Category Archives: Medical Cardiac Arrest

Hello, what are the criteria for identifying hypothermia in a VSA patient? This affects our treatment under ALS PCS 5.1 whether we consider early transport after one analysis. The situation that brought up this discussion was a patient who had been on the floor indoors for a number of days, but still presented with a hypothermic body temperature. If the patient had been found VSA, how would we identify to treat them under the full medical cardiac arrest, or be considered for early transport?

With the new medical cardiac arrest directive I have multiple questions: 1. If a patient re-arrests after getting a ROSC do we A) start the 20mins over? B) analyze once and then carry on to hospital with no further analyzes, or C) complete the remainder of the initial 20mins of CPR? Also does this answer change if the ROSC is at the initial site or in the back of the ambulance? 2. If patient arrests for the 1st time in the back of the ambulance, do you stop for the whole 20mins of CPR, does location of arrest to hospital make a difference? 3. If you have a refractory v-fib and we start early transport to hospital, do we continue to pull over and shock every 2 mins or so we stop shocking while on route to hospital?

Why are we waiting to implement the cardiac arrest medical directive changes until Feb?

For ALS-PCS 5.0: If a patient re-arrested prior to extrication, do we carry out another 20 minutes of resuscitation or do we go after first analysis?

Under clinical considerations medical cardiac arrest, plan for extrication and transport after 3 analyses. For Pediatric arrest would we do 3 analyses and go or complete 3 on scene and 4th before departing in ambulance?

So we had a call to a burn victim that was grossly charred, but was breathing. He started to deteriorate in transport but we made it to the hospital. I was wondering if he were to arrest if that would be a traumatic VSA, I know it's not a blunt or penetrating trauma but it doesn't make much sense as a medical cardiac arrest either. Also could a patient meet the standards for an obvious death after patient contact?

Should I ask for a DNR in every scenario where I may use what's contraindicated? If I were to show up for an unconscious but not VSA female and her husband is on scene and doesn't mention the DNR, should I assume they want treatment and continue with inserting an OPA and bagging if necessary or should I ask for a DNR before starting treatment? Would I get in trouble in this scenario if I treated this patient without the husband saying anything and then once we got to the hospital found out they had a DNR?

Hello, I have a question regarding the 4th analysis when you’re actively calling for a medical TOR. If they’re around I’ll speak with family to give them an update on what we’ve been doing, that I’m going to call and doctor and what the outcome of that phone call may be. Often, after I’ve had that chat, and made the call by the time I’m back the 2mins has passed and a 4th analysis may have been done by my partner. What would you like to see happen there. Do we perform that 4th analysis or is that only performed just prior to departure if we’re transporting. Thanks for your help.

Good day, forgive me if I’m mis-reading this, but CPER digest Oct 2021 just published an info-graphic suggestive of staying on scene to run a complete 4 analyses in the case of a pediatric cardiac arrest with a suspected cause/history which is highly suggestive of hypoxia/respiratory in origin. The rationale that they’re presenting is that you’ve got an arrest where CPR and artificial respirations are our best bet for reversing the cause of the arrest. Any discussion related to this? I believe that our current SWORBHP directives are to depart after 1 analysis for a suspected reversible cause of arrest, (unless the rhythm is shockable). Thanks for any clarification that you can provide.

The AHA and COVID-19 guideline has a caveat that states in "suspected or confirmed COVID-19 cases" we should implement the prescribed practices. In the event that the patient in cardiac arrest is not confirmed or suspected to have COVID-19 symptoms is it reasonable to every to pre-pandemic practice of resuscitation?

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