Do you consider this an arrest, and a save?

[MedicPatriot]

There is this one lady in my first due area that has affected my views of asthma for all eternity.

The first time we "met", neither me or the FR could feel a pulse. I stared at what looked like a purple & blue corpse with agonal breathing. She was very fat, but I still know I should have felt a pulse. I did compressions, and we just started to BVM when someone attached the AED after 2mins of CPR and I saw obvious sinus tach. So outloud I say "well either its PEA or she has a pulse" and sure enough a STRONG pulse that wasn't there before. Of course I am an airway nazi and didn't like how the guy was bagging her so I took over BVM , and after a while she was somewhat of a normal color. TERRIBLE compliance. Epi 1:1 .5 mg x 2, Decadron 10mg IVP. I wanted to drop a quick ETT with the Glidescope but I wasn't in charge that day and nobody listened. It was just near impossible to get air in her even with an adjunct. With a long time of wrist breaking poor compliance BVM she regained consciousness. She was talking and able to breathe somewhat normally.

So, was this a save? I think so. I mean maybe her heart wasn't stopped, but it wasn't strong enough to produce a palpable pulse...therefore PEA.

 

[usalsfyre]

Hypoxic arrest is a legit arrest. Sounds like a good job on y'alls part.

That said, does it really matter if anyone else considers it a save? Take personal satisfaction in a job well done.

 

[mycrofft]

Three types of BLS field resuscitation saves, as a rule; drowning (hypoxic), choking (hypoxic) and electrical shock with apnea (hypoxic).

 

[medic417]

Claim the saves then you must accept the blame for the deaths. Just learn from every call and move forward. We are not hero's.

 

[MedicPatriot]

The whole save thing is just a stat I am tracking to see how many cardiac arrest "saves" actually happen in my career. Not for bragging, just for statistics out of my own interest.

I was more-so wondering if this lady was in arrest or not. I thought maybe I could have felt a carotid pulse but not really so we did CPR. One thing is for sure, after cpr the pulse was rapid and BOUNDING.

Do you guys agree that it would have been good to intubate even though she probably would have responded to epi (she always does) and became conscious 30 mins later? BVM was getting poor results until 30 mins later.

 

[mycrofft]

Speak for yourself.h34r:

 

[jjesusfreak01]

I was arguing that some local medics shouldn't get (pretend, not official) credit for a cardiac arrest save because the cops at the mall where the patient had coded had done CPR and shocked the pt back into a perfusing rhythm long before EMS had arrived. I was like, what did they do for the patient besides a trip to the ER?

 

[Medic Tim]

I was arguing that some local medics shouldn't get (pretend, not official) credit for a cardiac arrest save because the cops at the mall where the patient had coded had done CPR and shocked the pt back into a perfusing rhythm long before EMS had arrived. I was like, what did they do for the patient besides a trip to the ER?

Depending on the situation they could have done a lot. Just because you get a pulse back doesn't mean you are out of the woods by any means.


That being said the security should be commended as they obviously did an excellent job.

 

[medic417]

I was arguing that some local medics shouldn't get (pretend, not official) credit for a cardiac arrest save because the cops at the mall where the patient had coded had done CPR and shocked the pt back into a perfusing rhythm long before EMS had arrived. I was like, what did they do for the patient besides a trip to the ER?

Did the Paramedics hang any meds to help patient keep that pulse? That is just one item of major consideration. Getting a pulse back is not as hard as keeping it. Pretty much anybody can pump chest and use the AED, so easy an emt can do it .

 

[DesertMedic66]

Did the Paramedics hang any meds to help patient keep that pulse? That is just one item of major consideration. Getting a pulse back is not as hard as keeping it. Pretty much anybody can pump chest and use the AED, so easy an emt can do it .

I find that very offensive haha

 

[jjesusfreak01]

Did the Paramedics hang any meds to help patient keep that pulse? That is just one item of major consideration. Getting a pulse back is not as hard as keeping it. Pretty much anybody can pump chest and use the AED, so easy an emt can do it .

Couldn't say. If the pressure was low after ROSC they probably hung dopamine and if the patient wasn't making any purposeful movement after ROSC they probably started inducing hypothermia. Honestly though, depending on the cause of the arrest and the amount of downtime those could do a lot of good or none at all.

In this case, the mall was about 5 minutes from a cath capable ER, so they probably didn't hang around scene for more than 10 minutes after making patient contact. In this type of situation where you had good CPR done quickly with quick defibrillation the patient needs definitive care in the ER rather than medics playing around onscene (more than necessary).

 

[mycrofft]

Yay, someone else knows a hospital is more definitive than an ambulance!