Working a code alone in the back?

[rock_shoes]

woah woah, wait.... you folks transport people who aren't ROSC?

Wow.... that's just.... wow...

Obviously there will be exceptional cases but to be transporting all arrests despite having done all of ACLS is just.... well, dumb.

I couldn't agree with you more. Is this just an american thing or do paramedics in countries outside of the states also run codes like this?

[ccmedoc]

I think you woudl have to think about it and sit it up in the back before you left so that you coudl do it.

The codes I have worked alone, my partner set up the meds we would need, and drove carefully to the hospital. He used the L&S, just drove sane. I have done it maybe 6 times, and had only 2 survive to be doners. Just a fluke I think. It is far from model cpr, but to take 5 seconds or so to push a med and check a pulse q 3 minutes is acceptable, I think.

[Stoker]

[fade]

I couldn't agree with you more. Is this just an american thing or do paramedics in countries outside of the states also run codes like this?

From an Aussie perspective, this topic is really interesting. It depends on which state in Australia you work, but in Victoria we have a policy that allows for us to "call" patients after 30 minutes of ALS care (the majority of our staff are ALS). It's a very rare occasion when a patient with no ROSC is loaded and transported.

In rural areas, running an arrest on your own isn't as uncommon as we would like it to be, in which case the focus is on good CPR and defib rather than drugs that lack evidence based research to suggest they make a difference to patient outcome.[fade]

[CBEMT]

woah woah, wait.... you folks transport people who aren't ROSC?

Wow.... that's just.... wow...

Obviously there will be exceptional cases but to be transporting all arrests despite having done all of ACLS is just.... well, dumb.

Imagine- not every place in the world is just like yours, for a variety of reasons. Amazing.

If you haven't noticed American/Canadian/European EMS differences yet, well, you just haven't been paying attention.

[DwayneEMTP]

I couldn't agree with you more. Is this just an american thing or do paramedics in countries outside of the states also run codes like this?

What I find even goofier that transporting all codes? When folks decide that because "someone" does it this way then this is the "American" way.

I can tell you it's not the Colorado Springs way. (20 mins ACLS then cease with medcon approval if possible, without approval if not.)

Do you simply have one blanket set of protocols for Canada? Everyone does everything the same way...everyplace? If not, what has caused you to believe that that is how it works here?

I swear, if I said "And I poked him in the eye with a 14g needle to check responsivenes." Someone would say "Really! That's how you do it in America? Anyone else do it the American way?"

Protocols vary here...

Just sayin'....

Dwayne

[rock_shoes]

What I find even goofier that transporting all codes? When folks decide that because "someone" does it this way then this is the "American" way.

I can tell you it's not the Colorado Springs way. (20 mins ACLS then cease with medcon approval if possible, without approval if not.)

Do you simply have one blanket set of protocols for Canada? Everyone does everything the same way...everyplace? If not, what has caused you to believe that that is how it works here?

I swear, if I said "And I poked him in the eye with a 14g needle to check responsivenes." Someone would say "Really! That's how you do it in America? Anyone else do it the American way?"

Protocols vary here...

Just sayin'....

Dwayne

I think we got our wires crossed here. I didn't mean to imply that it was just an "american thing". I was simply asking if it was a practise predominantly exercised in the US. From the responses read so far it seems to be a fairly common practice. I'm not assuming I'm asking.

We are by the way trying to work towards a national standard of care in Canada. That's the reason for our National Occupational Competency Profiles. Yes it's still a long ways off but I'm confident it will happen eventually. Can't speak for the other provinces but here in BC we are also moving away from a protocol driven approach and towards treatment guidlines. You perform whatever actions you are licensed to perform without having the order of events dictated by a fixed protocol. As long as you make your decisions based on sound medical evidence anything within your scope of practice is acceptable.

[RGalyon0911]

Do the best you can and generally doc understand you were alone if you don't get something done. But if you are transporting always remember the ABC's. Drugs don't do much good if the blood ain't going round and round. The good old saying; "air goes in and out blood goes round and round. Any variation of this is bad fix it."

[Mateo_1387]

Ahhh the old days of working a code with just you and your partner.

For me, it was the first few years of my career but Rid and Dust may know what I am about to speak of.

Rural county service, cardiac arrest in the middle of no where. You grab the patient on a backboard, get in the truck, intubate and hook up to the vent while partner is compressing. After that is done, we then hooked up the THUMPER....whoo hoo what a treat that beast was. Now you got the Thumper compressing, the vent working, it is time to do your IV and start some drugs while your partner drives.

What a fun time codes were then....

This is something for anyone to answer.

Has anyone put the thumper or autopulse on a patient because they thought they were fixing to code?

[akflightmedic]

HA HA...nice thought Matty...

Have you ever seen a thumper??? Anyways, no I would never put one on cause of a maybe.

Autopulse I can not speak intelligently of, as I have very limited experience with one.

I have however attached the pads from the monitor as a "just in case".

[VentMedic]

If I am working in the ED, I love to hear the Thumper coming in if I don't want to start up a ventilator for the ICU. I have not seen many success stories come out of its use over the past 20+ years. I have seen it thump a lot of different parts of the body besides the sternum.

The Autopulse is just hitting our area so I can not say much about it from personal experience.