystander CPR and electricity and you will see survival rates go through the roof.
Absolutely; count to five, insert scalpal.
As always, the trick is knowing when to do it.
(And how to RSI them first
Ooooh let me try!!
*Brown comes sprinting in his badly zipped up jumpsuit lugging a Thomas Pack, trips over, sprains his ankle and lands in a heap
Brown down, Brown down!
AnthonyM83
Forum Asst. Chief
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I like to describe CPR as a holding pattern until we can get defibrillation/drugs/otherprocedure. It does happen that CPR alone works, but it's rare and probably for very specific cases.
I've only had one patient open their eyes and start talking to us right away after ROSC (very altered / agitated). I've heard of that happening to coworkers too, but it's pretty rare.
You were just dead. Usually takes your body a bit to recover from that little problem....plus whatever the underlying cause was.
I've only had one patient open their eyes and start talking to us right away after ROSC (very altered / agitated). I've heard of that happening to coworkers too, but it's pretty rare.
You were just dead. Usually takes your body a bit to recover from that little problem....plus whatever the underlying cause was.
Is BASICS not nationwide in the UK? Well maybe not Wales, but heck I am told thats not part of the UK anymore and has been sawn off out of embarrasment
One of my co-workers has had somebody get up from being unconscious and puseless (supposedly) and thank them with just a bit of CPR. That I think was more a very severe bradycardia where the patient went unconscious for a bit.
You guys get all the news-worthy jobs while all I get is "chest pain ? cardiac - acute MI suspected, ischaemic type changes on 12 lead ECG".
LondonMedic
Forum Captain
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I think there are schemes that covers the whole country, however, it's patchy and actually getting an adequately trained doctor to anywhere in time to do anything useful is hardly guaranteed.Is BASICS not nationwide in the UK? Well maybe not Wales, but heck I am told thats not part of the UK anymore and has been sawn off out of embarrasment
I'm surprised nobody's mentioned waking up someone in asystole with CPR yet?
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Is anything in the NHS more than hardly guarenteed? Although I do like the NHS, you might not get the super sexy designer drugs delivered by a physician in super dooper orange getup but you at least get a big yellow van that goes NEE NAW NEE NAW for free right?
I'm surprised nobody's mentioned waking up someone in asystole with CPR yet?
Don't you watch telly, you have to zap it!
LondonMedic
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Only because Autopulse and LUCAS don't make great telly.Don't you watch telly, you have to zap it!
No, but apparently the old school "Thumper" CPR device from the early 1990s does seem worthy of some air time
I am not sure of its offical name but it was a blue handheld pneumatic bellow pump type thingy that we used back in the day hence why it was nicknamed the thumper.
EMS49393
Forum Captain
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Very interesting. Are these instructors EMT's or paramedics? Are they crusty? Because that sure sounds like something a crusty old EMT that was an instructor would say.
After a patient is in cardiopulmonary arrest, I can do a lot of things to try and make them well enough to truly be fixed. Honestly though, something was wrong with them that caused them to arrest, and those things can't often be fixed by EMS.
If there is no ROSC after I throw out every reasonable trick in my bag, and I've worked this thing hard for 20 minutes or longer, I'm calling a doc and getting that code called off. I don't transport cardiac arrests without ROSC unless they are pediatric or hypothermic. The only reason I'll transport a pediatric code is because the state makes me. Honestly, if a kid has been down for an hour, who is going to save them at that point?
Not to hijack this thread, but I thought that the paramedics in several other countries outside the US were much more educated then US paramedics. I was under the impression that a four year degree from university was required in the UK, as well as Canada, and other English speaking countries. (Forgive me, I don't see many posts from non-English speaking countries, so I do not mean to single them out.) In the US, you can go to paramedic school in a few months. You won't know anything, but you'll get to do all sorts of neat tricks.
jjesusfreak01
Forum Deputy Chief
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Seems to me that paramedics in the US do just fine with the scope of skills they are allowed to use, and those I have worked with seem to know their stuff well too. Maybe the problem is that outside the US where they require 4 year degrees for EMS they just aren't giving the medics a large enough scope?
Maybe 2 years is long enough to learn everything you need to master the current scope, and we should be thinking about seriously expanding the practice of those who are willing to spend much longer in school for EMS.
Maybe 2 years is long enough to learn everything you need to master the current scope, and we should be thinking about seriously expanding the practice of those who are willing to spend much longer in school for EMS.
Not every country requires a four year degree because none that I know follow the American system of education in which a Bachelors Degree is four years long.
New Zealand and Australia both require a three year Bachelors Degree for Paramedic (non ALS) and a Graduate Degree (one year) for Intensive Care Paramedic (ALS). There is a requirement for period of on-road consolidation (around one year after gaining the Bachelors Degree) before you are allowed to independantly practice as a Paramedic. In order to apply for Intensive Care Paramedic you need several years experience as a Paramedic.
The UK requires a two year Foundation Degree (FDSc) for State Registered Paramedic although most Universities offer a three year Bachelor of Health Science degree. I believe there is a requirement for those on the FDSc to complete a third year and get the BHSc at some point too.
Canada varies a bit and I can only speak for Ontario where a two year Diploma is required for Primary Care Paramedic and a one year addition for Advanced Care Paramedic.
Remember that although these programs may be shorter than a four year American Degree they are not the same in educational content. Specifically for AU, NZ and the UK they are highly specialised University programs; not two year programs at the local vocational training institute where you can fill up half of the credits with introduction to Seaseme Street and Colouring 101. They have no general education requirements and non clinical subjects so every class in the Degree is a clinically focused one.
As for the scope of practice, because we have so few levels (the UK has two, as does Australia and we have two that require a University education) you really cannot compare it to the US who is still back in the dark ages.