50 Wii CPR

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(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.

Mentions:

EMS Newbie Podcast DVDs
Philips Q-CPR (video with “hockey puck”) [Their EMS Cardiac monitor page is broken right now, should be here]
ZOLL AED Plus with CPR-D-padz

Kelly’s medic math post
Peter Canny’s Streetwatch – Notes of a paramedic

“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

Listener Questions

Sam KatzBurg’s Question on High Vis vests.
Anne: Hi there, I am about to start volunteering as an EMT-B for my first time. I’m really nervous, and not feeling very confident. What do the both of you think is something good to keep in mind when you’re starting out? I’m especially nervous about seeming like I don’t know what I’m doing to patients and fellow EMTs. How did you become comfortable with what you were doing when you started out?
Special Episode 3 with Dr Bill Drees of LoneStar College North Harris EMS Program.
ak – HI I’m currently in paramedic class and in my externship and I was wondering what your thoughts are on use of capnography on Pts that are not intubated I have heard from some medics that they think its a great tool but its only going to tell me that the Pt is having broncospasms which you can hear by listening to lung sounds via wheezes and that they’re trapping co2 and i was wonder what your thoughts on cpap are
Hi Guys, I’m an Student Paramedic in Queensland Australia. I note in the last PODCast you had a question and discussed handovers. We are taught and use AMIST. This stands for Age and name of patient, Mechanism of injury, Injury, Signs and symptoms (outside of normal parameters) Treatment and Transport criticality.

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

Jeff