96 minutes of CPR...

[Chief1C]

Any use of an AED? w/ all the grant opportunities focused on getting AED's to rural emergency services, you'd think there would be mention of one being used.

[Eydawn]

Quote: "During the course of the emergency, first responders shocked Snitzer a dozen times to jolt his heart out of its abnormal rhythm, or ventricular fibrillation. Ventricular fibrillation occurs when the heart's electrical circuits begin firing randomly, so the heart quivers and can't pump blood."

Quote: "Goodman and Mary Svoboda also gave Snitzer intravenous drugs to try to restore his heartbeat to normal. When he didn't respond, he called Mayo cardiac-arrest expert Roger White on his cellphone for guidance. Ultimately, they agreed to try a calculated overdose of a heart drug, amiodarone. It worked."

Looks like there were some legitimate cardiac issues here. Looks like they had a monitor or AED... and the following below kind of indicates to me that there was probably a monitor.

Quote: "Goodman and Svoboda began administering drugs: epinephrine, lidocaine, atropine and amiodarone, which they hoped would restore Snitzer's normal heart rhythm... 'Many things were going through my head at that point', [Goodman] says. 'This gentleman has not had a pulse for over an hour. He's unlikely to survive even if we can get a rhythm. Is this something we should call off?'"

Sounds like Goodman and Svoboda were paramedics, not just first responders, as they were pushing some first line cardiac meds. The first responders appeared to have been providing the compressions. I see no reason to doubt this story as presented, which is why I think Mike posted it... he's usually a lot more critical than I am of stuff and it seemed to pass muster for him.

Wendy

CO EMT-B

[BEorP]

Did anyone else listen to the 911 tape that they link to in the article? The caller stated (even after being asked to double check by the call taker) that the patient was conscious (although not alert). Who knows whether this is accurate or not, but it doesn't seem to be in line with the impression I got from reading the article that he just dropped and then got over an hour of CPR before anything changed.

[Chief1C]

Quote: "During the course of the emergency, first responders shocked Snitzer a dozen times to jolt his heart out of its abnormal rhythm, or ventricular fibrillation. Ventricular fibrillation occurs when the heart's electrical circuits begin firing randomly, so the heart quivers and can't pump blood."

Quote: "Goodman and Mary Svoboda also gave Snitzer intravenous drugs to try to restore his heartbeat to normal. When he didn't respond, he called Mayo cardiac-arrest expert Roger White on his cellphone for guidance. Ultimately, they agreed to try a calculated overdose of a heart drug, amiodarone. It worked."

Looks like there were some legitimate cardiac issues here. Looks like they had a monitor or AED... and the following below kind of indicates to me that there was probably a monitor.

Quote: "Goodman and Svoboda began administering drugs: epinephrine, lidocaine, atropine and amiodarone, which they hoped would restore Snitzer's normal heart rhythm... 'Many things were going through my head at that point', [Goodman] says. 'This gentleman has not had a pulse for over an hour. He's unlikely to survive even if we can get a rhythm. Is this something we should call off?'"

Sounds like Goodman and Svoboda were paramedics, not just first responders, as they were pushing some first line cardiac meds. The first responders appeared to have been providing the compressions. I see no reason to doubt this story as presented, which is why I think Mike posted it... he's usually a lot more critical than I am of stuff and it seemed to pass muster for him.

Wendy

CO EMT-B

Ahhhh... I only watched the news story on JEMS. Thankin' u 'ED'.

If you want to see something really creepy.. CPR on someone who is in the process of dying with an AAA. That was the last time I used the MAST. Every effort was in vain, but there were long periods of looking around, alertness, unintelligible speech, etc., in between bouts of CPR. MAST was the last ditch effort to obtain a BP, gave the pt. about an hour, long enough to make it to a specialty center and die in the OR.

I think the 911 call was made when he collapsed, so it's possible that he hadn't arrested yet.

[DwayneEMTP]

Quote: "During the course of the emergency, first responders shocked Snitzer a dozen times to jolt his heart out of its abnormal rhythm, or ventricular fibrillation. Ventricular fibrillation occurs when the heart's electrical circuits begin firing randomly, so the heart quivers and can't pump blood."

Quote: "Goodman and Mary Svoboda also gave Snitzer intravenous drugs to try to restore his heartbeat to normal. When he didn't respond, he called Mayo cardiac-arrest expert Roger White on his cellphone for guidance. Ultimately, they agreed to try a calculated overdose of a heart drug, amiodarone. It worked."

Looks like there were some legitimate cardiac issues here. Looks like they had a monitor or AED... and the following below kind of indicates to me that there was probably a monitor.

Quote: "Goodman and Svoboda began administering drugs: epinephrine, lidocaine, atropine and amiodarone, which they hoped would restore Snitzer's normal heart rhythm... 'Many things were going through my head at that point', [Goodman] says. 'This gentleman has not had a pulse for over an hour. He's unlikely to survive even if we can get a rhythm. Is this something we should call off?'"

Sounds like Goodman and Svoboda were paramedics, not just first responders, as they were pushing some first line cardiac meds. The first responders appeared to have been providing the compressions. I see no reason to doubt this story as presented, which is why I think Mike posted it... he's usually a lot more critical than I am of stuff and it seemed to pass muster for him.

Wendy

CO EMT-B

Wow, so because you and Mike said that it's valid then the rest of us should suspend our critical thinking? If not I'm not clear to the meaning of the bolded text above. As your quoted sources include no timeline then I would suggest that both you and mike need to be significantly more critical when reviewing such stories? (tongue half in cheek)

It doesn't list the ALS responders in the initial treatment, nor does it say when they arrived but I'm guessing that they came with the helicopter. It does sound like someone had an AED, as it states that he was shocked "a dozen times", right? If it was used from the beginning, how many shocks would he have gotten according to ACLS protocols had he remained in arrest for 96 minutes? If that number doesn't equal 12 then it would seem that his heart was in a non-shockable rhythm the majority of the time. Are we to assume that he was bouncing in and out of asystole then? Pretty unlikely, right?

The story makes little sense as presented. It makes a rah rah bullshit feel good piece, but to laud it as anything resembling an accurate document doesn't ad up for me. Could it be true? Sure. Could there be aliens living amongst us? Almost as likely...

Dwayne

[paramedicmike]

There are always variances and discrepancies in reported news stories. What's printed is seldom a completely accurate depiction of events. This article was, in all likelihood, written by someone who has absolutely no idea about EMS, cardiology or cardiac arrest and was basing it simply on what was told to him.

So what if I posted a "rah rah bullshit feel good piece"? Is it a good story? Yes. Does it reflect, in some way shape or form, how sometimes the stuff we do might actually work? Yes. Did I expect that people were going to question what happened? I did.

None of us were there. None of us knows exactly what happened. I understand that it is normal to question the story based on our backround. Keep in mind, however, that sometimes a posted article that tells a "rah rah bullshit feel good story" is just that... rah rah feel good bullshit.

Do you honestly think I didn't question some of what was published? I have no idea how true or accurate the reported events are. What I do know, after having spent many years in this industry, is that I have seen some really effed up stuff and cannot completely discount anything just because it sounds off the wall.

If nothing else, I hope the EMS organizations in question can use this piece of rah rah feel good bullshit as a fund raiser to help support their respective organizations. If the patient surviving isn't enough of a positive outcome (which, coincidentally, is being completely overlooked here), then perhaps funding the squads for a few more months or turning it in to a few more AEDs for their community is.

[Eydawn]

Let me clarify, Dwayne.

I see no reason to doubt this story as presented, because there's simply not enough to go on and it was obviously not written by a health professional. However, one can deduce that there were 2 paramedics on scene, and this call was very weird for them and they thought this patient was SOL and were really really surprised that what they did worked. Ergo, there is value in reading this story.

Do I automatically suspend my critical thinking because someone I trust posts? No. When I'm tired, and don't want to have to hyper-analyze every aspect of another damn thing that has incomplete info (really burnt on testing questions right now), will I tend to accept something more readily if someone I trust posted it? Yes. Sorry if that pissed you off. Hope you know you're one of those posters that I will more readily accept, Dwayne... so you better never screw up ;-)

I just accepted the story for what it was, because in the grand scheme of things, patients all over the globe are still going to die today despite good CPR and good paramedicine, or they will survive despite poor CPR and shitty paramedicine. I didn't feel a need to analyze it like a journal article, because that's simply not what it was. I did feel a need to highlight elements of it that demonstrated that this wasn't just a bunch of laypeople doing compressions with a couple johnny first responder types driving the ambulance... which is how some were choosing to portray it.

Wendy

CO EMT-B

[DwayneEMTP]

There are always variances and discrepancies in reported news stories. What's printed is seldom a completely accurate depiction of events. This article was, in all likelihood, written by someone who has absolutely no idea about EMS, cardiology or cardiac arrest and was basing it simply on what was told to him.

So what if I posted a "rah rah bullshit feel good piece"? Is it a good story? Yes. Does it reflect, in some way shape or form, how sometimes the stuff we do might actually work? Yes. Did I expect that people were going to question what happened? I did.

None of us were there. None of us knows exactly what happened. I understand that it is normal to question the story based on our backround. Keep in mind, however, that sometimes a posted article that tells a "rah rah bullshit feel good story" is just that... rah rah feel good bullshit.

Do you honestly think I didn't question some of what was published? I have no idea how true or accurate the reported events are. What I do know, after having spent many years in this industry, is that I have seen some really effed up stuff and cannot completely discount anything just because it sounds off the wall.

If nothing else, I hope the EMS organizations in question can use this piece of rah rah feel good bullshit as a fund raiser to help support their respective organizations. If the patient surviving isn't enough of a positive outcome (which, coincidentally, is being completely overlooked here), then perhaps funding the squads for a few more months or turning it in to a few more AEDs for their community is.

Sorry Mike, but you seem to have the impression that by questioning the story that I have questioned you and your skill also. That is not the case. I think the story is bullshit, but I have never had reason to believe you to be the same. My comments came on the heels of Wendy stating that your analytical skills are 'legend' (meaning only to show her respect). Do I believe it was a bad thing to post this story? Yeah, if you don't stand behind it I believe that it was bad to post it without comments and many of the younger and more inexperienced posters, as myself, might accept it as valid based simply on the fact that you posted it.

Do I believe that by posting it without comments that you then put your 'seal of approval' on it as Wendy seems to think? I don't. But I do believe that for a few moments you may have forgotten that this is a learning/teaching forum and posted something sensational.

I love that this story was posted, but am disappointed that it didn't get more comments. This is a perfect example of, "We want to feel that we're important so lets take all sensational stories at face value!" yet is the first step back to providers worshiping pseudoscience. And that is really bad.

I noticed that you used 'rah rah bullshit' over and over. I'm guessing that is because you believe i directed it at you? If so you are mistaken. If you used it because you were offended and felt that I was unfair to the story then you and I will have to split the sheets here. The story had nothing to offer our up and comming providers...

Wendy, I love you but I didn't read past, "I see no reason to doubt this story as presented, because there's simply not enough to go on and it was obviously not written by a health professional." This sentence is so far off in the ditch that I had to bail at that point....

Dwayne.

[Chief1C]

According to websites for these municipalities.. The town it was in, has no ambulance. One of the towns that assisted is a volunteer crew, the other is a career ALS service.

[DwayneEMTP]

...Yes. Sorry if that pissed you off. Hope you know you're one of those posters that I will more readily accept, Dwayne... so you better never screw up ;-)

What makes you think that I was pissed off? Because I disagreed with you? And by proxy, Mike because you lauded him?

...I just accepted the story for what it was, because in the grand scheme of things, patients all over the globe are still going to die today despite good CPR and good paramedicine, or they will survive despite poor CPR and shitty paramedicine. I didn't feel a need to analyze it like a journal article, because that's simply not what it was. I did feel a need to highlight elements of it that demonstrated that this wasn't just a bunch of laypeople doing compressions with a couple johnny first responder types driving the ambulance... which is how some were choosing to portray it.

Wendy

CO EMT-B

I disagree with the last paragraph. You did in fact defend the article and you did so by cutting and pasting very specific parts of it, right? I simply disagreed with you. In the past I've bragged on you as one of the most intelligent posters here. Are you now so well respected that I can't disagree with you unless I'm 'pissed?' I have almost no doubt whatsoever that you are off int the ditch on your opinion here. And if that pisses you off, then I'll be happy to discuss that with you. But surely you know better by now than to think that I'm going to change my opinion because you get pissy?

As presented the article makes a half asses attempt at pretending to be valid. As someone with an English major I would think that you would be offended that they did such a poor job as to not go all the way. For such pot holed nonsense to be news has come to be accepted. For us to validate it here as 'news' is even more horrendous. As something that " I see no need to question...' is simply sinful.

Dwayne