|04-18-2010, 09:49 PM||#1|
Forum Asst. Chief
Full Arrest Narrative
Ok I know this is kinda dead horse territory but I wanted to get some other opinions and not just those who I work with. I've had my first couple full arrests as a paramedic rider and while both were not only my first as a paramedic but were my firsts...period (both were ROSC and are in ICU still). Anyways I've written two different narratives, trying two different styles (these are for class). Could I get some advice on writing a narrative for cardiac arrests?
My two went like this (details changed to protect HIPAA). Additionally this is JUST the narrative, I also included medical history, medications, age, non-hipaa violating demographics, etc that we got on scene in another section of the document. I very rarely repeat their history in the narrative unless it is SPECIFIC to the run as I've already written that info on another page of the run form.
Cardiac Arrest 1:
Pt found supine, CPR in progress via FD. FD on scene states a neighbor heard a loud bang from suspected fall of the pt and initiated 911 response. Suspected downtime approx 25-30 minutes. Unk history, Unk Meds, Unk Allergies, ID on scene recovered by PD. FD reports AED attached no shock advised, CPR in progress for 10 minutes c minimal interruption. Defib pads attached to monitor, CPR halted. Pulseless, asystole. CPR resumed, intubation attempted c success by paramedic (7.0), IO access obtained, Epi 1:10000 1mg via IO, pt immobilized c minimal interruption. Rhythm and pulse reassessed. ROSC, pulse verified x2 carotid, sinus tach on EKG. Moved to ambulance -> C-3 <Hospital>. Enroute: ventilation's & O2 maintained, ETCO2 @ 46, EKG shows possible ST elevation in leads II, III, & AVF, 12-lead not obtained due to transport time and available resources. EKG trend to sinus brady, pulseless after reassessment. PEA (Sinus Brady). CPR resumed, Epi 1:10000 1mg, Atropine 1mg. Rhythm reassessed, pulseless, PEA sinus tach, CPR resumed, 3rd Epi given. Arrived to <hospital>, prior to transfer from stretcher to bed reassessed c ROSC. Pt moved, report given, care transferred to ER staff.
Cardiac Arrest 2:
Pt found supine in floor, CPR in progress by FD. Pt was found by husband approx 10 minutes prior to arrival unresponsive, not breathing. Husband pulled pt into floor and began CPR until arrival of FD. FD ventilating PT, AED attached, no shock advised. CPR ceased, EKG reads sinus brady PEA. CPR resumed. IO initiated R tibia, 1L Saline WO, Epi 1:10000 1mg & Atropine 1mg given on scene prior to transport. -> c-3 <hospital>. Enroute: Intubated 6.5 ETT, + ETCO2, +Breath Sounds x4, - Epigastric sounds, + Visualization. Ventilated 12/min BVM. Persists sinus brady PEA, epi 1:10000 1mg & Atropine 1mg given. Approx 5 minutes from hospital rhythm check reveals PEA @ 80, epi 1:10000 1mg given. On arrival to hospital pulses faint carotid, heart sounds extremely faint. Report given to <hospital> MD, care transferred to ER staff.
Last edited by Dominion; 04-18-2010 at 09:51 PM.
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