asystole

[JPINFV]

Correct me if I'm wrong, (unless in medic school) but it appears that the OP is a Basic... the only protocol he/she should be concerned with or initiating is calling for ALS and good quality ventilations/compressions.

...because discussing resuscitation past an AED is obviously a violation of the Paramedic Secrets Act of 1966! Maybe they can find a spot at Club Gitmo for him for violating the secrets!

 

[mct601]

I can honestly say I've learned some valuable knowledge in this thread. I knew atropine and epi were given for cardiac arrests, but did not know why.


and I'm glad there are people willing to take the time to share their knowledge on a subject matter. I'm always willing to listen.

 

[LondonMedic]

We removed pacing and atropine about three years ago because of a lack of efficacy

Who is 'we'?

 

[s4l]

Who is 'we'?

I assume whichever department he is with.

 

[LondonMedic]

I assume whichever department he is with.

Or country?

I would question departments unilaterally changing resus guidelines, in europe we have the Resus Council (www.resus.org) standardise the guidelines. The end result is that wherever you go and whoever you work with you'll be doing the same thing. I would suggest that an arrest is not the time to be arguing over who's guidelines we're following and what we're going to do next?

 

[Aidey]

Welcome to the US....most places have put their personal touch on the AHA ACLS guidelines, or don't even use them at all.

Our protocols list the general steps and then add at the bottom "or current AHA ACLS standards". It definitely is not standardized.

 

[Veneficus]

Or country?

I would question departments unilaterally changing resus guidelines, in europe we have the Resus Council (www.resus.org) standardise the guidelines. The end result is that wherever you go and whoever you work with you'll be doing the same thing. I would suggest that an arrest is not the time to be arguing over who's guidelines we're following and what we're going to do next?

Are we looking at the same website? The one where the primary link is online degrees advertising a masters degree in as little as 15 days from work experience?

 

[JPINFV]

I believe he's trying to point to www.resus.org.uk

 

[kittaypie]

san bernardino still has pacing protocols for asystole. don't know how effective it is though.

 

[LondonMedic]

I believe he's trying to point to www.resus.org.uk

Yer, thanks.

 

[MrBrown]

Who is 'we'?

new zealand

 

[SammyGirlMedic]

san bernardino still has pacing protocols for asystole. don't know how effective it is though.

In my area, we still have pacing in our current protocol. We also have the little sentence at the end that says, "Or current AHA ACLS guidelines."

 

[dave3189]

I always here everyone posting how forums like this are all about improving our industry. I hear a lot about how to present yourself and professionalism. Yet, there were quite a few silent ALS folks on this thread after the comment about what a Basic should concern themselves with in regard to cardiac arrest. As I pointed out in a pvt message to alphatrauma, I'm not intending to get some atropine and start acting outside my scope by administering it to patients. I am simply eager to learn so I can eventually go to the next level. The idea that that a Basic should be discouraged from asking questions and educating themselves is absurd! I have a feeling that although nobody is saying much, there are a lot of ALS people on this thread that would agree with me. If the purpose of this site is really to help train, educate and mentor EMS professionals, than people should feel comfortable and should be encouraged to ask these questions.

 

[AnthonyM83]

Yet, there were quite a few silent ALS folks on this thread after the comment about what a Basic should concern themselves with in regard to cardiac arrest. As I pointed out in a pvt message to alphatrauma, I'm not intending to get some atropine and start acting outside my scope by administering it to patients. I am simply eager to learn so I can eventually go to the next level. The idea that that a Basic should be discouraged from asking questions and educating themselves is absurd! I have a feeling that although nobody is saying much, there are a lot of ALS people on this thread that would agree with me. If the purpose of this site is really to help train, educate and mentor EMS professionals, than people should feel comfortable and should be encouraged to ask these questions.

When I read your post, I thought I had missed other posts where you had been flamed for asking your question. Reviewing it, though, alphatrauma is the ONLY one who made such a comment, and some who backed you up, so there really shouldn't be any reason to feel uncomfortable asking questions. Alphatrauma was obviously a random outlier. That's probably why not many others stepped up to defend you, because you didn't need defending. If he had gone off on you or others had agreed with him, I'm sure many others would have stepped in.

So, no worries, just keep doing as you do

 

[18G]

Alphatrauma's comment was out of line. Don't ever hesitate to ask questions regardless of what level they pertain to.

 

[alphatrauma]

dave3189

Okay... deep breath

My statement was not saying that one should not attempt to further themselves educationally.

You wanted enlightenment on asystole and the practical application of Epinephrine and Atropine. While my statement/reply may have been abrasive, there was a point.

Considering you seemed to be having difficulty grasping the concept of asystole, one can draw a reasonable conclusion that your basic understanding of the heart's anatomy/physiology is flawed. Is it your lack of comprehension or lack of quality instruction? Regardless, the result is the same.

That being said, how do you (or anyone else) possibly think you will gain any REAL knowledge or practical/functional understanding of ALS interventions by what is posted in this thread? Do yourself a favor and learn the right way... from those who are actually qualified to teach! Anyone can post anecdotal tidbits, local protocols and wiki pages. I would argue that you tighten up the fundamentals in your scope before adding weight to an already questionable foundation.

That being said, you have every right to pursue whatever avenues you wish to augment your training/lust for knowledge. And please don't assume that lack of universal acquiescence equates to some notion of intellectual propriety.

 

[JPINFV]

You wanted enlightenment on asystole and the practical application of Epinephrine and Atropine. While my statement/reply may have been abrasive, there was a point.

Considering you seemed to be having difficulty grasping the concept of asystole, one can draw a reasonable conclusion that your basic understanding of the heart's anatomy/physiology is flawed. Is it your lack of comprehension or lack of quality instruction? Regardless, the result is the same.

Then start basic and work up. If I'm explaining something and I'm not sure where the questioner's knowledge base is, then I'll start with more general topics. For example, on another forum a question came up regarding pulmonary physiology and H2CO3, including why H2CO3 will spit out a hydrogen. Since I didn't know what the OP's base level of knowledge, I started out with a quick explanation of what a catalyst does. Then I did a real basic introduction to the chemistry to expain the basics of acid/base theory. I'd like to delude myself that that had more impact on a person asking a question than "Don't worry about it, it's above your pay grade."

That being said, how do you (or anyone else) possibly think you will gain any REAL knowledge or practical/functional understanding of ALS interventions by what is posted in this thread? Do yourself a favor and learn the right way... from those who are actually qualified to teach! Anyone can post anecdotal tidbits, local protocols and wiki pages. I would argue that you tighten up the fundamentals in your scope before adding weight to an already questionable foundation.

You never know. On the same board there's a story about a medic catching a dystonic reaction months after a scenario was posted. The medic ran the patient presentation through medical control first, but the physician agreed and gave the order for Benadryl. Similarly, there's enough smart people on here that anything that doesn't pass the sniff test will get called out quickly.

 

[dave3189]

Last time I checked, the EMT-Basic course curriculum does not go into detail about the success rates and ACLS methods of resuscitation for patients in asystole. That being said, I'm not going to waste anymore time and energy on this topic. It is clear to me (and now to the last couple posters) that for whatever reason, you have a chip on your shoulder. You’re embarrassing yourself and your profession!

 

[alphatrauma]

That's you're opinion, and you are perfectly entitled to such...

be well