why give false hope

[Shishkabob]

I brought up this call in class. The entire class turned on me. The mothers in the class said that they would rather have the bill and know everything was done that could be. Personaly I still believe you shouldnt run an obvious death. I dont care who it is. But thats just me.

I, as a Paramedic, can do EVERYTHING a physician can in a medical cardiac arrest.



Not going to waste the gas, time, energy, or public's life/safety rushing a body to the hospital when I've already done everything they will, short of calling it, which I too, can do in the field.

 

[JPINFV]

In other news, 3 paramedics and 2 civilians died as an ambulance going code 3 crashed into a car while the crew was senselessly flogging a dead baby for the sake of the parents.

 

[Flightorbust]

, short of calling it, which I too, can do in the field.

Here a basic can call it if there are obvious signs of death.

 

[JPINFV]

Here a basic can call it if there are obvious signs of death.

Arguably no pulse and multiple rounds of "do not shock" from the AED.

 

[Tigger]

I, as a Paramedic, can do EVERYTHING a physician can in a medical cardiac arrest.



Not going to waste the gas, time, energy, or public's life/safety rushing a body to the hospital when I've already done everything they will, short of calling it, which I too, can do in the field.

Can you put in a central line?

Mind you transporting a code so that they can get a central line is some pretty bad reasoning, and it's almost certainly a futile effort, but I am not aware of a lot of ground-based providers that are currently doing this.

 

[JPINFV]

Can you put in a central line?

Mind you transporting a code so that they can get a central line is some pretty bad reasoning, and it's almost certainly a futile effort, but I am not aware of a lot of ground-based providers that are currently doing this.

How many medical codes have you seen where the physician put in a central line?

Now, how many of those were codes brought into the ED in arrest by EMS?

 

[Tigger]

How many medical codes have you seen where the physician put in a central line?

Now, how many of those were codes brought into the ED in arrest by EMS?

One, and it was brought in by EMS. I understand it is not the norm however, and the whole thing was a mess. Guy walked into a fire station, dropped, was worked for 20 minutes, pulse obtained, transported, coded enroute, and was then worked for two hours in the ER. In the the ER he was shocked 12 times and received at least that many doses of epi, and after the doc finally decided to call it the next time he crashed, wouldn't you know he didn't and he was transferred to the ICU where he died the next day, unsurprisingly.

The whole time I couldn't help wonder what the heck we were doing with this guy. The flat line was appearing on the monitor with too much frequency to equal survival.

 

[Shishkabob]

If you want to go that route, yes, there are Paramedics who are able to do central lines. However, in a medical arrest, an IO is just dandy.



There is, however, an exception to transporting an arrest: My agency and a local cath center are doing a trial where persistant Vfibs, after exhausting all other methods in the field, are transported, non-priority with a Lucas device, to the cath lab where they do a cath. Apparently it's showing good results for things such as coronary lesions.

 

[usafmedic45]

Why give false hope?

Because the medics are too cowardly to say "I'm sorry, there's nothing we can do."

Both of these comments could more or less be perfectly applied to a lot of threads on this forum, especially with regards to people failing exams and such.

Not a fan of it, but you can't fault people for their agency's issues.

No, but on more than one occasion I circumvented protocol by pointing out that moving an obviously dead body is a felony in most states as is interfering with a coroner's investigation of said dead body. I can tell you from working that side of the equation that nothing makes a dead baby investigation more confusing that overzealous transport and the associated disruption of the crime scene.

 

[usafmedic45]

Apparently it's showing good results for things such as coronary lesions.

Nothing like a well-perfused myocardium and hypoxic encephalopathy to make for good results.

 

[JPINFV]

Nothing like a well-perfused myocardium and hypoxic encephalopathy to make for good results.

I've always been mildly interested to wonder if a heart lung machine could be made portable enough to use in a pinch...

 

[usafmedic45]

Yeah, there are portable ECMO units that would work and they've tried it before. A PUBMED search should bring up the studies. The technical issues with gaining access and priming the damn thing are the big hurdles for field use. Also, stop and think about the dumbest paramedic on this forum...you really want them trying to do a venous and arterial femoral cutdown in the field?

 

[Tigger]

If you want to go that route, yes, there are Paramedics who are able to do central lines. However, in a medical arrest, an IO is just dandy.

I think we can probably agree that those are few and far between. It's also a silly argument on my part since as you note, there is not much reason to do preform one.

 

[JPINFV]

you really want them trying to do a venous and arterial femoral cutdown in the field?

To be fair, the indication would be asystole anyways.