ERDoc Posted June 6, 2006 Posted June 6, 2006 You are the doc at medical control when you receive a call for a field pronouncement. Your coversaton goes like this: EMS: We have a 77y/o male witnessed cardiac arrest. On my arrival the pt had lividity to his face. They were doing CPR and bagging the pt. His abd is distended. He has signs of not being viable. I want to stop CPR. Doc: So, the arrest was witnessed and CPR was started right away? EMS: Yup. The nurse said his face turned blue as soon as he went down. He now has lividity in both hands. Can I stop? So, what do you do?
Ridryder 911 Posted June 6, 2006 Posted June 6, 2006 Place on the monitor and try to get a better hx., was there any perfusion with compressions? R/r 911
JPINFV Posted June 6, 2006 Posted June 6, 2006 lividity of the face? How long has the patient been down? What is the current rhythm? What rhythms has the patient progressed through and what treatments have been preformed? ETA to the nearest paramedic receiving center?
ERDoc Posted June 6, 2006 Author Posted June 6, 2006 EMS: The pt has been down about 15 minutes total now. They said they started CPR as soon as he went out. Yeah, he has lividity, his entire face was blue when we got here and now his hands are starting to turn blue. The only thing done is CPR. Can we terminate? Oh, you want to know what rhythm he's in? Hold on I have to put the monitor on him.
vs-eh? Posted June 6, 2006 Posted June 6, 2006 This is an ALS car? Lol... It's obviously not lividity. You don't get lividity within 15 mins and it is generally dependent (i.e. gravity). I assume they aren't doing CPR with him face down... Sounds like cyanoisis...Sounds like a PE... History, rhythm, and ummmm transport would be warranted if this is a BLS crew. If it is an ALS crew, ummmm decertification is in order. Actually it would be in order for any crew... Even if this wasn't witnessed and they thought they were obviously dead... WHY ARE YOU DOING CPR ON AN OBVIOUSLY DEAD PERSON! Fire everyone.
JPINFV Posted June 6, 2006 Posted June 6, 2006 please tell me this wasn't a real call. Hmm, "lividity" of the face and hands sounds more like cyanosis (calling captain obvious?). So, umm, are you [ems crew] getting good chest rise when bagging? Is he intubated (can someone say esophageal intubation?)?
ERDoc Posted June 6, 2006 Author Posted June 6, 2006 Yes, this was an actual call that I took a little while ago. I posted it more to vent than for a real learning experience. This is an ALS crew (EMT-CC for you New Yorkers). CPR was started by the NH staff when they witnessed him collapse, 15 minutes prior to EMS contacting medical control. EMS: Oh, so I got asystole on the monitor. Should we stop CPR now?? Doc: No, let's avoid a wrongful death lawsuit and work this one to the ER.
vs-eh? Posted June 6, 2006 Posted June 6, 2006 Yes, this was an actual call that I took a little while ago. I posted it more to vent than for a real learning experience. This is an ALS crew (EMT-CC for you New Yorkers). CPR was started by the NH staff when they witnessed him collapse, 15 minutes prior to EMS contacting medical control. EMS: Oh, so I got asystole on the monitor. Should we stop CPR now?? Doc: No, let's avoid a wrongful death lawsuit and work this one to the ER. Do these people still have jobs? I still find it amazing that a NH started CPR and recognized the arrest! I don't know how you could possibly rationalize your incompetence in that situation...
Asysin2leads Posted June 6, 2006 Posted June 6, 2006 EMT-CC, or Came Close, lol And why should we push for the paramedic standard across New York State and the rest of the nation? Read the scenario above several times until it makes sense. Which hero rescue response squad were they from?
ERDoc Posted June 6, 2006 Author Posted June 6, 2006 EMT-CC, or Came Close, lol And why should we push for the paramedic standard across New York State and the rest of the nation? Read the scenario above several times until it makes sense. Which hero rescue response squad were they from? It was *******HIPPA******** Fire Department. 8)
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