----- Original Message -----
From: Jeremy Mayhew <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, April 24, 2000 10:35 PM
Subject: Re: Single handed CPR
>
> -----
> > Absolutely right. I have been pressing my local Service (I am not on the
> steering group for some reason) for two
> > years now that unless the crew get ROSC they should not transport from
the
> scene.
>
> Rowley, you prompted me to examine the recognition of death protocol for
> your (and my!) local service.
>
> under "conditions requiring ECG evidence of asystole" it states
> 1) submersion for > 3 hours in adults over 18 with or without hypothermia
> 2) Continuous monitored asystole, despite CPR for > 20 minutes in a
> normothermic patient
> 3) Patients who have recieved no resuscitation for at least 15minutes
after
> collapse and have no pulse, or respiratory effort on arrival of the
> Ambulance Personnel.
>
> Iain, its certainly the practice in Sussex (as I'm sure you're aware) to
> send a second backup crew or fast responder to assist in cardiac arrest.
So
> single handed CPR is not advocated.
> I don't for a minute suggest this is always possible, and Mike's technique
> may occasionally be needed.
>
> The Leicester study showed the
> > futility of bringing in those who were not in VF when the crew found
them
> or the patient went into VF on them.
> > Not one of 700-odd survived to leave hospital. Why are we subjecting our
> crews to this risk? Some of ours trail 20
> > miles under blue light conditions and sooner or later there will be a
> fatality.
>
> Very fair and valid point, though some crew discretion should be allowed?
> e.g. 40 year old collapse at home, CPR being performed by distressed
> relatives etc. Or outdoors, where patient already taken into ambulance?
>
> I think a public education campaign would be required so the public
> understand what can and can't be achieved - otherwise crews would be at
risk
> of abuse and animosity!
> > Best wishes,
> >
> >
> > Rowley Cottingham
>
> Jeremy
>
>
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