ChaseZ

I doubt this would work well. It looks like it would displace the surface tissue but do a poor job of actually applying pressure to a bleeding vessel. Also looks like a good way to create a Pseudoaneurysm or Retro bleed.

Can you explain why you feel the need to use a NRB @ 15Lpm or bag this patient? Why do you think this patient has pale skin.....And why do you think more oxygen would fix that? Aspiration pneumonia does not really fit the scenario and is a far stretch at that. Sounds like anaphylaxis r/t transfusion reaction. Reaction to platelets is rare but does happen. I think they treated her appropriately. Monitor and transport to the ED

I am surprised they loaded Lovenox along with a Heparin drip. Good luck if it is a dissecting aneurysm. I think a Tridil Drip would have been beneficial until further diagnostics could be obtained.

It seems that a lot of medics are reluctant defer treatment until the ER even with short treatment times. Just because you can do something does not necessarily mean you have to do it. I am not sure if it is just a matter of professional pride or what. There is nothing wrong with waiting until the patient is in a more controlled environment with better equipment or allowing a higher qualified provider to take over. Like systemet stated RSI is a great example of a procedure that should be deferred when ever possible.

With nursing it is usually a multi-year suspension/probation with rehab or permanent ban. If you test positive for non prescription meds that could be acquired from the hospital you are almost always permanently banned, even for first offenses.

Agree with the above. Did your mother have any paperwork with her stating who was the POA and primary contact? The Assisted living center "should" have sent a med recon and face sheet when sending her to the hospital. On our quick sheet we have up to 3 urgent contacts and their relationship listed and It is usually assumed that the first person listed is the POA/Proxy but it does not always work out that way. We have to dig through the paper chart to find the admission paperwork and see if there is any POA listed. Not to make excuses for the hospital but your sister should have corrected them or called you.

Quoting statements from the ICN and ANA means absolutely nothing. They are both professional organizations that do not represent all nurses nor do they prove any type of legal or ethical obligation aside from their members. As stated earlier many people identify themselves as nurses who are not RNs or even LPNs. I personally would not throw away my job or my career for one patient, call me heartless. It sounds like the nurse said "they don't want her resuscitated" meaning the family. I have encountered this a lot where the family will not make the patient a DNR because they are afraid it will lead to inadequate care or neglect but they do not actually want their family member resuscitated. It is a bad situation but it happens. It also does not sound like the patient was ever in full arrest

I have to work tomorrow morning and I am bringing a small bag with extra clothes, snacks, etc just in case. If my replacement does not show up then I can not leave so it may turn into a long day.

I would suggest go shadowing a RT. Depending on the hospital it can be very mundane and boring. Basically going around giving nebs, treatments, setting up cpap/bipap, etc. while other RTs are in the ICU with vents, drawing ABGs, and responding to codes.

I may be young, hell you have been doing this almost a decade longer than I have been alive, but I am not gullible and most certainly not uneducated. But years of experience does not automatically make you an expert. Doing something wrong for 30 years does not really mean much. Yes, there are some studies that are biased either overtly or through less obvious statistical trickery but for those of us who actually understand research and statistics they are easy to spot. Medicine is dynamic and ever changing. Many things we swore by years ago have been found to be ineffective or even harmful but that does not in anyway discredit new research and changes. We learn and improve with time. Actually, In hospital cardiac arrest survival rates have been rising over the past few years. Prehospital cardiac arrest survival rates are tricky and involve many factors outside the control of EMS. We know that early CPR and defibrillation are they key to survival. Regardless of how good our interventions are they are not going to bring back a guy who has been pulseless with no CPR for 10 mins. If you truly believe that the only reason ACLS changes is to sell books than there is no point in trying to argue with you and I sincerely hope you retire very soon. Why are you correcting "the rookie"? First of all I am pretty sure he is not a rookie. He is not wrong, that is one of the reasons a patient may vomit during CPR. Obviously not the case in a patient who has vomited prior to arrival but that does not mean it is not correct. Why do you keep using the same anecdotal flawed logic. And I think everyone will agree that advanced airways are necessary in those rare incidences of excessive blood or vomit in the airway. The study's main focus is uncomplicated cardiac arrests, the most common.

I was thinking the same thing

So much fail in this post.... I am sure you could produce a study showing anything you want but producing one that holds up against academic scrutiny and is publishable in a scientific journal is another story. Wouldn't it be nice if paramedics were required to take statistics, research, and EBM courses. The risk of aspiration using a LMA w/ PPV is fairly low and is a good compromise to ETI. What do you think happens to the gross or micro-aspirate that pools around the ET cuff?

I hope all of your patients treat you with the same courtesy and attempt to sue you into poverty every chance they get. I am in no way discrediting what happened to Dwayne but there is a difference between reporting questionable practices / billing and attempting to sue a provider for financial gain. This is why so many providers are crippled by fear of litigation

So what would have happened if you tubed the stomach? Would you have just pulled it out? Left it in place? Documented the attempt?

In our hospital resuscitations we have been progressively moving intubation further and further back on the priority list. The official policy is definitive airway at 10 mins. Anesthesia can usually get them tubed while compressions are going.