Transporting Code Blues/Cardiac Arrests

[CBEMT]

Richard, with the upmost respect to your decades of experience .... just because you have a "local protocol" does not mean it is necessarily the best thing to do in the particular case.

But because it IS local protocol, it means we don't get to decide what's the best thing to do in the particular case.

So you and Zippy treating us like we're morons because we follow our legal obligations pisses us off after a while. Clear enough?

[Richard B the EMT]

Kiwimedic and CBEMT, unfortunately, both of you, seemingly on opposite sides of the issue, are both absolutely correct.

[paramaximus]

A bit off topic I know, but have any of you looked at the data on Induced Hypothermia on post cardiac arrest patients?

It's almost unbelievable. In my esteemed opinion, this will soon become the standard of care. Now when I say soon, it may be years for EMS, but the science is astounding. To answer your earlier questions

1. My service and those surrounding us are way behind the ball on many things. Running codes to the hospital is one such area. So pretty much, unless there are certain criteria, we transport them.

2. I don't want to transport anyone. In the perfect world they would all walk to the side of the ambulance and sign a No Transport without me even having to get out. But no, not usually. I don't enjoy in engaging in actions of futility. With that said, I have gotten pulses back on people I never would have expected it on. If the Induced Hypothermia data is accurate, those people now have a much better chance at survival without debilitation.

3. Gains? I don't know that there are any. There have been a few times in my career where they have gotten something back in the ER, usually short term perfusing rhythm, and then death. I think I'm with the consensus that if you don't get them back in the field, you're not getting them back down the line.

4. Risks? It is probably more physically demanding, but as far as potential accidents I don't think it's any greater than any other transport.

5. Call them all in the field? I'd like to see the broader data on it. Personally, I don't see a benefit. That is perhaps because I work in a rural area with just a couple small hospitals. If transport is working better elsewhere, then I'd love to know. Otherwise, I think it they're dead in the yard after X amount of time working it, they'll be dead in the ER.