Pediatric Cardiac Arrest

[taporsnap44]

You are a paramedic unit composed of a medic and a basic. You are toned out for a 7 week old cardiac arrest. Arrive on scene and find the mother and farther very upset, leading you to the baby. The mother states that the baby was sleeping in his crib when she checked on him 3 hours ago. Before the call she went to check on him and he was unresponsive, not breathing and no pulse. You are 7 minutes from the hospital, and an engine is on scene for manpower.

This scenario is to see how other providers would handle this. I have not yet been on a pediatric cardiac arrest but have been discussing this with various people as to how to handle. Do you grab the baby and run out the door, doing CPR and such enroute to the hospital. Or do you work the code in the ambulance or in the house.

 

[Shishkabob]

Totally depends on how long the kids been down, as chances are it will probably be called on scene if it's been an extended period. If not, PALS. There's a 3 hour gap between when the baby was last seen alive, and when it was 'confirmed' that he was down. Could already be too late. Add on top of that, dispatch time.


There's not much a hospital can do in a cardiac arrest that you can't do on scene.

 

[NREMTB12]

funny that this article comes up, just yesterday in Metro we had a 2 year old that had fallen into a swimming pool and was pulse less and apneic, basically the hospital is a 5 min drive from that residence, so they had the FD run in and grab the child and then got in the back of the rig and they were gone, ambo was on scene maybe 15 sec. tops, i dont believe the kid made it, though not at the fault of the medics becuase they did exactly what i would have done...get them to definitive care as quick as possible

 

[PapaBear434]

That was my very first released call, except it was a seven MONTH old. I was the basic, I was riding with a medic, Engines showed up...

Oh, I didn't mention that? The call was on the city border of Norfolk and Virginia Beach, and no one had any idea who's call it was, so EVERYONE came. We were the only ambulance, but we had two engines, three chiefs, three "zone" cars with medics on board... And everyone wanted to ride in my truck to the hospital.

 

[Ridryder911]

No difference than if it was an adult except the history and of course medication(s).

R/r 911

 

[taporsnap44]

No difference than if it was an adult except the history and of course medication(s).

R/r 911

That was my thought, stay on scene or in the back of the ambulance and work it until ROSC or you have to call it.

 

[sdaileyemt]

My teacher has brought up similar situations but I would grab and run. Go code 3 for about a mile then cut it to code 1 contact base and call it. Simply because you said 3 hours since last seen "alive". But I would do that one not really to give the parents hope but to show them you did soothing and with parents and pedi death parents can get combative and my scene can be come extremely unsafe. Just my though again only a student with a few rides under my belt so if I am wrong let me know please I am here to learn.

 

[LucidResq]

MyGo code 3 for about a mile then cut it to code 1 contact base and call it.

You do realize that in this situation, the parents are almost certainly going to be right behind you.

 

[Shishkabob]

Go code 3 for about a mile then cut it to code 1 contact base and call it.

And here we go. Puts public at risk, does nothing for patient, and puts you and your partner at risk.


/grabs popcorn and waits for Rid

 

[sdaileyemt]

Well I could have fire buy me a window, Like talk to them bout paperwork of some sorts just to give me time to get far away enough to were they can't be right behind me. And if not then go code 3 all the way but definitely get in and out ASAP. Valid point though I did not even well I mentioned it but never clicked. Thank you. Sorry re read Linuss' post, You are right bout public risk, So i guess scoop and go code 1 we are 7 Min out so no reason for code 3 the patient is more then likely passed so I would attempt CPR in route but check with my Medic and Med Control and call it.
And what is RID?

 

[Shishkabob]

If it's not going to make the slightest bit of difference in pt outcome, you have no reason to be going LS back to the hospital.

 

[sdaileyemt]

Ya see my edited post you do have a point I did not take into consideration. Only thing I thought was leave scene ASAP! Because it can turn violent.

Also apologize if any of my posts sound stupid or if I do not know terms or abbreviation I am a student here to learn lol

 

[reaper]

Not many pedi codes turn violent. Show coding is not helping the parents. If the pt is viable, then work it as normal. If it is not viable, call it and turn your attention to the parents. They will need your help more then a pt that has been down to long!

 

[sdaileyemt]

O ook well then, My teacher just mentioned when we were talking bout the anger stage of death that in pedi cases it can and at least in our area can turn violent, But if it is a non violent then definitely try CPR and resuscitation in a room away from the parents, I would do that as a new EMT because it would be hard to concentrate with mom and dad yelling in my ear, I know something to get used to but not the time to learn i will learn when Susie falls off her bike lol. And then call it if needed and comfort the parents just be real with them listen to them talk to them do what they need. I personally would either way hope I NEVER have to see this ontop of being a new EMT I am a new dad so ya.

 

[Sasha]

So let me get this straight... You are going to put you and your partner at risk fir a dead person ... Give the family false hope by dramatically speeding away... Violate the childs body... Add a hospital bill onto of a funeral and ems bill.... And allow the family to drive to the hospital in an emotional state because you can't break the news? Some patient advocate.

 

[Shishkabob]

If it's an acute medical incident, chances are the parents will be in too much disbelief to get angry. You're there to help, they know it, and generally don't fight you.

Yes, people will "bug" you, but it's for the better if you let them watch.

 

[ResTech]

I have only had two pediatric arrests.. one was a two year old who fell into her grandparents swimming pool one Summer and the other was last month which was a 5 month old at a daycare facility.

If the child is viable, I feel picking up the child and going straight to the Ambulance is a good idea. Then you have the child in your comfort zone and away from the distraction of the parents. I think this saves time. I do firmly believe the parents should always be allowed to see their child during care if time permits and not be kept in the dark.

 

[sdaileyemt]

So let me get this straight... You are going to put you and your partner at risk fir a dead person ... Give the family false hope by dramatically speeding away... Violate the childs body... Add a hospital bill onto of a funeral and ems bill.... And allow the family to drive to the hospital in an emotional state because you can't break the news? Some patient advocate.

Well you did not have be so rude and disrespectful said on several occasions I am a STUDENT I am LEARNING! And after hearing over statements I changed mine, Were I live/going to be working it is a BAD city, number 5 crime rate in US so yes if I believe it is going to get violent DAMN right I am OUT it is there emergency not mine as my instructor says. But like I said if it is a safe situation do everything I can call it and confront the parents and help them. So please I appreciate all the the REAL help.

 

[Ridryder911]

Well I could have fire buy me a window, Like talk to them bout paperwork of some sorts just to give me time to get far away enough to were they can't be right behind me. And if not then go code 3 all the way but definitely get in and out ASAP. Valid point though I did not even well I mentioned it but never clicked. Thank you. Sorry re read Linuss' post, You are right bout public risk, So i guess scoop and go code 1 we are 7 Min out so no reason for code 3 the patient is more then likely passed so I would attempt CPR in route but check with my Medic and Med Control and call it.
And what is RID?

That's me. Okay... here we again! Did your EMT class have an theatrical and acting as a portion of it too? C'mon where in the hell; did you ever read you would start CPR and then stop for dramatics? Either do the job correctly or get out. Your basically saying... "I can't deal and do my job!" I'll let the ER tell them that they are dead and might as well tell them I was negligent. Yeah, I gave the family false hopes and now have also gave them an additional $3.000-5,000 bill. Congratulations!

Now, not to be rude. We will teach you and assist you in how to do things right. You giving false hope is unethical and could have serious consequences.

If the child is dead.... he/she is dead. You inform the family, assist them for counseling, etc. and should have LEO at the scene already. Until otherwise proven it is a crime scene and medical examiner division will handle the rest.

*Late entry: did not see you were a student, so don't be thin skin and you will learn!
R/r 911

 

[sdaileyemt]

Well thank you I do realize my first post was deffo not the route to go, But I agree with my revised plan haha, apologize if the first one was sounding like a **** move just something I herd about it and in my first instinct sounded right but DEFINITELY wrong move.