Chest compression rate

[Kaisu]

I wonder if the ER staff are using info on there monitors combined with education and experience to give them criteria to go outside the standard rates and techniques.

This is exactly what I was trying to ask. That being said, I have observed fast compressions on every patient I have brought in. That's why I want to go to the medical director and question him.. when it is not busy... when he's got time. If they are doing it wrong, I want to get it fixed because I do NOT walk away from my patient just because I've dropped him/her at the ED. Our medic/ED relationship is more like the one Dwayne describes than the drop 'em and leave type. I've been here long enough that I may be able to make things better.

[gemshrc]

Dear friends, I can't agree more as what's happening in the ER's around the world. Remember they see us as "Just an Ambulance Driver"!!!

What is the medical legal implications if, and I say IF, the Dr, Nurse etc did do ACLS to work in the ER?

[Richard B the EMT]

As reported in this and other forums, and the trade publications like JEMS, fix the beat that you compress to, by singing the BeeGees "Stayin' Alive". Someone had it in their MP3 player, and let me listen while he did CPR on the "Annie". Damn, it worked!

[mobey]

As reported in this and other forums, and the trade publications like JEMS, fix the beat that you compress to, by singing the BeeGees "Stayin' Alive". Someone had it in their MP3 player, and let me listen while he did CPR on the "Annie". Damn, it worked!

Into the night

Nickleback, also works well.

Unfortuntly, you have to listen to nickleback to do it.

[Medic2891]

As a medic that has worked in an er I can tell you it is nothing more than adrenaline as someone has previously stated. I know this is funny but I use the song Stayin Alive as my meter for rate. It is exactly 100 bpm. I have passed this on to some of the EMT's that I work with and have caught them humming or singing it to themselves while doing compressions.

[HuiNeng]

As for asking questions........ Well..... you will get used to being treated with hostility when confronting/questioning ER staff. That does not mean you should not do it.

If you want what is best for the pt, work them at the scene and involve competent ALS providers, with multiple compressors.

Does humility work? Asked of someone other than the one doing compressions at the time, "Pardon me, but that compression rate is faster than I was taught. Is s/he a just bit amped, or is there something on the monitor that I need to learn about?"

[Richard B the EMT]

I have passed this on to some of the EMT's that I work with and have caught them humming or singing it to themselves while doing compressions.

Can you see the complaints being registered, "That damn EMT was so blase' that he was singing something from 'Saturday Night Fever' while doing the CPR to my grandma!"

[mobey]

"Pardon me, but that compression rate is faster than I was taught. Is s/he a just bit amped, or is there something on the monitor that I need to learn about?"

"Hahaha..... Hey Mike, this ambulance driver thinks your compressions are too fast"

[HuiNeng]

"Hahaha..... Hey Mike, this ambulance driver thinks your compressions are too fast"

That's kinda what I thought would happen. ;-)

[dca37]

Unfortunately, you may simply have witnessed poor CPR. It is not uncommon for ED Staff to perform poorly under pressure that professional EMSer's flourish under.

I have brought a few PT's into the ED while performing CPR, and usually a competent team of doctors and nurses who train for these scenarios is waiting, and the situation is well handled.

Unfortunately, last year I brought in a COPD pt on O2 (as per NYC protocol and our medical control with whom I verified afterwards) and the nurses left the pt on O2. withim 15 minutes or so the pt went into resp then cardiac arrest. Myself and my bls partner watched the ER doctor with 3 nurses attempt to run the code. The ER doc was more nervous and panicky than a rookie on his first major trauma. The nurses were doing such a poor job of cpr that i turned to my partner and said, "we could do better treatment doing bls cpr, than they are doing with a doctor." He nodded his head.

We did not intervene, not that they would have let us. And they called it. I was furious, and wrote a letter to the head of my agency, who forwarded it to the head of the hospital.

Nothing came of it, as far as I can tell, but I tried to do something to make up for the piss-poor job the ED staff did working the code. Now i dont bring really bad patients there anymore.

Morale of the story: some ED staff: Doctors, nurses, CNAs, etc will be great @ what they do, and some will be really bad. Like in every group, there are always the good and the bad performers. Which hospital in your area has more "good" than "bad" on there staff?