EMT student seeking some advice :)

[island emt]

it was a TV show where they often forget to check in with folks in the business to find out how it is done in REAL life.

Sedation is commonly given prior to cardioversion with a conscious pt.

[vonk]

it was a TV show where they often forget to check in with folks in the business to find out how it is done in REAL life.

Sedation is commonly given prior to cardioversion with a conscious pt.

I may be wrong but I have watched night watch in the past my impression was that they just film the EMS responders while they get real contacts... but ever field medics make mistakes, thats just life

[paramedicmike]

There are times when pre-cardioversion sedation is appropriate. There are times when pre-cardioversion sedation takes a back seat to cardioverting.

[Just Plain Ruff]

I've done more sedation with cardioversion than without but when they need it and sedation will be counterproductive to the end result, Zap em I say and once cardioverted you can always give em something for their discomfort. But to with hold cardioversion because you are trying to get them sedated when electricity is what they absolutely need, well that's just bad medicine.

[ERDoc]

I have never cardioverted a conscious person. Most of the time they are unstable enough to be unconscious or stable enough to wait for the nurse to grab the propofol (we tend to skip the consent form and JHACO required time-out).

[Just Plain Ruff]

my experience has been the patient who is on the brink, near to arrest but still semi conscious. Unfortunately the end result was an arrest on the patients who were on the brink.

But with respect to your point Doc, you have the luxury of multiple licensed people working with you that allows you to give sedation and get ready for cardioversion. the majority of times these can be done at near the same time, give the sedation, let it work and then Zap.

but the two patients who got cardioverted by me without sedation were when i was working as a single medic with a single EMT with no other help. Time was of the essence to get them cardioverted. Unfortunately, the end result was not good. The next step for those two patients was defibrillation.

Just my 2 cents.

[island emt]

He also has the luxury of milk of amnesia or the michael jackson cocktail to give them rapid amnesia & sedation.

All we had access to in our drug box was was MS/fentanyl & midazolam.

[Just Plain Ruff]

He also has the luxury of milk of amnesia or the michael jackson cocktail to give them rapid amnesia & sedation.

All we had access to in our drug box was was MS/fentanyl & midazolam.

HAAAAAAAAAAAAAAAAAA that's funny, no matter how you look at it. Michael Jackson cocktail, Island you slay me!!!!

[paramedicmike]

A friend of mine from grad school calls it "Jackson Juice".

[A_Messick1]

I may be wrong but I have watched night watch in the past my impression was that they just film the EMS responders while they get real contacts... but ever field medics make mistakes, thats just life

I don't necessarily think the need for immediate cardioversion was really needed in that episode. At the top of memory I believe the pt was completely alert and conscious. Yet I don't know what kind of rhythm he was in or what the immediate risk was.