Would You Work This Code?

[ncmedic309]

I just now saw your reply.

I find it almost criminal to have a patient in VFib and not work it. If I was the patient, I would surely come back to haunt you. If you were working one of my family members, I would surely knock you out (no offense) and defibrillate him.

As was said, there could be underlying medical conditions. Or a rare commotio cordis.

As a side note on penetrating trauma arrests, they have the best survival chances in ERs due to potential for correctable causes. And you won't be able to determine all those in the field (such as pericardial tamponade).

You should go back and take another look at my post - "VFIB arrest secondary to blunt trauma" was the exact wording. I'm not referring to a VFIB arrest secondary to a possible medical etiology causing a traumatic event. In this situation, the patient would have to have a significant mechanism of injury associated with the arrest that would lead me to believe that the arrest occured secondary to trauma. Let's use a little bit of common sense here folks, why would you not make an attempt on anybody in VFIB when you suspect the arrest has a medical etiology? Another bit of information that I would like to share, to this day all of my traumatic arrests either blunt or penetrating have been in an PEA or asystolic rhythm. I've never been tempted to defibrillate any of them nor have I seen the need.

Your attempt at knocking me out better be a good one, cause when I get back on my feet not only will you get your ass kicked and go to jail, the outcome of the call is going to be the exact same (no offense) - hopefully you would feel better about it though...

[EMT City Administrator]

Keep it civil.

[spenac]

Keep it civil.

Think were trying to keep it civil as in civil war.

OK sorry. But I could not resist.

[HERBIE1]

What I find humorous is that despite all the rancor and vitriol, according to the poll in this thread, 75% of respondents would NOT work this arrest. Methinks some folks argue just for the sake of arguing...

[tniuqs]

Would you work this code???

Yes [ 27 ] [75.00%]

No [ 9 ] [25.00%]

Best look again ...

When you say respondents, those that agree with the "Work the Code" through vote vs the others that attempt to rationalize while they would not and a further point VFib and PEA were introduced after the initial post .. its a EMTCITY rule if a thread is posted then it will go of topic .

cheers

Edited May 27, 2009 by tniuqs

[HERBIE1]

Would you work this code???

Yes [ 27 ] [75.00%]

No [ 9 ] [25.00%]

Best look again ...

When you say respondents, those that agree with the "Work the Code" through vote vs the others that attempt to rationalize while they would not and a further point VFib and PEA were introduced after the initial post .. its a EMTCITY rule if a thread is posted then it will go of topic .

cheers

Oops- damn typo. My bad...

I realize that most threads get derailed- and the longer they progress, the more off track they get. My point was that yes, after some qualifiers, that despite all the rhetoric to the contrary, most people WOULD work that patient.

[EMT Headed]

Yep, work him if he's got a pulse.

[AnthonyM83]

You should go back and take another look at my post - "VFIB arrest secondary to blunt trauma" was the exact wording. I'm not referring to a VFIB arrest secondary to a possible medical etiology causing a traumatic event.

Good, cause that's what I was referring to as well. A cardiac arrest secondary to blunt force trauma that's in VF. I'd consider it almost criminal to see that rhythm and not shock it, when you had a chance to save that person's life.

Let's use a little bit of common sense here folks, why would you not make an attempt on anybody in VFIB when you suspect the arrest has a medical etiology?

Use that same common sense: Why would you not make an attempt on anybody in VFIB when you suspect the arrest has a blunt trauma etiology?

[fiznat]

I've cardioverted a pulseless VT once on a traumatic arrest. It converted right into PEA and went downhill from there.

I'd still do it again though. It is my personal opinion that if you leave treatable causes on the scene without even an attempt then you are an idiot.

[AnthonyM83]

Certain percentage of every VFib will go into PEA. That's understood, but you still have to try. Because (I'd say) 100% of every VFib will turn into asystole or PEA. So at least you might have gotten away with a VF that turned into something else....