Would You Work This Code?

[iMac]

I didn't even read passed sentence Number 2. With my scope if CPR has been started, I have to keep going.

[Katiebug]

Thanks for the clarification. Still would work it. Intubation, Epi, Atropine, possible bi-lat decompression, work him till we get to the hospital. The guy deserves that much of a chance. At least I'm to assume so since I don't personally know him. I'm sure his wife and kids think so. Oh, his mom and dad would probably appreciate it too.

[Kaisu]

Thanks for the clarification. Still would work it. Intubation, Epi, Atropine, possible bi-lat decompression, work him till we get to the hospital. The guy deserves that much of a chance. At least I'm to assume so since I don't personally know him. I'm sure his wife and kids think so. Oh, his mom and dad would probably appreciate it too.

How much do you think they will appreciate the enormous bill for transport, rescusitation efforts, ED room, etc. etc. for what was clearly a doomed effort ? And as you are extrapolating, how much do you think the family of the dead patient across town that could have been saved if resources had not been expended on a hopeless case were not tied up working the hopeless case?

Edited May 15, 2009 by Kaisu

[mediccjh]

I would have to say no.

Chances are that the bystander who felt the pulse felt their own.

The reason he's in PEA is because chances are there is no blood left to go through the heart; the electrical system just hasn't realized it.

However, if you have a hostile/unruly crowd, you're probably better off working it, just scooping and running. I've had to do that a couple of times in Newark due to hostile crowds and not enough po-lice.

[croaker260]

How much do you think they will appreciate the enormous bill for transport, rescusitation efforts, ED room, etc. etc. for what was clearly a doomed effort ? And as you are extrapolating, how much do you think the family of the dead patient across town that could have been saved if resources had not been expended on a hopeless case were not tied up working the hopeless case?

All valid arguments against transporting the patient, and valid discussion points on our medical system in general...., but in THIS patient, the way THIS scenario was presented, THIS patient would get worked.

In my system, possibly on scene and called, possibly transported...and ligit arguments for and against both.....but he would get worked, not left there because we speant 10 minitues justifying why we didnt want to instead of doing our job.

Im not saying he had a huge chance of survival, but you will never know if you dont try to work him and treat the KNOWN REVERSIBLE CAUSES OF PEA..and do it QUICKLY.

Edited May 15, 2009 by croaker260

[Happiness]

Well I would work this code as he dosn't fit in my protocol not to. As l don't pronounce death because im not a Dr. and someone is performing CPR thats all I need to make my decision.

[Katiebug]

How much do you think they will appreciate the enormous bill for transport, rescusitation efforts, ED room, etc. etc. for what was clearly a doomed effort ? And as you are extrapolating, how much do you think the family of the dead patient across town that could have been saved if resources had not been expended on a hopeless case were not tied up working the hopeless case?

How much will you appreciate it when the family drags you to court to explain why you didn't try to correct the PEA? How will you justify that when it is your job to do it? Are you going to say that your opinion was that he would have no quality of life if you resusitated? Would you be qualified to make that call on scene? Sometimes, yes you are. In this case, no. You would get lambasted in court.

Aside from that, the guy had a chance. Albeit a small one, but a chance none the less. That's enough to work it.

[Dustdevil]

Im not saying he had a huge chance of survival, but you will never know if you dont try to work him and treat the KNOWN REVERSIBLE CAUSES OF PEA..and do it QUICKLY.

Completely agree.

While I agree with Kaisu, that the bystanders may well have felt their own pulse, the presence or lack of a pulse does not factor into the necessity to work the patient.

You gotta work it. If you haven't seen such a patient pull out of it, you haven't been in the field long enough yet.

[ERDoc]

PEA=work it

asystole=DRT

You have to consider/treat the potential causes of the PEA.

[EMTech114]

In my opinion, I would not have worked this code, first off its a trauma code so that to me is red flag number one, second is the PEA,yes it can be converted into a better rhythm but overall, who knows, third is how the patient was presenting so again, nope; tell the family some BS story of how we tried yada yada yada but overall its a no go.

Edited May 16, 2009 by EMTech114