Tapout

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

We received a post- arrest the other night in the local ER. She (a dialysis pt who missed her rx due to the winter storm) called 911 saying she couldn't breathe and "was probably having a heart attack." 2 minutes later PD broke down her door and found her asystolic-- started CPR. 2 more minutes later ALS arrived and loaded a few rounds of Epi and Atropine into her. Got a pulse. Gave 1 more of Epi and 1 more of Atropine. Scrambled her to me in the local ER with a pulse of 40 (mostly ectopic, med-based beats). We immediatley began the hypothermia protocol (AKA Code Cool).
Fast forward: 2 days.
She was warmed back up in our ICU from 93 degrees to 98 degrees and was extubated the day after. 2 days later she was extubated and asked ME, the one who received her and wrote her off as non-viable, ""What the Hell was I thinking bothering you people with my medical problems??? I'm so sorry I bothered you all!"
WE broke her ribs, tore her lip tubing her, and jammed lines and tubes all over the place in her tiny body, and she's apologizing to ME. This is why I do this. Beyond words. Seriously. There's so rarely a save post-arrest, and if the person survives, he/she rarely comes out of it as much more than a plant on a window sill. And she thanked ME.
Merry Christmas and Happy New Year, all. NEVER forget why you do what you do and NEVER assume your efforts are fruitless. This woman was proof to me to always the assume the outcome is going to be a GOOD ONE.

Welcome all... and kumusta and mabuhay to my Filipino brother! Enjoy this site. It's an excellent source of info and entertainment. You may love what is said or you may hate it, but so long as you post intelligently and with respect, your views are as welcome as you are!

Know what, guys? We here are not all firefighters. There are plenty of ems and hospital care providers who try to post intelligent stuff here, and very often get picked apart by non ems and non hospital people. Then there are the cops among us who try to post and get jammed up by their own IAD. Only FF's seem exempt from most of the criticism that keeps the rest of us from posting.

Know what, guys? We here are not all firefighters. There are plenty of ems and hospital care providers who try to post intelligent stuff here, and very often get picked apart by non ems and non hospital people. Then there are the cops among us who try to post and get jammed up by their own IAD. Only FF's seem exempt from most of the criticism that keeps the rest of us from posting.

EMSbuff, thanks for the post and the stats. However, I have to add that the theoretical numbers often OVERESTIMATE the limits at which people actually become symptomatic and at risk for serious injury and/or death.
The Sleepy Hollow incident involved 3 people brought to the Phelps ER, of vastly different ages and sizes. The woman, otherwise healthy and very young, had a temp of 102 and a CO level of 30. She was seizing, vomiting and non-responsive.
Her child, 5 years old and also otherwise healthy, was also unresponsive, also febrile at 103.6, vomiting and also post-ictal but without a previous seizure hx. Dad told me she was probably seizing like the Mom has done in the past- like mimicking her somehow. I almost could have bought that, but kids can't mimick fever too. The child's lips and orbits around her eyes were cherry red. The child's CO level was only around 13.
The man who carried both in turned out to be Dad. He only complained of a bad headache but his eyes were bloodshot and he looked like he was wearing red lipstick. His CO level was 32.
After 100% O2 all around those CO levels drastically and immediately dropped. Turns out the FD found CO levels in the multi-dwelling house of over 30. If the other 3 kids and 2 adults had not been removed from the building, they'd all have died. No question.
After the child brought to Phelps got the oxygen, her temp dropped to 99.2 and she woke up. Mom also woke up and wanted out of the hospital ASAP. Dad was awake the whole time but stopped complaining of a headache. All were transferred to Jacobi and all will (thank GOD) live to tell the tale and hopefully never BBQ in the house again.
My points:
1. Don't go only by the CO level. ANYTHING OVER 5 IS POTENTIALLY LETHAL, regardless of the age of the victim.
2. If you ever find 2 victims suffering ANY of the same symptoms, regardless of age, get the FLIP out of the environment, call the FD and let them check out the environment from which the victims came.
3. If you, as an EMS provider, EVER show up and find someone down for any reason, and YOU suddenly find your head and/or eyes hurting, GET THE FLIP OUT of the environment and call the FD! Even if it is not CO, the FD will still thank you for playing it safe. And you might save your own life and those still in the house if it DOES turn out to be CO.
Please read this twice, at least. Being handed an unresponsive kid was traumatic enough and will stay with me a long time. But saving her was the best Christmas gift I'll get this year, bar none. We in this business know we rarely get such a good alignment of the planets and actually end up high-fiving each other over a save. Know what you're getting into early, know when to ring the bell and back the flip out. Then call in the calvary so you can get home safely to your peeps so you can tell them the tale as you pat yourself on the back for seeing it BEFORE you became a victim of it.
Be safe.
Tapout

I know this is not new, but the article is interesting nonetheless. For those who have used it, like it? Love it? Hate it? Why?
I know most of you reading this are pre-hospital, but I still want to hear your thoughts. We used it recently in my ER, but the outcome wasn't a happy one.
I welcome any input. Thanks...
http://www.usatoday....ling29_ST_N.htm