Jenjas7476825

He was sitting on his bed when it occurred. He never made it into the stair chair. He was still on the second floor of the house. Instead of beginning CPR a plan was formed to get him removed from the house...which was difficult being since he was unconscious at this point. Stair chair was not going to work and stretcher was outside. Sheets were used instead. I guess I have no respect for the ALS team anymore because it was so hush hush...they wanted to hurry up and get him outside to the stretcher...but the time it took to get him removed delayed CPR. Once we got him from the second floor to the main floor they wanted to use a different route i.e. instead of using the front porch stairs where the stretcher was at the bottom. Some back and forth went on (come on guys!...someone's life is literally hanging by a thread) I knew the fastest route was the front door...which was 5 feet away...the route they wanted to take had fewer stairs but it would have taken us to the far rear of the house on the opposite end of where we needed to be. This was when I was told to shut up. It took all of us to carry him. He was slippery and heavy. Front route was taken eventually but time was wasted arguing about what was the best route to take. By the time he got inside the ambulance it really didn't matter what meds were given....too much time was wasted and I can't help but wonder if he could have survived had CPR been started in the house. I am aware of the benefits of ALS in an emergency but there is a holier than thou attitude and you have no control once care is transferred. I brought it to my Chief's attention....I am going to walk since I have been told "You don't sh!t on someone elses playground". There is right and wrong and everything about this call was WRONG. I think I'll go back to working in doctor's office. There might have been a different outcome had the code been worked right there on the spot....did they not want the family to see that? I am trying to understand the logic. CPR did not begin immediately in the ambulance. One of them was fumbling trying to gain IV access while the other one was trying to intubate. Compressions began once he was successfully intubated (difficult due to tracheal shift and fluid in airway.....his words)

Got a call to an elderly Jamaican lady with abdominal pain. Assessed her and loaded her up. She had a very thick accent so it was hard to understand her. She kept saying I got da vine and kept pointing down there. Lifted the sheet to see and there were green sprouts coming out. She was laughing that the potato she had entered into your vagina successfully kept her prolapsed uterus from falling out and she had a vegetable garden down there. Ummmm yeah because potatoes sprout in warm moist enviroments. She ended up with a hyster as a result and no more prolapse

Yes he died. I don't know why bicarb was the go to when there are other ones that could have been used. The family stated early on there was suspicion of low potassium. Though I didn't ride with ALS to hospital I saw everything that happened in the back of the rig beforehand. Truth is they were freaking out because that 30% chance that patient could crash was not factored in as if his symptoms were not enough evidence already that he was in serious trouble. ALS instead of starting CPR began working on removing him from the house. ALS who checked his pulse and whispered in my partners ear he is crashing. I presume so the family would not hear. They wanted to get him out as fast as possible but that presented a challenge since it is harder to carry a larger patient out when its dead weight. ALS may be great with their state of the art technology but I prefer basic let's get the patient packaged and transported to the hospital no bells no whistles. I believe there should be no delay in transport because you never know when that call could go south...and when it goes south it does very quickly if you are not prepared for it. There is a code of silence what happens in the rig stays in the rig. This isn't right. I disagreed with the plan and was prompted told to let ALS handle it as care had just been transferred to them.

Me personally I would have not delayed CPR. The problem is once BLS transfers care to ALS what the care plan is is on them. There was potential for a suit because CPR was unnecessarily delayed by 10 min. The 164 pulse was what it was before it became unpalpable and before being placed on monitor. I would have transported post haste. ALS team does not like having toes stepped on if you don't agree with the plan of action. ALS was caught off guard and was not prepared. A 12 lead was not placed. It was just the cardiac monitor leads so not having a 12 lead ECG the whole picture of what the heart was doing was unknown. It looks bad when epi and sodium bicarb are administered via the same route....not supposed to be mixed. the family had no idea how lax the care actually was and it is sad to witness that.

Previous to cardiac monitor pulse 164, BP 200/110, RR 40, when pt went unconscious there was no palpable pulse, breathing appeared agonal. One minute after monitor applied pt went astystole. BLS and ALS on scene. CPR delayed until in ambulance

Pt presents with acute respiratory distress. Pt postures losing consciousness inside house before packaging/transport. Cardiac monitor shows Accelerated Idioventricular Rhythm. Now that Pt is unconscious removal is more difficult due to patient size, 6'2" tall man. Stretcher outside Do you begin CPR inside the house? Or begin removal and begin once you have pt inside rig? If you know removal is going to difficult and it would delay CPR how would you proceed?