Did I waste my days as a paramedic? Is low-tech care the answer?

[KD5NRH]

If the latter, the lack of medical certs should only help her case - she's not a corpsman/EMT anymore, but still had usable, if older skills.  Not being employed or certified, she's not required to keep them up.  Or at least that's my take on it.

That's a part of the reason my first aid and CPR certs are decades out of date.  If at all possible, leave it to someone who has insurance that covers them for those situations.  Otherwise, I'll do what I can, but only to the extent that it's critically needed.

[Firethorn]

That's a part of the reason my first aid and CPR certs are decades out of date.  If at all possible, leave it to someone who has insurance that covers them for those situations.  Otherwise, I'll do what I can, but only to the extent that it's critically needed.

Having watched the episode, my cynic self thinks that things went about as well as could have.  My less cynical self wants to fight it in the court of public opinion - Between people liking the military, her record, sob story, and heroism, I can't help but think that a twitter campaign or some such would easily pull in enough money for not only a good lawyer but going to college.

Speaking of which, where's her post 9/11 GI bill?  That should pay for 100% of tuition, a smidge towards books, and E-5 dependent rate BAH for living expenses.  The right college should take most of her training, she should only need whatever the navy isn't bothering to provide(that army/air force does provide) to get her EMT certification.

[Scout26]

That's a part of the reason my first aid and CPR certs are decades out of date.  If at all possible, leave it to someone who has insurance that covers them for those situations.  Otherwise, I'll do what I can, but only to the extent that it's critically needed.

Really, you make decisions based on a fictional TV show?!?!?!?  Why not actually check the law your state law then make a fully informed decision.  


Hell, even Illinois has a Good Samaritan Law.  You can't be sued for rendering first aid and "doing your best to your knowledge."  So even if you do CPR and screw it up, you can't be sued (yes, even in Illinois) unless it's willful (or are getting paid for it).  Doctors, nurses and even dentists are covered if they render aid and are not being paid for it.

http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=2076&ChapterID=58

In fact, when we took CPR a year ago in Boy Scouts, they told us that CPR is only successful in something like 8-12% of the times it's used.  Most of the other times that person is DRT.  Even if they had their grabber right there in the ER or Cath Lab of a Hospital, there's nothing that can bring them back.  Lights Out, Game Over.

And if you do CPR right you will break ribs.  If you don't, you are not doing compressions hard enough.

[cassandra and sara's daddy]

I am waiting for aed cost to come down

[Marnoot]

I am waiting for aed cost to come down

The costs are coming down, just slowly. Currently you can get one for $899 on Amazon, which is down quite a bit from where they were a few years ago.

[cassandra and sara's daddy]

Yup 500 is my magic number


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[KD5NRH]

Really, you make decisions based on a fictional TV show?!?!?!?

Actually, never watched the show.  Got that advice from a tilecrawler who was in the process of suing a dentist who had done some damage to his client during CPR. 

[Scout26]

Actually, never watched the show.  Got that advice from a tilecrawler who was in the process of suing a dentist who had done some damage to his client during CPR. 

If the client was his patient, then yes he can be sued.  You however, cannot be.  Unless you charge for your CPR services.  If the client was not the dentist's patient then the dentist has an affirmative defense and your tilecrawler can go FOAD.

[cassandra and sara's daddy]

Tile crawler cruising for a settlement


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[roo_ster]

Tile crawler cruising for a settlement


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This.

Logic, law, and fact has nothing to do with it.

[MillCreek]

So maybe epi in cardiac arrest is not all that hot either:  http://www.medpagetoday.com/Cardiology/Arrhythmias/48884

[AmbulanceDriver]

So maybe epi in cardiac arrest is not all that hot either:  http://www.medpagetoday.com/Cardiology/Arrhythmias/48884

As soon as I read that worse outcomes were dose-dependent, my first thought was, "well, the longer they're down, the more doses of epi they get....  I wonder if the worse outcomes might be related to length of arrest vs. epi administration...."

And sure enough...

Limitations

One limitation was the lack of information about why one-quarter of patients didn't receive epinephrine, Ewy said.

Another was the less favorable prognostic characteristics of those who did get epinephrine, he noted, writing that "they were older, less likely to have a witnessed event, and less likely to present with a shockable rhythm, and they had a longer duration of resuscitation (P<0.001)."

[emphasis mine]

I mean, realistically, cardiac arrest and resuscitation from it are incredibly brutal assaults on the body and brain.  Between hypoxia/anoxia, CPR, defibrillation, and all the drugs we throw at the patient, then add on all the issues with reperfusion and stagnant blood, and I'm frankly amazed that anyone survives....

ETA:  That's not to say that epi may not have some serious effects.  The amount of epi we administer during a cardiac arrest, I'm surprised patients don't go straight into v-tach if we get a pulse back.   

[KD5NRH]

If the client was his patient, then yes he can be sued.  You however, cannot be.  Unless you charge for your CPR services.  If the client was not the dentist's patient then the dentist has an affirmative defense and your tilecrawler can go FOAD.

However, I don't doubt he caused a fair amount of hassle for the dentist before it was thrown out.

Another one of those situations where if he files enough of those, someone might just pay up rather than take the time to get it booted.  One in a hundred would keep the bills paid.

[MillCreek]

As soon as I read that worse outcomes were dose-dependent, my first thought was, "well, the longer they're down, the more doses of epi they get....  I wonder if the worse outcomes might be related to length of arrest vs. epi administration...."

And sure enough...

And the less likely to have a witnessed arrest and shockable rhythm.  Poor prognosis all the way around.

[SADShooter]

So maybe epi in cardiac arrest is not all that hot either:  http://www.medpagetoday.com/Cardiology/Arrhythmias/48884

A lot of uncertainty and grounds for further study. Our group is contemplating a clinical trial, but there's a debate regarding how to structure the arms for most definition.

I think I mentioned previously there is also an ongoing study evaluating amiodarone v. lidocaine v. plain saline, with the thought that the active drugs may be harmful.