watch out for those routine transfers:
Last week we were taking a 6 month old from our childrens hospital back to a long term care facility that specializes in children with major medical/mental issues that can't be taken care of at home.
infant had trach, vent dependent; she had 2 cardiac arrests in last 2 months and was a full code still: GCS was 6: 4,1,1; She was diagnosed with a viral URI; needed suctioning more often.
transport was approx 60 min, pt on monitor Sinus tach at 150, no ectopy; great cap refill. no biox probes on the truck for an infant.
approx 50 min into transport pt started to brady down. at approx HR of 100 min I took her off the vent and started bagging her; hoping it was a vent issue and it would help. It didn't. good breath sounds, no congestion, did a quick suction of trach, no problems, no change. started compressions at approx HR of 80: still bagging with 100% O2. pt still going down. EMT-B preceptee took over CPR, I put shock pads on her, CPR for 2 min (protocols before attempting to shock). did quick check: asystole. (Code summary showed sinus tach, NSR, Sinus Brady and asystole).
we had already diverted to small town hospital: phone report was basically: "6 month old, cardiac arrest, not shockable, CPR in progress IV/IO attempt en route, see you less than 5 minutes".
Wiping leg for IO, (no IV sites found); when we stopped at ED. they worked her for 30 min with our help (small hospital, busy, short staffed). 3 rounds cardiac drugs; pediatrician came from home, he jogged, (faster than driving through parking lot).
We did everything right, started fast; she still died.
my partner has been EMT-B for almost 2 years, it was her first arrest in truck and first death (and had to be a 6 month old) she is taking it hard: "if I drove faster, etc". Our preceptee is taking it better than she is.
trying to help her out is tough; I have been doing it for 10 years, and is probably 15-20 infant arrest and it is tough on me to.
any ideas to make it easier on partner?
Last week we were taking a 6 month old from our childrens hospital back to a long term care facility that specializes in children with major medical/mental issues that can't be taken care of at home.
infant had trach, vent dependent; she had 2 cardiac arrests in last 2 months and was a full code still: GCS was 6: 4,1,1; She was diagnosed with a viral URI; needed suctioning more often.
transport was approx 60 min, pt on monitor Sinus tach at 150, no ectopy; great cap refill. no biox probes on the truck for an infant.
approx 50 min into transport pt started to brady down. at approx HR of 100 min I took her off the vent and started bagging her; hoping it was a vent issue and it would help. It didn't. good breath sounds, no congestion, did a quick suction of trach, no problems, no change. started compressions at approx HR of 80: still bagging with 100% O2. pt still going down. EMT-B preceptee took over CPR, I put shock pads on her, CPR for 2 min (protocols before attempting to shock). did quick check: asystole. (Code summary showed sinus tach, NSR, Sinus Brady and asystole).
we had already diverted to small town hospital: phone report was basically: "6 month old, cardiac arrest, not shockable, CPR in progress IV/IO attempt en route, see you less than 5 minutes".
Wiping leg for IO, (no IV sites found); when we stopped at ED. they worked her for 30 min with our help (small hospital, busy, short staffed). 3 rounds cardiac drugs; pediatrician came from home, he jogged, (faster than driving through parking lot).
We did everything right, started fast; she still died.
my partner has been EMT-B for almost 2 years, it was her first arrest in truck and first death (and had to be a 6 month old) she is taking it hard: "if I drove faster, etc". Our preceptee is taking it better than she is.
trying to help her out is tough; I have been doing it for 10 years, and is probably 15-20 infant arrest and it is tough on me to.
any ideas to make it easier on partner?