At 05:58 PM 07/01/01 -0500, Mike Bjarkoy wrote:
>
> 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?
You've Got to love those ride alongs !
Sure are an eye opener. (Good & Bad)
Although sometime you may not get the whole picture...
How many shift did you do ?
Cause a few thing appear a bit out of Wack
... Seattle or not
"Sod Bicarb is regarded as a first line treatment after Epi and Calcium "
I am certain they do not routinely use Ca+
Save for specific presentations (Ca Blocker OD, Hypercalemia... ie lots of
your
Dialysis Pt arrests)
So short of any clarifications... this is really scenario specific
Dialysis Pt in Arrest are assumed to be Hyperkalemic
Thus the use of calcium in this case... most certainly
- in the presence of asystole &
- especially after an extended resp time.
As for Bicarb... I would suspect that it's only used on Intubated & well
hyperventilated Pts.
Charles Brault EMT-P
------------------------------------------------------------
Free Web Email & Filter Enhancements.
http://www.freewebemail.com/filtertools/
------------------------------------------------------------
|