Mike,
Out of curiosity, how do Medic One achieve their excellent figures ?
In a recent article in the New England Journal of Medicine (Vol 343 No17)
there was some statistics posted on the use of AEDs in casinos in the US.
53% of patients receiving defibrillation survived to discharge, 74% for
those with time of arrest (witnessed) to shock of less than 3 mins and
49% for those after that time.
Another article, reporting survival rates with airlines 191 patients off the
ground and 9 in the terminal. 40% survival rate.
With the time taken to deliver ALS (ACLS?) support to the patient,
what are the critical elements that enhance Seattles figures ? Do they
have first response / lay repsonse with AEDs etc ?
Kind regards,
Ross Boardman
UK
-----Original Message-----
From: The list will be of relevance to all trainees including undergraduates
and [mailto:[log in to unmask]]On Behalf Of Mike Bjarkoy
Sent: Sunday, January 07, 2001 22:59
To: [log in to unmask]
Subject: Re: Community Cardiac Arrest Drugs
Hi
Recently I popped over to 'run' with Seattle Medic One. Which is arguably
the
best paramedic service in the world? They guarantee a 49% success rate on
cardiac related arrest. I witness this first hand - 4 cardiac arrests and
they got 2 back.
The reason for the posting was that on one of the arrests they used Calcium.
24 year old male weighing about 22 stone who was a renal dialysis patient.
He
was in asystole with fire-fighters doing CPR. We (medics) got to the
incident
after about a 9 minute journey and they tubed him, IV access and gave Epi
and
asystole. They then followed it with Sod Bicarb and Calcium. They got a
rhythm and pulse back after a couple more minutes and remained in NSR all
the
was to ER.
These chaps have a bunch of drugs at their disposal and will administer it
on
the basis of patient needs (i.e. what the drug can do to reverse the
arrest).
Sod Bicarb is regarded as a first line treatment after Epi and Calcium is
there if they need it. So, anecdotally - I've seen it work and therefore -
it
works. Can anyone prove it has NO place in the cardiac arrest protocol to
warrent not having it in their drugs kit?
Mike Bjarkoy
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