Your patient arrests as you pull up to the ER

[p3medic]

I'm with Dwayne, I'm of Irish desent, so this whole measuring thing is making me uncomfortable....

[CTXMEDIC]

Holy Crap....

Some of the smartest people on the forum locked in what seems like a never ending penis measureing contest.

C'mon guys. This is an awesome thread, great ideas and many things I may not have thought of before...Perhaps it's time to move on?

Dwayne

Booya! +100

[Eydawn]

Beg pardon. I wasn't in the middle of a lecture about proper grammar and spelling when I made one of my remarkably infrequent typos. As I am a phonetic person, I simply forgot about the "t" at the end of that word since it is seldom pronounced. Touche indeed.

Dwayne, I have no pecker, so your comparison doesn't apply to me...

As far as the actual topic goes, it seems only prudent that one would move a patient from an environment with limited resources to a hospital, where they presumably have greater resources and are better able to serve the patient. Also, it must be kept in mind that time is tissue... so I wouldn't decline to provide care in favor of wheeling the individual into the hospital (as it is always nice to give the ED a heads up when you're bringing a code in) but I also wouldn't dally past the first cycle of interventions in the back of my truck. Start CPR, analyze rhythm, control airway, call hospital and tell them that status has just changed, deliver shocks if warranted, and get moving.

Wendy

CO EMT-B

[Mateo_1387]

So where do you draw the line? If you are at a residence right next door to the ER do you work it on scene and call it or do you load and go? How far away do you have to be?

I'm not questioning if you work it or not, I'm questioning HOW you would work it.

If they code in the ambulance at the doorstep, I would go on in, because there is a need for more resources. I would perform an intervention such as defibrillation or medication administration before entering the ER. A code on scene gets worked on scene, even when the house is beside the ER. I have worked a code right beside the hospital, in a Dr. Office. We worked it for 20 min, and called it on scene too.

[CBEMT]

I've had this happen a number of times. If they are in a shockable rythm, we'd defib X's 3 if needed in the back and rush them into the cardiac room. It was a relatively short distance.

You're going to stay outside for 6 minutes? :?

[Camulos]

You're going to stay outside for 6 minutes? :?

Why would this take 6 minutes?

Stay safe,

Curse :evil:

[chbare]

It is a reference to the newer AHA guidelines that recommend one shock followed by two minutes of CPR. I suspect the original post was referencing situations back when "stacked shocks" were common practice.

Take care,

chbare.

[firedoc5]

It is a reference to the newer AHA guidelines that recommend one shock followed by two minutes of CPR. I suspect the original post was referencing situations back when "stacked shocks" were common practice.

Take care,

chbare.

That's the I understood it. Most of my career was back in those "old" days. You shocked three times or until the rhythm converts. BAM, BAM, BAM, and move.

[Quakefire]

Yumm KFC

That's the I understood it. Most of my career was back in those "old" days. You shocked three times or until the rhythm converts. BAM, BAM, BAM, and move.

[Camulos]

It is a reference to the newer AHA guidelines that recommend one shock followed by two minutes of CPR. I suspect the original post was referencing situations back when "stacked shocks" were common practice.

Take care,

chbare.

Interesting!!!!! Perhaps we have differing recommendations.

In Australia, the Australian Resuscitation Council (ARC), still recommends an initial 3 stacked shock strategy in cases where the arrest (VF/VT) is witnessed by the rescuer and a defibrillator is immediately available. Please see page six on the following link;

http://www.resus.org.au/policy/guidelines/...py_for_aals.htm

It would be interesting to establish whether the ARC recommendations and the AHA standards conflict on this particular topic. And if so debate the possible reasons for this discrepancy. If someone could provide a link to the AHA guidelines I would be appreciative.

Stay safe,

Curse :evil: