So you think he was REALLY dead?

[mrhunt]

Trying to get a good topic to draw people in! Anyways, still relevant.

So call comes out as an overdose with CPR in progress by Law enforcement. Show up with multiple PD units on scene to a sketchy trailer park with a Sketchy dude in his 30's with snoring respiration's and responsive to painful stimuli. Sketchy & panicking Girlfriend on scene states pt Just smoked Fentanyl immediately before hand and that PD administered 2mg of narcan I.N. Law enforcement is mostly females (not like that matters really) but theyre notably sorta "worked up" and state they were doing CPR on the pt before hand (no cpr was being done when we showed up however). Pt has obvious bruising to sternum with no crepitus or obvious deformities to chest region.

So anyways, TINY *** trailer home so i go to get the guy on a tubby tarp to move him out and he just pops right up, GCS 15 and no complaints aside from some traumatic chest pain. Throw in a line during transport, all vitals normal and He sits in a chair by the nurses station so they can monitor him.

So! It was obviously an overdose and a very straight forward one at that. Overdoses obviously cause respiratory arrest which leads to cardiac arrest,
But imo, it appeared highly unlikely that this guy ACTUALLY coded and then PD got Rosc on him with 2 rounds of CPR and 2mg of narcan IN? especially when they stated he was having snoring respirations the entire time.... Sure it COULD have been agonal breathing....and SURE he's a fairly young and somewhat healthy guy aside from the excessive drug use (Track marks all over with admitted Meth & fentanyl use frequently) which could easily lead to Rosc in a situation like that with a touch of narcan and a few compressions....

But.... No airway, minimal CPR being done on a Soft couch so highly in-effective, and The officer who did the CPR was very, emotional? Kept saying how "you were DEAD! You have to go! Your chest is BROKEN, ITS BROKEN!!" Also, she said this cause when the guy popped up he was A&0X4 and extremely insistent about refusing transport and i was this close to having to AMA him.

Have you guys ever seen that though? Whats your opinion on this? Think PD is just being their typical Hero Selves? Or just being completely inappropriate and dont know how to check for a pulse?

Do you guys ever do any medical training with your local law enforcement?

 

[mgr22]

If the patient were truly in cardiac arrest, I don't think Narcan would have worked. Also, the patient's sudden recovery from dead to A&O sounds much more like an OD treated with Narcan.

Narcan may work in a patient who's presumed to be pulseless but has a pulse or is in a low-flow state. I'm guessing that was the case with this guy. Here's a relevant article:

Naloxone in Cardiac Arrest

Naloxone is a potent opioid receptor antagonist with an excellent safety profile and ability to reverse opioid-associated respiratory depression. Is it as effective when you're faced with patients in cardiac arrest secondary to an overdose?

www.emra.org

 

[DrParasite]

Or just being completely inappropriate and dont know how to check for a pulse?

That's my guess. They heard OD, gave narcan, did nothing, couldn't find a pulse (because they didn't know where to look), and started CPR. Maybe gave some more narcan just because. I've never seen CPR alone cause ROSC, esp with a spontaneous return to consciousness,

My rule: if he's breathing, even if he's snoring, then his heart hasn't stopped. But I'm just a dumb hose dragger.

Do you guys ever do any medical training with your local law enforcement?

our cops aren't medical personnel (well, some are from their previous life, but that isn't their job function), so you will hear anecdotal reports of cops giving 8mg of narcan to unconscious diabetics.... They also handle all of their own training internally, so.... well, if you don't care, and your evaluator just needs you to make sure a box is checked... you get the idea.

To be honest, give the cop a life saver award, take the guy to the hospital, and call it a day.

 

[E tank]

I guess I'd say 'who cares?' If you're going to give lay people the ability to medically intervene in a single life threatening situation with very basic orientation and no greater contextual understanding at all, yeah, they're going to do cpr sometimes. When all you know is a hammer, every problem will look like a nail. If that's problematic in your system, work to end the program, but they saved the guy.

 

[Carlos Danger]

I mean, if he was having snoring respirations the whole time, then he never arrested. Could have been on the verge of arresting though, for sure. Occam's razor would suggest that they just failed to palpate an existing pulse, which of course may have been weak from hypotension.