Still alive?

Achilles

Forum Moron
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Curious what everyone’s thoughts are on this.
i’ve Heard of similar situations, but they’re few and far between.
granted it is a news article and some information may be inaccurate, but it certainly doesn’t look good.

 

E tank

Caution: Paralyzing Agent
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There's a general term called "Lazarus Syndrom" where this type of thing happens. When it does happen (pretty rare) it is not uncommonly in someone with end stage COPD where they arrest for one reason or another and aggressive resus efforts result in dynamic hyper inflation of the lungs. Bigger tidal volumes coupled with not allowing sufficient expiratory time in a patient with obstructive airway dz leads to hyper inflated lungs.

This causes an increase in intrathoracic pressure that impedes venous return to the heart and basically causes PEA. When efforts cease, the lungs are allowed to deflate, venous return isn't impeded any more and the blood pressure returns. I wouldn't be very optimistic about the ultimate outcome.

Take away is to allow sufficient expiratory time when trying to resus a patient like this.

Other reasons why this phenomenon occurs, obviously, but this is a common and avoidable one.

 

Tigger

Dodges Pucks
Community Leader
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Recently had a "senior" medic go off on me for suggesting that putting a 4 lead on a deceased person is acceptable in pretty much any circumstance someone finds it appropriate. I don't need straight asystole to say we're done/not starting but it takes 10 seconds to make sure there aren't "surprises" later.
 

dutemplar

Forum Captain
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Unless there are major indications of permanent death, I'mma gonna get that 4ld ECG strip just because I can. Traditionally did the 30 second listen for any cardiac tones. Wouldn't mind a POCUS on the heart, but hey.

Excluding: Decapitation, incineration, decomposition, rigor mortis, dependent lividity, evisceration of major organs, "injuries incompatible with life (heart, lungs, brains on the ground next to 'em, a good norse blood eagle, fell/jumped from the 5th floor and is impaled on a dozen pieces of rebar through the whole body including two through the head, multiple through the chest...), fetal maceration, or just plain nuts like laying unconscious smurfed and not moving in the mamba enclosure at the zoo.

I was very very very worried once. Went out for a cardiac arrest. 80ish year old male. Worked it. No response. Called it. Like 2 hours later, same address, cardiac arrest, 80ish year old male. Like WHAT THE... Was going a bit crazy wondering what the heck I could have missed? ... Funeral director collapsed loading the dude. Worked the funeral director, but was able to take him to the hospital and left the police babysitting the half-loaded first one.
 

DrParasite

The fire extinguisher is not just for show
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Recently had a "senior" medic go off on me for suggesting that putting a 4 lead on a deceased person is acceptable in pretty much any circumstance someone finds it appropriate. I don't need straight asystole to say we're done/not starting but it takes 10 seconds to make sure there aren't "surprises" later.
What was his issue? you get a strip, it shows asystole, and you have objective evidence that the person was dead when you left him. yeah, everything else is a judgment call (are pupils fix and dilated, is that really rigor, was that a line of lividity, are they cold in a warm environment, and the old "oh yeah, he dead, no one can still be alive after that," etc), but that 4 lead is pretty hard to argue.
 
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Achilles

Achilles

Forum Moron
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Here’s the Facebook statement from the department.
6FE51180-BD75-4BF1-BB41-1B9FB91DDEBA.jpeg
 

StCEMT

Forum Deputy Chief
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We actually had something similar happen recently. Crew and sup work it, get orders, call it. While packing up, someone noticed she was breathing again.
 

Tigger

Dodges Pucks
Community Leader
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What was his issue? you get a strip, it shows asystole, and you have objective evidence that the person was dead when you left him. yeah, everything else is a judgment call (are pupils fix and dilated, is that really rigor, was that a line of lividity, are they cold in a warm environment, and the old "oh yeah, he dead, no one can still be alive after that," etc), but that 4 lead is pretty hard to argue.
No idea. He's very much into "minimal treatment" is the right treatment. I've put leads on several day old bodies. I knew they were dead. But it's a lot easier to objectively show it.
 

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