First Rural Cardiac Arrest...

[EMS Guru]

I have to add, after the pt was called deceased on scene, the monitor was still attached during the cleanup phase. When PT was pronounced monitor was showing an organized junctional rhythm, albeit PEA. After CPR was d/c'd, this pt appeared to have a rhythm FOREVER. 10 minutes later the monitor was still showing an idioventricular rhythm of about 28bpm. After everything was cleaned up (15min later, total), the monitor was still showing a rate of about 15. Has anyone ever seen this? My guess was this was the epi still working away.

[Ridryder 911]

I the monitor was still showing a rate of about 15. Has anyone ever seen this? My guess was this was the epi still working away.

Yes, very common.. epinephrine When you call a code it is BEST to turn-off the monitor! When one makes the decision of "calling it quits" then all machinery is turned off immediately. PEA may show up and can be interpreted that the patient may be viable from non-emergency personal. I also suggest codes not to be called with PEA situations as well, never know if perfusion might re-occur.... most common practice is Aystole in 2 leads .. ( seen that wording before)

Far as travel & treat, actually the whole purpose & ideology of EMS was to stabilize prior to transport. Now, the important thing is deciding how much one can be stabilized prior to transport. This is where education, experience comes into play.

Be safe,

R/R 911

[vs-eh?]

I have to add, after the pt was called deceased on scene, the monitor was still attached during the cleanup phase. When PT was pronounced monitor was showing an organized junctional rhythm, albeit PEA. After CPR was d/c'd, this pt appeared to have a rhythm FOREVER. 10 minutes later the monitor was still showing an idioventricular rhythm of about 28bpm. After everything was cleaned up (15min later, total), the monitor was still showing a rate of about 15. Has anyone ever seen this? My guess was this was the epi still working away.

Why was the monitor still on after this length of time? Once the patient is pronounced, get your final strip or end-tidal waveform and turn it off.

At the very least should a family member walk in and see a rhythm, well, you'd see how issues might occur.

Maybe it was the epi...Or maybe the patient was STILL ALIVE!!!!!! Dun dun dunnnnnnnnn...

[EMS Guru]

I guess the monitor wasnt turned off because nobody botherd to, I dunno. Either way, monitor was and had been turned away so only the Fire/EMS personnel could see it, and all the family was in the other room. Just an oversight I suppose. People were still picking stuff up, and I turned off the monitor, because it was starting to creep me out.

[Dustdevil]

People were still picking stuff up, and I turned off the monitor, because it was starting to creep me out.

That's why it tends to stay on too long -- because people are mesmerized by the bouncing ball. Out of sight is out of mind.

[Nate]

I have to add, after the pt was called deceased on scene, the monitor was still attached during the cleanup phase. When PT was pronounced monitor was showing an organized junctional rhythm, albeit PEA. After CPR was d/c'd, this pt appeared to have a rhythm FOREVER. 10 minutes later the monitor was still showing an idioventricular rhythm of about 28bpm. After everything was cleaned up (15min later, total), the monitor was still showing a rate of about 15. Has anyone ever seen this? My guess was this was the epi still working away.

Did he have a watch on? I once had a patient who was DOA and while getting my strip his cell phone went off and it picked up on the monitor...also had their watch "ticks" show up as well.

[EMS Guru]

I dont recall if he had a watch or not, but no cell phone, as we did a quick pat down during initial assessment. Plus, if he DID have a cell phone, it probably would have gotten fried at 200 joules.

[Nate]

I dont recall if he had a watch or not, but no cell phone, as we did a quick pat down during initial assessment. Plus, if he DID have a cell phone, it probably would have gotten fried at 200 joules.

You'd be surprised at what does and doesn't.

[Dustdevil]

I dont recall if he had a watch or not, but no cell phone, as we did a quick pat down during initial assessment.

[sarcasm]Ooooh! Did you get informed consent for that search? You may have violated the patient's constitutional rights and committed battery too! [/sarcasm]

[Guest]

Ok i give up ... Every call should be worked on scene until they are either able to drive themselves or they are dead. Your all better so you can sit back and relish in your superiority. I concede to you.