Woman dies in ambulance when oxygen runs out

[Chief1C]

(Open the link in the previous post, and click on the image)

See that knob on the small white and green panel?

That's the emergency bypass valve. Open it, and the electric oxygen switch doesn't need to be used. Great for firefighter rehab. Doors, open, cool breeze, ambulance off-no exhaust... Open the valve, and work as if the unit were running.

Flow meter, aspirator volume control, emergency bypass valve.

Edited June 15, 2010 by 4c6

[Kiwiology]

For a patient to desaturate to the point there they um, die without noticing is horrendously bad ... the ambo was probably on Facebook mobile or something

[BushyFromOz]

For a patient to desaturate to the point there they um, die without noticing is horrendously bad ... the ambo was probably on Facebook mobile or something

Shit, im busted now.....

[aussiephil]

Shit, im busted now.....

I was really playing flick fishing on my iPhone......

[Kiwiology]

I was really playing flick fishing on my iPhone......

You bastard how dare you be able to afford an iPhone .... bloody Johnnos :D

[EMS49393]

Perhaps I'm just overly cautious and nervous, but I would have also had the patient on a cardiac monitor along with EtCO2 while doing that transfer. The more safe-guards you have in place, the better your chances of a positive outcome. We can't break down charges where I am at, and a vent patient is automatically ALS, why not pull out all the stops to ensure a successful transfer?

Yes, I understand they are on a chronic vent patient and do not require that type of monitoring in the facility, but I'm not in the facility, and I don't have a nice, fancy vent that alerts me for apnea or changes in CO2 readings. I have an autovent, which, to be honest, I really don't care for anyway, but aside from that, it doesn't have any short of alerting mechanism like a regular ventilator.

Of course, one can always rely on their eyesight as well. Did they happen to notice the lack of chest rise and fall any time during that eight minute period, or were they buried in paperwork, or as someone else stated, mobile facebook? I also like to verify the presence of lung sounds through out a transport as well. Reassessment, call me crazy.

This type of call is exactly why I hate doing anything but patient care in the back. The only time I'm not giving a patient 100% of my undivided attention is when I have to call the hospital. My reports are generally less than 30 seconds long, and I continue to watch my patient while I'm giving my alert. If my patient is critical, my EMT gives a brief report, or has our dispatch center notify the receiving hospital so they can prepare for an incoming critical patient.

When I'm transporting a patient, the priority (along with our safety) is the patient.

[exodus]

All our venters get ETCO2, SPO2, 3 Lead, NIBP, and occasionally aIBP. It seems fishy though that soley the o2 would cause her to die in only 8 minutes, especially when the vent is still pulling in o2 from the room air. And our LTV1200's alarm to hell for any tiny little thing...

[chbare]

All our venters get ETCO2, SPO2, 3 Lead, NIBP, and occasionally aIBP. It seems fishy though that soley the o2 would cause her to die in only 8 minutes, especially when the vent is still pulling in o2 from the room air. And our LTV1200's alarm to hell for any tiny little thing...

You assume they were using a ventilator that has it's own compressor. However, they very well could have been using a pneumatic powered ATV like an Autovent 2000 that does not even have an alarm when it runs out of gas. It just quits working.

Take care,

chbare.

[JPINFV]

You assume they were using a ventilator that has it's own compressor. However, they very well could have been using a pneumatic powered ATV like an Autovent 2000 that does not even have an alarm when it runs out of gas. It just quits working.

Take care,

chbare.

That's what boggles my mind. I find it hard to believe that an autovent would come close to meeting any sort of standard of care for long term vent patients.

[EMS49393]

That's what boggles my mind. I find it hard to believe that an autovent would come close to meeting any sort of standard of care for long term vent patients.

It doesn't. IMO, the autovent is garbage. Some people love the hell out of it. I prefer to a more hands on approach to my airway for short trips, mainly because I like being in control of my tube, and I'm very protective of it. For a longer transport, there should be a respiratory therapist with one of their portable vents going along for the ride if an autovent is your only option.

I have to say, and it might be because I'm an American paramedic, but we are in no way trained well enough to deal with a long term vent patient, or trained in the use of the more sophisticated ventilators. Because of that, if a patient requires a long transport, they deserve a quality ventilator and a respiratory therapist that is well versed in their equipment. Don't get me wrong, I came out of a fantastic program, but we had our equipment. The RT's from the hospital and their portable vents didn't even come into our class. Do I really feel comfortable taking care of an obviously sick patient with a piece of machinery I have NEVER set eyes on, let alone used? I don't, and I bet my patient and their family doesn't either.

So, if my option is an autovent, I'm going to use every other item of monitoring equipment in my arsenal. Including the fancy piece of equipment between my ears. I wasn't given this brain as a fashion statement, it was to use.