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PostPosted: Thu Mar 23, 2017 9:59 am 
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Well today I had a cardiac arrest, my first one (turns out they are not as common as one thinks), suspected drug overdose, potentially 2 hours without CPR (last seen alive two hours before we were called).

upon arrival at scene, immediately requested support from fire department for extrication and CPR, 2nd ambo crew on route with ICP back up. Had to cut ropes holding gate closed to get access, then climb up some very shonky stairs (we'll come back to these) found pt in bed, skull dragged them to the lounge and started CPR, breaking ribs on first compression.

Airway sucked, pt kept aspirating and we weren't able to succeed in getting a patent airway, my thanks to the paramedics at the head end, they got covered in vomit. IV access no go so IO was done (EZ-IO Device). monitor applied and rhythm asystole.

20mins of CPR later and 1 mg of adrenaline, not to mention 2 C cylinders and two filled suction units its was called per QAS guidelines. this is where it gets fun.

The fire department arrives and informs the 7 paramedics and the family that the stairs are unsafe (no s*** sherlock), so we have to wait in the house, with the body, the blood, the puke and the family with all our gear while the fire department sets up a ladder as a temporary staircase, the police arrive (dead body, police problem) and we hand the body to their care before returning to station for cleanup.

90 mins later, after all the paramedics have had a bath and in new uniforms, after every bag has been emptied and the vomit cleaned out, after both suctions units have been cleaned, after the cylinders replaced and after all the stock used has been replaced we announce we are back in service, and are going for burritos.

on route, we get sent to someone who called the ambulance so someone could check his blood pressure...

hope you had fun reading!

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PostPosted: Thu Mar 23, 2017 10:16 am 
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Great story! I am not sure I want burritos for a while though. :clownshoes:

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PostPosted: Thu Mar 23, 2017 10:34 am 
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raptor wrote:
Great story! I am not sure I want burritos for a while though. :clownshoes:


I'm not sure they ever got burritos!

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PostPosted: Thu Mar 23, 2017 11:01 am 
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Hiroshima_Morphine wrote:
raptor wrote:
Great story! I am not sure I want burritos for a while though. :clownshoes:


I'm not sure they ever got burritos!


We did, they were tasty, excellent for a wet and stormy night...also soul food :awesome:

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PostPosted: Thu Mar 23, 2017 11:47 am 
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What is ICP in this instance, and where was the IO placed?

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PostPosted: Thu Mar 23, 2017 10:48 pm 
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springer wrote:
What is ICP in this instance, and where was the IO placed?

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Intensive Care Paramedic (ICP) able to intubate, conduct IO insertions, more drugs.

Right leg, just below the knee

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PostPosted: Thu Mar 23, 2017 10:54 pm 
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taipan821 wrote:
Well today I had a cardiac arrest, my first one (turns out they are not as common as one thinks), suspected drug overdose, potentially 2 hours without CPR (last seen alive two hours before we were called).

upon arrival at scene, immediately requested support from fire department for extrication and CPR, 2nd ambo crew on route with ICP back up. Had to cut ropes holding gate closed to get access, then climb up some very shonky stairs (we'll come back to these) found pt in bed, skull dragged them to the lounge and started CPR, breaking ribs on first compression.

Airway sucked, pt kept aspirating and we weren't able to succeed in getting a patent airway, my thanks to the paramedics at the head end, they got covered in vomit. IV access no go so IO was done (EZ-IO Device). monitor applied and rhythm asystole.

20mins of CPR later and 1 mg of adrenaline, not to mention 2 C cylinders and two filled suction units its was called per QAS guidelines. this is where it gets fun.

The fire department arrives and informs the 7 paramedics and the family that the stairs are unsafe (no s*** sherlock), so we have to wait in the house, with the body, the blood, the puke and the family with all our gear while the fire department sets up a ladder as a temporary staircase, the police arrive (dead body, police problem) and we hand the body to their care before returning to station for cleanup.

90 mins later, after all the paramedics have had a bath and in new uniforms, after every bag has been emptied and the vomit cleaned out, after both suctions units have been cleaned, after the cylinders replaced and after all the stock used has been replaced we announce we are back in service, and are going for burritos.

on route, we get sent to someone who called the ambulance so someone could check his blood pressure...

hope you had fun reading!


Wow, I didn't know they had burritos in Australia. That's globalization for you.

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PostPosted: Fri Mar 24, 2017 1:17 am 
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Went for tacos after picking up my first dead body. Best and worst tacos I ever had. Great story, the first one usually sticks with you. I was REALLY hoping ICP was insane clown posse :lol:

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PostPosted: Fri Mar 24, 2017 7:03 am 
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Just be glad the body hadn't set long enough to get "ripe".
That's not a smell that promotes the eating of burritos after the first exposure.

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PostPosted: Sun Mar 26, 2017 1:46 pm 
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Everyones protocols are different, so I am always curious - 2 hours should have been enough time for dependent lividity. Our protocols say say DL means no extreme measures.
I have seen where some departments have zero documented threshold for discontinuation of resuscitation, even when it is beyond obvious (i.e. decomp has begun or visible injuries are not compatible with life functions) for emt basics or anything below paramedics.


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PostPosted: Sun Mar 26, 2017 3:51 pm 
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SRO1911 wrote:
Everyones protocols are different, so I am always curious - 2 hours should have been enough time for dependent lividity. Our protocols say say DL means no extreme measures.
I have seen where some departments have zero documented threshold for discontinuation of resuscitation, even when it is beyond obvious (i.e. decomp has begun or visible injuries are not compatible with life functions) for emt basics or anything below paramedics.


I'll link you the relevant sections of our Clinical Practice guidelines
https://www.ambulance.qld.gov.au/docs/clinical/cpg/CPG_Resuscitation_General%20guidelines.pdf
https://www.ambulance.qld.gov.au/docs/clinical/cpg/CPG_RecordingOfLifeExtinct_managementofadeceasedperson.pdf

extremities were room temperature, core was still warm. the patient was in the grey area where the criteria for CPR and ROLE were both satisfied.

now if you excuse me, I have a date with Tropical Cyclone Debbie :crazy:

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