(48:11) Ron started cardiology this week and they went back to basics CPR. For about 6 hours this week. He and Kelly discuss changes to CPR. We talk about the Phillips cardiac monitor “hockey puck” and the Zoll AED’s talking. Survivor Paramedic has Ron’s class down to 7 students, but we supplemented by 8 nursing students, meaning there are more women than men in the class.
Also is “neurologically intact” a good measure of resuscitation success? What do they track when gauging success? Can you intubate while someone is compressing the chest?
Also talked about how Ron’s White Cloud Fu overcame an entire district of EMS calls on Saturday.
“The National Registry of Cardiopulmonary Resuscitation (NRCPR) was developed by the American Heart Association to provide a better understanding of the circumstances surrounding in-hospital cardiac arrest.17 Although the primary purpose of the NRCPR is quality improvement, it is a robust database that includes objective assessment of neurological status by cerebral performance category (CPC). The CPC is a valid measure that defines function using a simple scale, where CPC-1=good cerebral performance, CPC-2=moderate cerebral disability, CPC-3=severe cerebral disability, CPC-4=coma or vegetative state, and CPC-5=certified brain death.18 Our objective was to use the NRCPR to identify factors associated (positively or negatively) with CPC-1 or -2 at discharge (henceforth referred to as “neurologicallyintact survival” [NIS]) for patients with acute HF who suffer an in-hospital cardiac arrest.” –Circulation: Heart Failure. 2009; 2: 572-581
Special Episode 3 with Dr Bill Drees of LoneStar College North Harris EMS Program.
For Example chest pain – Bill, 45, woke from sleep app 7AMLeft sided chest pain radiating to Left arm. on arrival pale sweaty, hypotensive,tachycardic, ECG -ST elevation lead 2,3, AVF. we’ve given oxygen @ 4l/m nasal, Aspirin 300mg, IV access morphine 10mg good effect transport code 1 ETA 10min. On pre arrival call only change is we add last name and date of birth so a file can be made or retrieved if previous patient.
Same AMIST for Trauma patients. EG. Bill 45, riding bike fell hit headon concrete, no helmet. ALOC upto 10min, vomit x2 nil resp distress, laceration Right occipital, normotensive, tachycardic, we’ve immobilised, oxygen IV access, metoclopramide 20mg IVI code 1 ETA 10min.
physician given chance to ask questions when handing over in resus or trauma room. This seems to work well.
Also , in response to some discussion on your health reforms and potential increase in workload for ambulances. We have free ambulance to residence as subscription is included in there electricity rates. So we get alot of taxi jobs. We do however get to leave some people at home if there is no clinical or social reason to go to hospital by ambulance. This is the secret to free health provisions- clinical knowledge to point out ambulance transport is not warranted. In saying that our hospitals are overflowing as it is cheaper to go to hospital than see a GP.
Thank you for the podcasts I do enjoy them