Needing fire on a cardiac arrest

[crazyemt5150]

See thats how we run, I am used to running a ca with more than 2 people we will either have a firefighter go with us or if we are running a three man crew. As you said people should be rotated often for good cpr, i don't think transporting a ca and doing cpr en route is bad but having someone that is tired doing compressions is bad

[firedoc5]

Doing CPR in the back takes practice. You might have to use one hand for compressions and one to hold onto the OMG bar, but you get use to it. :?

[iMac]

Doing CPR in the back takes practice. You might have to use one hand for compressions and one to hold onto the OMG bar, but you get use to it. :?

Then use your right foot to hold the BVM which technically leaves you with your left foot for any other extra little thing that might need doing.

[akroeze]

See thats how we run, I am used to running a ca with more than 2 people we will either have a firefighter go with us or if we are running a three man crew. As you said people should be rotated often for good cpr, i don't think transporting a ca and doing cpr en route is bad but having someone that is tired doing compressions is bad

Apparently my last post was missed.

Transport of Patients in Cardiac Arrest

If an EMS system does not allow nonphysicians to pronounce death and stop resuscitative efforts, personnel may be forced to transport to the hospital a deceased victim of cardiac arrest who proved to be refractory to proper BLS/ACLS care. Such an action is unethical.

This situation creates the following dilemma: if carefully executed BLS and ACLS treatment protocols fail in the out-of-hospital setting, then how could the same treatment succeed in the emergency department? A number of studies have consistently observed that <1% of patients transported with continuing CPR survive to hospital discharge.

Delayed or token efforts, a so-called "slow-code" (knowingly providing ineffective resuscitation), that appear to provide CPR and ACLS are inappropriate. This practice compromises the ethical integrity of healthcare providers and undermines the physician-patient/nurse-patient relationship.

Many EMS systems authorize the termination of a resuscitation attempt in the out-of-hospital setting. Protocols for pronouncement of death and appropriate transport of the body by non-EMS vehicles should be established. EMS personnel must be trained to focus on dealing sensitively with family and friends.

[crazyemt5150]

Apparently my last post was missed.

Old news someone already posted that thanks though

[BEorP]

I don't think you need to give them a chance when doing so involves transporting L&S with an unbelted provider doing CPR in the back. We have to transport medical arrests in Ontario as a PCP unless your service is participating in ROC's TORIT study. Hopefully this study will change that.

I don't believe that TORIT was a ROC study.

[zippyRN]

<snip>

The hospital can do more in way of advanced procedures that only doctors can do....

like what ? nothing that any other Als provider can or can't do with suitable operational guidelines for SCA

central lines....

of no value compared to an EJ perpherial line or IO

cardiac massage....

open cardiac massage has no place in SCA with a 'medical' aetiology ... there may be a place in trauamtic cardiac arrest but you really need a field physician to do that ( e.g. successful field thoracotomies on patients with pentrating chest trauma as performed by london HEMS ... )

etc...... no one really questions it we just do what our protocol says to do....

which is why leftpondian healthcare is so messed up

We are actually not limited we our one of the more open ems systems in that we can do alot with out ever asking its really nice..... as i said protocol is protocol is protocol

banjos is banjos, doctors is doctors and paramuppets don't need none of that book learnin'

[WolfmanHarris]

I don't believe that TORIT was a ROC study.

You're right. TORIT is research being fone by University of Toronto's Prehospital and Transport Research Program (now called Rescu). I think of them first as being involved in ROC even though TORIT and the other studies are not part of it.

[firedoc5]

Then use your right foot to hold the BVM which technically leaves you with your left foot for any other extra little thing that might need doing.

Naw, the BVM goes between your knees. Just kidding. We always had at least two people in back on a code. One person was assigned to airway and nothing else basically.

[iMac]

Naw, the BVM goes between your knees. Just kidding. We always had at least two people in back on a code. One person was assigned to airway and nothing else basically.

My glutes aren't that good