Team Focused CPR

[fab50gal]

Is anyone using Team Focused CPR wherein you remain on scene working the arrest for approximately 30 minutes? If you obtain ROSC the patient is transported to a PCI facility. It not the patient is pronounced on scene without being transported. Just wanted to get thoughts, successes, failures, ideas for improving, how you have educated medical responders, community, etc.

[cprted]

We only transport with CPR if we can identify a treatable cause or in special cases like paediatric arrest. Otherwise, we work it for 30 mins on scene and then consult with the Doc regarding discontinuation.

Here is the link to our Treatment Guidelines

http://www.bctg.bcas.ca/Category/Principles/105

[Chief1C]

Trained for it, "pit crew high functioning cpr" however, we haven't had an arrest.. in a while. (I knocked on wood before I said that)

[medicgirl05]

This is how we work codes. I think it works great.

The only time I've ever encountered any resistance is at the nursing home. The nurses don't like not being in charge. They want us to load the patient and go.

[rock_shoes]

We only transport with CPR if we can identify a treatable cause or in special cases like paediatric arrest. Otherwise, we work it for 30 mins on scene and then consult with the Doc regarding discontinuation.

Here is the link to our Treatment Guidelines

http://www.bctg.bcas.ca/Category/Principles/105

Beyond that ALS crews can consult the EP and call it earlier than 30 minutes. Entirely depends on the situation of course. In my own experience I have only transported a pulseless patient once since coming back as an ACP. The hospital was literally 2 minutes away, including the patient move, and the patient had a potential treatable cause we didn't have the drugs required to treat (Hydroxocobalamin for a patient pulled out of a house fire).

This is how we work codes. I think it works great.

The only time I've ever encountered any resistance is at the nursing home. The nurses don't like not being in charge. They want us to load the patient and go.

I haven't encountered this particular issue. Most likely that's because ALS crews are considered to be on a relatively equal footing to nurses where I work. If anything nurses are considered a lower level of care than ACP's/CCP's in the out of hospital environment.

[Richard B the EMT]

My Paramedics usually work the code, dump half of the drug box into the patient, call OLMC for permission to terminate, and usually get the order to dump in the other half in before permission to terminate is given.

On the other hand, sometimes we get the order to transport with CPR in progress.

However, I only recall a few ROSC over my career. None were my assignment.

[medicgirl05]

I have had 2 ROSC as a paramedic. One was never discharged from the hospital. The other is still riding his bicycle around town. Those are among about 4 that I have transported to the ER. Luckily our medical director is great. I have developed a relationship with her so that she pretty much trusts me to do whatever. I call her tell her what I have and what I want and she usually says go ahead.

[scubanurse]

Nursing homes get audited in my area if they have too many deaths in a year so they always push to transport away from the facility so the death didn't occur at the facility.

[island emt]

just like : NO ONE EXPIRES IN THE Operating Room.

It's always in recovery

[ERDoc]

This is how we work codes. I think it works great.

The only time I've ever encountered any resistance is at the nursing home. The nurses don't like not being in charge. They want us to load the patient and go.

"Here's my medical director's number. You are more than welcome to give him/her a call and discuss his/her choice of protocols."