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Old 12-19-2008, 05:18 AM   #1
AlaskaEMT
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Pericardial Centesis


Do any of you have standing orders to perform Pericardial Centesis?

If not, should you? After all, it's part of the H's & T's.


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Old 12-19-2008, 08:04 AM   #2
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When I first started, it was a standard to administer Epi Intracardiac. It along with many other procedures were determined to be too dangerous.

As well as performing pericardial centesis is too dangerous, in regards to H & T's; there are many other procedures we are not allowed to do as well as judged to be too dangerous and risky.

Sometimes, one has to keep thing in perspective.

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Old 12-19-2008, 08:39 AM   #3
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Also, if your pt requires a pericardial centesis, it will be because you are that far down the algorhythm that it will be a last ditch effort. It is there because it might help the pt when a doctor does it. Basically it is there so that the MD can show the family on paper that everything was attempted to revive the pt.
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Old 12-20-2008, 03:23 AM   #4
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Many flight programs and critical care programs still have it within their protocol. I know of at least one occasion when it may have bought some time.
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Old 12-20-2008, 03:37 AM   #5
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Quote:
Originally Posted by Ridryder911 View Post
When I first started, it was a standard to administer Epi Intracardiac. It along with many other procedures were determined to be too dangerous.

As well as performing pericardial centesis is too dangerous, in regards to H & T's; there are many other procedures we are not allowed to do as well as judged to be too dangerous and risky.

Sometimes, one has to keep thing in perspective.

R/r 911
You know Rid, I get a kick out of the look on a new Emt or medics face, when I explain to them how we used to do intracardiac Epi, with the 6 inch needles!
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Old 12-20-2008, 03:59 AM   #6
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intracardia epi, pericardial centesis along with a hundred other procedures that are both approved and not scare me in the hands of some of the medics on the road today. granted, they are probably in the minority; but i have heard about, read about, worked with and qa'd many medics who imho shouldn't be practicing at the chair van driver level, much less as als providers. giving them a 6 inch needle and telling them to pulp fiction a guy frightens me to the core.
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Old 12-20-2008, 06:55 AM   #7
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It is still in our Flight program protocols. I've done the procedure twice in the last 10 years.

No. You do not need to use a spinal needle.
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Old 12-26-2008, 09:11 PM   #8
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I don't think it's in the ALS scope here.
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Old 01-04-2009, 10:15 PM   #9
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Yes it should be in our protocols. If a patient is that far down they will die w/o relief of that pressure. Might die anyway but at least give them a chance.
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Old 01-04-2009, 11:11 PM   #10
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Quote:
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I don't think it's in the ALS scope here.
I'm almost certain its in the protocals but I don't think any medical Director in AB would allow it to be done, even the "great" Dr. Sukram...
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