Sunday, 9 September 2012

Calling it

They have power to make this decision on the basis of knowledge and experience but I'd argue we are using a lot more knowledge and experience out there in the world because we keep going for as long as possible.

http://news.bbc.co.uk/today/hi/today/newsid_9749000/9749017.stm

However, we are pre-hospital and doctors factor in the time we've been working on a patient before calling it.

Good quality CPR over a long period if necessary is in everyone's best interests but there has to be a time limit, so doctors will need to be given guidelines for ending the attempt, just as we are.

Xf

5 comments:

Anonymous said...

Nice to have you back!

Are there any interventions, kit or treatments that you don't yet have in the pre-hospital setting that would improve outcomes?

Apart from the classic, Early CPR, Early Defib, etc.

Thanks

Mjolinir said...

I note that this Study ONLY relates to 'in Hospital cardiac arrest'. Rebuttable presumption - they already had significant 'health problems.'

The available "Lancet" abstract contains quite a lot of statistics. I wonder if the 'Best :V: Worst' data might be different if the REASON for them being In-Patients was taken into account?

[http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60862-9/abstract]

Anonymous said...

After 45 minutes of CPR, I start to think about calling it as:
1. its getting less effective
2. if we cant get them into VF or a shockable rythem we are unlikly to get them back
3. we we dont have a lucas CPR device onboard
4. if we are over 45 minutes away from A&E or we are 'staying and playing'

Anyway nice to see you posting :)

Xf said...

Anon

Nothing special apart from experience, those necessary skills, drugs and faith in what you are doing. As has been pointed out, the outcome for these patients is often down to simple reasoning and the potential for a fair quality of life should they survive.

The Wise Monkeys said...

I think that its worth while to point out that CPR during transport is the least effective period doctors and nurse have the pleasure of adequate beds and top kit available on hand they don't have to pull their patient out of a car and work on them. Its also good to point out there is little emphasis on the rhythm that the patient reverts to (if they do )

:)