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(First Responder Network)   It's not every day that a cardiac arrest is caught on camera. Then again, it's not every day it happens at an ambulance station either   (firstrespondersnetwork.com) divider line 75
    More: Hero, cardiac arrest, cinematographers, ambulances, police stations, cameras  
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4746 clicks; posted to Video » on 21 Feb 2013 at 3:39 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-02-21 03:22:43 PM
Nice find subster. Should be shown at CPR/AED classes.
 
2013-02-21 03:43:35 PM

WTFDYW: Nice find subster. Should be shown at CPR/AED classes.

www.cardiauk.com


It's really rare to actually catch a cardiac arrest on Camera. Even rarer for it to make it onto TV in the States. HIPAA killed a lot of the shows, like Life in the ER and Paramedics: Life on the Streets which showed what REALLY happens when a person does.

When you work as a team, good things happen.

/really shocked this went green.
 
2013-02-21 03:47:49 PM

BronyMedic: WTFDYW: Nice find subster. Should be shown at CPR/AED classes.

[www.cardiauk.com image 629x259]

It's really rare to actually catch a cardiac arrest on Camera. Even rarer for it to make it onto TV in the States. HIPAA killed a lot of the shows, like Life in the ER and Paramedics: Life on the Streets which showed what REALLY happens when a person does.

When you work as a team, good things happen.

/really shocked this went green.


I'm shocked to. Simply because it's informative. That dummy just doesn't cut it.

/doing First Aid, CPR/AED retraining in a couple weeks
 
2013-02-21 03:55:03 PM
Strange how his arms raised slowly by themselves right after they laid him down and began the chest compressions.

Paging Dr. Fark ...
 
2013-02-21 03:58:24 PM

Bob The Nob: Strange how his arms raised slowly by themselves right after they laid him down and began the chest compressions.

Paging Dr. Fark ...


It happens. Cardiac-induced Seizure and posturing caused by his brain not getting enough blood. If you look at the EKG, he doesn't actually have his heart stop - it goes into Ventricular Tachycardia. It's just beating "too fast" to pump out blood. They start CPR because he's got signs of poor perfusion and a questionable pulse.

If you notice to, when he does it, he also starts gasping. Those are agonal respirations, and are not effective breathing patterns. It's the reason they teach laypeople to do CPR when they see it.
 
2013-02-21 04:02:32 PM
I purchased four AEDs for our company a year or so ago. I hope it was a "waste" of $6000.00.
 
2013-02-21 04:03:47 PM
That was pretty awesome. Thanks for the link, subby.
 
2013-02-21 04:04:24 PM
that video was somewhat intense ...thank you for no voice commentary crap. That made it a lot better.
 
2013-02-21 04:37:21 PM

WTFDYW: I purchased four AEDs for our company a year or so ago. I hope it was a "waste" of $6000.00.


Need more folks wasting money like this.  Kudos to you, sir.
 
2013-02-21 04:49:08 PM
Just forwarded it to the guy I occasionally teach CFR and EMT-B with. Nice find, subby.
 
2013-02-21 04:50:04 PM

WTFDYW: I purchased four AEDs for our company a year or so ago. I hope it was a "waste" of $6000.00.


My company turned me down in 2008 for a single AED purchase. They couldn't justify the $2k expense.

Seeing what they DID spend money on instead was, well, shocking. And not in the good way.
 
2013-02-21 04:50:25 PM
Happens in station more than you might think. But in order to survive, this is exactly how quickly CPR and defibrillation needs to happen.
I think it's funny because I give the same "Your EKG is a little odd" line when I see shiat I don't like.
 
2013-02-21 04:57:19 PM
Good find, thanks subby.

/wants an AED for Christmas
 
2013-02-21 05:00:08 PM

WTFDYW: Nice find subster. Should be shown at CPR/AED classes.


It will be.
 
2013-02-21 05:00:27 PM

cretinbob: Happens in station more than you might think. B


Laws, yes. M-O-O-N spells "Firefighter/medics drop in station all the damn time." And on the fireground, too.

We've lost 5 or 6 firefighters/EMTs/Medics in station or on a fireground in the last 7 or 8 years. One guy was the last you'd ever think had heart issues. Ran marathons, didn't eat anything that cast a shadow, trim, about 5'8 and 140lbs, dropped on the golf course. 39 years old. Standing chatting with his guys (he was a Captain), his eyes rolled back and he went down like a sack of potatoes.
 
2013-02-21 05:06:13 PM

Bob The Nob: Strange how his arms raised slowly by themselves right after they laid him down and began the chest compressions.

Paging Dr. Fark ...


Judging by the rate, but not being able to see the EKG proper, he was most likely in vtach. He's unresponsive and pulseless and for all intents and purposes, he's dead (Jim).
There is still a bit of contractility to the muscles, though he has no control. I'm trying to think of an analogy. I'm sure I'll think of one later.
 
2013-02-21 05:09:55 PM
How does an AED work?
 
2013-02-21 05:12:22 PM

dramboxf: cretinbob: Happens in station more than you might think. B

Laws, yes. M-O-O-N spells "Firefighter/medics drop in station all the damn time." And on the fireground, too.

We've lost 5 or 6 firefighters/EMTs/Medics in station or on a fireground in the last 7 or 8 years. One guy was the last you'd ever think had heart issues. Ran marathons, didn't eat anything that cast a shadow, trim, about 5'8 and 140lbs, dropped on the golf course. 39 years old. Standing chatting with his guys (he was a Captain), his eyes rolled back and he went down like a sack of potatoes.


There was a medic who was transporting a patient around here who went into sudden cardiac arrest and died.
I also had a patient who was having a massive cerebellar stroke, and the closest hospital that could deal with it (requires surgery) was about an hour and a half away, so of course we flew him out. Came to find out later they had just finished working one of their own they found deceased in his bunk at the station.

But again, everyone thinking they need to go out and buy an AED, it was the chest compressions that did the most good here. It was a witnessed arrest and he was in a rythm that could be interupted. An AED will not reverse asystole or restart your heart. There was a lot that was cut out of this, and my only complaint is that the editing made it look too easy.

Why yes, I expect to die in the back of an ambulance myself. I just hope I'm not transporting at the time.
 
2013-02-21 05:14:47 PM
I wonder if the stress of being filmed for a TV show had anything to do with him having a heart attack right there in front of the cameras?
 
2013-02-21 05:15:42 PM

Wise_Guy: How does an AED work?


Kind of long, but worth a read because it's in laymans terms.

Short answer: It interupts a chaotic electrical signal that causes the heart to beat ineffectively, potentially returning it to an effective rhythm. However if the rhythm preceding the chaotic rhythm was asystole (not beating), then that's what you get back.
 
2013-02-21 05:16:52 PM

cretinbob: But again, everyone thinking they need to go out and buy an AED, it was the chest compressions that did the most good here.


QFT. Study after study is showing that ACLS, in the field, for the most part, is...well, not useless per se. But razor-sharp BLS skills (CPR and non-hyperventilating O2 support) are going to have a much better outcome than IVs and drug regimens, etc.

Not every time someone drops will they have a shockable rhythm, so good CPR skills are a must.
 
2013-02-21 05:17:58 PM
Also, those medics in the vid weren't using an AED. That was a medic-fired defib.
 
Bf+
2013-02-21 05:31:58 PM

Perlin Noise: that video was somewhat intense ...thank you for no voice commentary crap. That made it a lot better.

AverageAmericanGuy: That was pretty awesome. Thanks for the link, subby.

dramboxf: Nice find, subby.

BronyMedic: really shocked this went green.


This, that, and the other!
 
2013-02-21 05:35:01 PM

Bf+: BronyMedic: really shocked this went green.


Oh, that's very punny.

;)
 
2013-02-21 05:49:25 PM
I had a heart attack a few years ago. Still haven't summoned up the courage to watch the video.

/I got better.
 
2013-02-21 05:57:48 PM
Nice save boys. Nice CPR and conversion from the tachycardia. It's always nice to see a conversion like that, with a good ending. Too often even if you are right there with the autodefib, and cpr..they still don't make it. It's nice to see a win for a change.

/EMT
 
2013-02-21 06:05:05 PM

Wise_Guy: How does an AED work?


/It analyzes the rhythm of the heart, and if it sees an arrhythmia, such as tachycardia, or some other arrhythmia, it will charge, and give the user a verbal command to push the button that "hopefully" converts the arrhythmia to a sinus rhythm.  You don't (as is commonly believed) shock a person who is in a state where their heart is not beating at all.  There is no rhythm to convert, and the AED won't allow you to shock a "flat line" patient. You do CPR on someone like that, and introduce various drugs to hopefully get it restarted to a sinus rhythm or at least a arrhythmia you can convert.  The sad thing is..you have minutes to start CPR at least or there will be brain damage due to hypoxia.
 
2013-02-21 06:07:24 PM
after reading the intro i couldn't watch the video. it upset me just to read what happened. i don't know how emergency responders and health professionals do what they can do. i consider them hero angels and i thank God they live among us.
 
2013-02-21 06:16:55 PM

KrispyKritter: after reading the intro i couldn't watch the video. it upset me just to read what happened. i don't know how emergency responders and health professionals do what they can do. i consider them hero angels and i thank God they live among us.


It was pretty admirable how quickly they went to automatic when their suspicions arose.  It must lead to some shiatty times, but I hope on most days, they go home feeling pretty awesome about what they do.

\what did you do today?
\\oh, saved a couple of lives
 
2013-02-21 06:17:54 PM
That guy better hope he has some real good health insurance. His medical bills must be sky-high at this point.


Oh wait.....never mind.
 
2013-02-21 06:26:20 PM

dramboxf: Also, those medics in the vid weren't using an AED. That was a medic-fired defib.


Yeah, camew back to say that. It does have an automatic mode.
It's a Life-Pak 15 made by PhysioControl. They are damn good (I use LifePak 12s, piss on Zoll, don't even think about Phillips)
They'll set you back, depending on options $25k-$35k. That's without all the cables and extra batteries too. To be fair I was looking at a state bid sheet, so they may be a bit more depending on the dealer.

It'll monitor pulse O2 sat, B/P, do 3 lead and 12 lead EKG. You can monitor CO2 and CO levels depending on the model. In addition to defibrillation and synchronized cardioversion (which is probably what they did to this guy, not defibrillate) you can perform transcutaneous pacing.
They are worth every penny.
 
2013-02-21 06:35:26 PM
a guy I worked with had a video of himself having a heart attack. He worked in public safety and they have cameras in their offices. it was kind of creepy.

He went out on disability because he couldn't do the job anymore.
 
2013-02-21 06:35:46 PM

cretinbob: It'll monitor pulse O2 sat, B/P, do 3 lead and 12 lead EKG. You can monitor CO2 and CO levels depending on the model. In addition to defibrillation and synchronized cardioversion (which is probably what they did to this guy, not defibrillate) you can perform transcutaneous pacing.


Wow. They've come a long way from a LifePak 3.

I thought you only cardioverted afib or EMD/PEA.
 
2013-02-21 06:40:29 PM

dramboxf: Wow. They've come a long way from a LifePak 3.

I thought you only cardioverted afib or EMD/PEA.


I saw a lifepak 9 in use the other day at a referring I did a transport from, and was almost shocked. I haven't seen those since 2006 around Memphis.

Never cardiovert PEA. It's one sure way to ensure you never get them back. ACLS had to add in a section explaining this because people were cardioverting PEA and asystole.

You can cardiovert vtach with a pulse, the various forms of SVT if they're unstable or you're a nice enough person to give them some fentanyl and versed first, and atrial fibrillation/flutter. (In the field, you want to avoid doing the later until they've been loaded with heparin if they've been in it longer than 24 hours. Be kinda bad to cause them to have a PE or Stroke.) But these are synchronized shocks - they ensure they deliver the shocks before the absolute and relative refractory periods to keep from killing the patient.

Since he had no pulse in the video, they lit him up with 200 joules, then 360 when that didn't work.
 
2013-02-21 06:47:01 PM

BronyMedic: EMD/PEA.


Well, the fact that I called PEA EMD should tell you how long ago I read an ACLS protocol. LOL.

Have you been reading about any of the ground-shifting changes coming in ACLS? Abandoning epy?

Or some of the BLS stuff coming down the pike, like not boarding every single patient that might have even just heard of someone having a spinal jolt?

Fascinating stuff.
 
2013-02-21 06:53:21 PM

dramboxf: Have you been reading about any of the ground-shifting changes coming in ACLS? Abandoning epy?


We might just be trading in the Epi for Sodium Nitroprusside as a front line cardiac arrest drug.

dramboxf: Or some of the BLS stuff coming down the pike, like not boarding every single patient that might have even just heard of someone having a spinal jolt?

Fascinating stuff.


That's been coming down the line for years, and the EMS profession in the US has been fighting tooth and nail against it because they're afraid of getting the pants sued off them for that one, mythical missed occult spinal injury (You have a better chance of finding bigfoot alive). If we cared about spinal immobilization, we'd be using KEDs and vacuum mats with every patient who has neuro symptoms.
 
2013-02-21 06:56:55 PM

BronyMedic: That's been coming down the line for years


I helped teach a CFR class as recently as fall of 2011 and we were still All About The Long Board. I also hear a lot of medics whining about possibly losing ETI in favor or King or other advanced airways.
 
2013-02-21 07:04:15 PM

BronyMedic: We might just be trading in the Epi for Sodium Nitroprusside as a front line cardiac arrest drug.


FTL: Sodium nitroprusside-enhanced cardiopulmonary resuscitation improves resuscitation rates after prolonged untreated cardiac arrest in two porcine models.

Wow. I didn't know Christina Hendricks was doing medical research.
 
2013-02-21 07:15:22 PM
Fascinating Subby. UK first aider and as has been noted above, you can sing Nelly the Elephant to Resici-Annie until you're blue in the face but there's no substitute for at least footage of hands on experience
 
2013-02-21 07:28:40 PM
I've had 2 episodes where I simply could not get my breath (I'm 50)... drove myself to the hosp ER both times - whenever I'd cough (not while driving) I'd loose my vision for a second or so... turns out my electrical signal to the upper part of my heart had it beating at around 222 and a BP of 182/148 or so (kinda hard to read the machines behind you with wires and an IV sticking out of you. I was told I was dehydrated and given magnesium and some other stuff. Took in around 4 bags of saline but they kicked me loose after 6 (+/-) hrs the first time. Did the same thing the 2nd time (about 10 months later) but then called me back in 20 minutes later. Fortunately I live right between Forsyth Memorial & Baptist Bowman Grey and have interns/residents/RNs and assorted med professionals living all around me, so as long as I can make it to the front yard, I should be fine.
 
2013-02-21 07:56:16 PM
Wow.  Just wow.  That was amazing.

So glad they got him back.
 
2013-02-21 07:58:30 PM
Back in 1998, I was living in Tucson, AZ. I was 33 years old. I was about 100lbs overweight. I fell asleep one night on my left side, fully dressed. Side note: My father died of a massive MI when he was 47.

I woke around 2:30am, feeling very hot and sweaty and dizzy with my left arm hurting. I felt a tightness, a pressure in my chest.

I had my roommate drive me to the ER since the hospital was only about 3 blocks away. Walked into a triage nurse yakking on the phone. She points to a chair. I shake my head. "Chest pain, left-arm pain, sweating." She directs me to a treatment room. They get me hooked up to the 12 lead, and as I'm shifting on the gurney to make myself more comfortable, I let out a belch that probably rattled the 3 floors above me. ER resident comes in, sees my EKG is a nice NSR (if a touch tachy, LOL) and correctly determines that my left arm hurts because I slept on it, my chest is tight because I have gas, and I'm sweaty because I fell asleep in Tucson fully dressed.

....thiiiiis close to getting discharged and she asks some personal history questions. "Both parents alive?"

"Dad's dead...47, MI."

"Welcome to an overnight stay in our telemetry unit."

FARK.

Stress test 3 days later revealed I have the heart of an Ox. My doctor now hates me. My bloods are great, my EKG is fantastic, and I'm still 75lbs overweight. (Losing quickly though...) My resting bp is usually 110/80 or so.
 
2013-02-21 08:13:35 PM

dramboxf: I also hear a lot of medics whining about possibly losing ETI in favor or King or other advanced airways.


Never happen in the US if the NREMT, NAEMSP and NAEMT have their ways. I COULD see it in urban areas where the average transport time is five minutes, but nowhere else. Especially not in the critical care transport or helicopter EMS environment.

The idea that Paramedics should not perform ETI is based on a group of research studies conducted by a doctor who had a demonstrated bias against Paramedics having intubation in their toolkit. JEMS did an article not too long ago on it where they deconstructed the study and pointed out the major issues it ignored - namely Paramedic oversaturation, and fewer avenues for them to practice a high risk, low volume skill.

dramboxf: I helped teach a CFR class as recently as fall of 2011 and we were still All About The Long Board


IIRC, the national standard curriculum update has it that selective immobilization and spinal rule-outs are only to be done by EMT-Basics and above. It's kinda the same reason that you're not taught to titrate oxygen as a CFR or Basic, and they tell you to give everyone a NRB at 15 liters.


The solution is to stop cranking out medics wholesale from unaccredited, often corporate affiliated programs that spring up overnight and give substandard education - teaching people to pass the Registry rather than teaching them to be Paramedics. Thankfully, as of 2014, you cannot get a Paramedic if you don't graduate from an accredited institution, and this is going to kill many of them.
 
2013-02-21 08:47:04 PM

dramboxf: cretinbob: Happens in station more than you might think. B

Laws, yes. M-O-O-N spells "Firefighter/medics drop in station all the damn time." And on the fireground, too.

We've lost 5 or 6 firefighters/EMTs/Medics in station or on a fireground in the last 7 or 8 years. One guy was the last you'd ever think had heart issues. Ran marathons, didn't eat anything that cast a shadow, trim, about 5'8 and 140lbs, dropped on the golf course. 39 years old. Standing chatting with his guys (he was a Captain), his eyes rolled back and he went down like a sack of potatoes.


Well, if you have to go that's a good way to go. Fast and merciful.
 
2013-02-21 08:53:22 PM

bump: I've had 2 episodes where I simply could not get my breath (I'm 50)... drove myself to the hosp ER both times - whenever I'd cough (not while driving) I'd loose my vision for a second or so... turns out my electrical signal to the upper part of my heart had it beating at around 222 and a BP of 182/148 or so (kinda hard to read the machines behind you with wires and an IV sticking out of you. I was told I was dehydrated and given magnesium and some other stuff. Took in around 4 bags of saline but they kicked me loose after 6 (+/-) hrs the first time. Did the same thing the 2nd time (about 10 months later) but then called me back in 20 minutes later. Fortunately I live right between Forsyth Memorial & Baptist Bowman Grey and have interns/residents/RNs and assorted med professionals living all around me, so as long as I can make it to the front yard, I should be fine.


Next time call 911. Don't drive yourself when you think you're having a heart attack. If you die while you are driving you can take innocent people with you. That is so selfish.
 
2013-02-21 09:24:17 PM
I emailed this video to my work email. it will come in handy with training sessions.

Thank you subby
 
2013-02-21 09:50:16 PM

WTFDYW: I emailed this video to my work email. it will come in handy with training sessions.

Thank you subby


If you want more videos like it, I can hunt as many as possible down. My email is in my profile.

/subbie.
 
2013-02-21 10:11:08 PM
Those were some shiat compressions.  Or at leas they started out that way.  Maybe he got better.  Didn't watch the rest.
 
2013-02-21 10:54:35 PM
Great find, BronyMedic!
 
2013-02-21 10:54:59 PM

cretinbob: Life-Pak 15


I went searching for info, found this:
http://gizmodo.com/5192188/lifepak-15-defibrillator-so-cool-youll-fo rg et-youre-having-a-heart-attack

the video they post on there actually does make me want to cart one around all the time.  (and I wish I knew where the music in video is from).
 
2013-02-22 12:12:25 AM
In boy scouts, and later in medical science class in high school, I was taught to do 15 compressions, stop to either breath twice for the person or have another person breath twice, then repeat. Basically what you would see on any movie or tv show where CPR is performed.

I was told recently that the chest compressions were by far the most important part of CPR, and that you should never stop doing them until the EMTs arrive. Is that really the case?

Also, in the video, why did they call an ambulance, only to later transport the person in the helicopter?
 
2013-02-22 12:39:52 AM

I Havent Killed Anybody Since 1984: In boy scouts, and later in medical science class in high school, I was taught to do 15 compressions, stop to either breath twice for the person or have another person breath twice, then repeat. Basically what you would see on any movie or tv show where CPR is performed.

I was told recently that the chest compressions were by far the most important part of CPR, and that you should never stop doing them until the EMTs arrive. Is that really the case?

Also, in the video, why did they call an ambulance, only to later transport the person in the helicopter?


Ideally, under the current AHA guidelines (2010) the ratio is 30:2 for single rescuer and 2 rescuer adults (and continuous compressions with an advanced airway). HOWEVER, if you don't want to give breaths (e.g. no barrier device), then just do compressions continously.
 
2013-02-22 01:35:23 AM
And *that* is why I have an ICD.

CSB: recently showed up to my cardiologist for a regular follow-up and was met first by three Fellows. They tried taking my blood pressure using an automatic BP machine: no luck. They tried a second machine: no luck, just errors. So they tried manually found the cuff defective. As they were trying another cuff and saw they were getting the same results, my normal doc poked in head in and said "oh yeah, that happens." The Fellows were in awe that I was fully conscious with a BP of 50/30, but even better were the faces they made when I told them I drove there!

/ on a good day I'll make triple digits
// still young enough to get off your lawn
 
2013-02-22 03:44:41 AM

Marshall Willenholly: I wonder if the stress of being filmed for a TV show had anything to do with him having a heart attack right there in front of the cameras?


Lolz. Any stress from being filmed is negligible compared to the stress of simply doing his job.

My wife's an ESD/911 Op. I'm a state-certified firefighter (volunteer). Emergency services is stressful work, and you don't always eat that well considering the hours involved (wife does 12-hours shifts, overnight... no lunch break. Eat when/if you can, generally quick and easy, less-than-healthy food). #1 cause of death for emergency service workers is heart attack. As a firefighter, you're MUCH more likely to drop dead in the station/at home/on the fireground than you are to actually DIAF.

I can't speak for the firefighter/police/EMT crews, but there isn't a single dispatcher in our county that isn't medicated for stress/anxiety/depression/blood pressure/cardiac issues. Being on the line with someone as they shuffle off their mortal coil is a regular occurance for the folks on the phones and radios. People dying on you all the time wears on you over the course of a career.
 
2013-02-22 03:46:44 AM

I Havent Killed Anybody Since 1984: In boy scouts, and later in medical science class in high school, I was taught to do 15 compressions, stop to either breath twice for the person or have another person breath twice, then repeat. Basically what you would see on any movie or tv show where CPR is performed.


It changed back in 2005 with the AHA guidelines update to 30:2 in adults and one man child/infant CPR. The reason being is that they found in adults that the compression were more important than the ventilation in a patient with a primarily heart-related cause for their cardiac arrest (Most kids have healthy hearts, and arrest because of respiratory causes or shock, so ventilation is more important in them). Two man child CPR is 15:2 now, which emphasizes the importance of ventilation in that population.

I Havent Killed Anybody Since 1984: I was told recently that the chest compressions were by far the most important part of CPR, and that you should never stop doing them until the EMTs arrive. Is that really the case?


In Adults who suffer a sudden cardiac arrest, you're absolutely right. Hands-only CPR buys time for defibrillation for certain heart rhythms, and to correct the underlying cause for the others, and most adults who suffer a cardiac arrest, unless it's from a respiratory cause, have adequate blood oxygen saturation to support the minimal oxygen requirements of the body during cardiac arrest.

You shouldn't stop CPR unless you get signs of circulation back, i.e. the patient is spontaneously breathing (not gasping), wakes up and says get off me, or you are physically unable to continue due to danger or exhaustion.

I Havent Killed Anybody Since 1984: Also, in the video, why did they call an ambulance, only to later transport the person in the helicopter?


Possibly because they couldn't fly at the time they called for ground transport, or they felt he was stable enough initially to go by ground. I don't know what the UK's aviation rules are, but here there are very specific criteria for when a medical helicopter can and cannot fly. Based on what they said in the video, I'm assuming he was having an Inferior/Posterior Wall STEMI, which is a type of time dependent heart attack they identified on his EKG after he arrested and was brought back, so they made the decision to fly once they were able to.
 
2013-02-22 03:51:31 AM

JPINFV: then just do compressions continously


As I understand it, the act of compressing and releasing the chest does expel and inhale a little bit of air, enough to keep things working if you don't have the time to give breaths. Here is my favorite video on the subject
 
2013-02-22 03:53:57 AM

Lets talk frankly about internal cleanliness: Marshall Willenholly: I wonder if the stress of being filmed for a TV show had anything to do with him having a heart attack right there in front of the cameras?

Lolz. Any stress from being filmed is negligible compared to the stress of simply doing his job.

My wife's an ESD/911 Op. I'm a state-certified firefighter (volunteer). Emergency services is stressful work, and you don't always eat that well considering the hours involved (wife does 12-hours shifts, overnight... no lunch break. Eat when/if you can, generally quick and easy, less-than-healthy food). #1 cause of death for emergency service workers is heart attack. As a firefighter, you're MUCH more likely to drop dead in the station/at home/on the fireground than you are to actually DIAF.

I can't speak for the firefighter/police/EMT crews, but there isn't a single dispatcher in our county that isn't medicated for stress/anxiety/depression/blood pressure/cardiac issues. Being on the line with someone as they shuffle off their mortal coil is a regular occurance for the folks on the phones and radios. People dying on you all the time wears on you over the course of a career.


An interesting note is that any Firefighter, EMT, or Police Officer who dies of a heart attack or asthma attack within 12 hours of leaving a working fire or accident scene is considered a line of duty death for the purposes of federal death benefits. Cancer deaths in Firefighters and EMTs too. Volunteers are notorious for this, they'll work too hard or get too much CO or Cyanide, or other products of combustion while fighting a fire, go home, and then be found dead the next day from a coronary.

To be quite honest, dispatchers have it harder than EMTs and Paramedics do. We have the advantage of knowing we did everything we could for someone. Dispatchers have to deal with that feeling of helplessness with every call.
 
2013-02-22 07:44:18 AM
I have an old acquaintance who is an EMT that I bump into from time to time. He is very morose about his job. I asked how thing were going and he responded with, "Oh, saving lives, prolonging suffering."

That statement sticks with me.
 
2013-02-22 10:16:44 AM
QFT:

BronyMedic: stop cranking out medics wholesale from unaccredited, often corporate affiliated programs that spring up overnight and give substandard education - teaching people to pass the Registry rather than teaching them to be Paramedics.


...and nurses.
(fired a few in my time)

/REALLY gets my goat
//former paramedic and ER nurse... getting a kick, etc., etc.
 
2013-02-22 10:40:34 AM

BronyMedic: . JEMS did an article not too long ago on it where they deconstructed the study and pointed out the major issues it ignored - namely Paramedic oversaturation, and fewer avenues for them to practice a high risk, low volume skill.


My EMS system has something called "Paramedic Engines." When someone dials 911 for a medical emergency, in almost every single case (EMD can decide otherwise,) a Fire Department engine with at least one medic aboard is dispatched, as well as an ambulance with (most likely) one medic and one EMT aboard. (Sometimes it's two medics, but never less than one.)

The issue we're seeing is not strictly oversaturation in our system, but that the FD medics are, by an overwhelming majority, getting beat to the call by the ambulance medic. Because medical command goes to the transporting medic, AND the FD won't allow one of their firefighters to go in the ambulance unless the patient is literally circling the drain, our FD medics don't get to perform ETIs and other medic-only skills very often. Then every 2 years they go to recertify and they're failing certain motor skills over and over and over again. We do have one FD that transports (Petaluma) and another city only sends an ambulance (no FD) for calls (Rohnert Park) but for the rest of the county, that's generally how it goes.

On the time-to-transport issue vs ETI, I agree in the helicopter/CCT environment. I was talking mostly about having the EMDs change protocols to make ETI a third or fourth choice for advanced airway in 10-or-less transport situations.
 
2013-02-22 11:20:50 AM
That was a pretty cool video and I'm happy the guy made it. First responders have my unqualified respect, that is a job I simply couldn't do.

I don't mean I wouldn't want to do it, I seriously think that I would be incapable, mentally and emotionally, to perform under those circumstances.

/best I could do is balance your checkbook while you stroked out.
//Fine lotta good that would do.
//Seriously, hats off to first responders. I am constantly in awe of what you are capable of.
 
2013-02-22 12:52:29 PM
In America he would have then been handed a bill for $30,000 as he regained consciousness.
 
2013-02-22 02:23:53 PM

I Havent Killed Anybody Since 1984: Also, in the video, why did they call an ambulance, only to later transport the person in the helicopter?


May have been answered, but there is probably a local hospital within 10 minutes or so ground transport. If he were not stable, that is had his vital signs not improved and his EKG still looked bad, it would be better to take him there for further treatment and stabilization before taking him to a big hospital that would have the capability of doing angioplasty or other immediate invasive procedures.
The fact remains, most people who suffer from cardiac arrest die, even if advanced CPR starts right away. WHen the heart is starved of oxygen by a blocked artery the muscle dies and you get what is called an infarct. That dead tissue generates an electrical charge that if it gets big enough, disrupts the normal electrical charge that makes the heart work correctly. If that area of dead muscle is too big then we can correct the electical problem (the arrythmia) but the physical problem can't be overcome.
By god I'll try though.
 
2013-02-22 02:38:11 PM
My father went into cardiac arrest while being examined by his cardiologist.
 
2013-02-22 04:00:37 PM
Remember when I was having a tachycardia - wasn't feeling well so drove myself to the hospital and for the first time ever the triage nurse checked my pulse and, ignoring a full waiting room, said "Please follow me." Was in a bed with 4 doctors immediately there with a cash-cart.

It's always nice to see professionals at work.

/pulse stayed steady at 199 - managed to fight them off from using the crash-cart until it went down
//doing the vagal maneuver on yourself is a great party trick
 
2013-02-22 04:08:01 PM

dramboxf: My EMS system has something called "Paramedic Engines." When someone dials 911 for a medical emergency, in almost every single case (EMD can decide otherwise,) a Fire Department engine with at least one medic aboard is dispatched, as well as an ambulance with (most likely) one medic and one EMT aboard. (Sometimes it's two medics, but never less than one.)


You can thank the Fire Department unions for that. The IAFF is a powerful lobbying group when it comes to Paramedic deployment and education in the United States, and is responsible for a LOT of the troubles involving it today. There's actually evidence that having more paramedics in a system causes worse patient outcomes. Fire Departments want Paramedics, and in turn - want to take over EMS from the Third Services and Hospitals because it lets them justify manpower and apparatus budgets. What invariably happens in large departments is that the Fire side siphons off the EMS side. While there ARE departments which do EMS very, very well - like Seattle, Nashville Fire, Memphis, etc, many of them get into the business because of union and special interest group pressures.

dramboxf: The issue we're seeing is not strictly oversaturation in our system, but that the FD medics are, by an overwhelming majority, getting beat to the call by the ambulance medic. Because medical command goes to the transporting medic, AND the FD won't allow one of their firefighters to go in the ambulance unless the patient is literally circling the drain, our FD medics don't get to perform ETIs and other medic-only skills very often. Then every 2 years they go to recertify and they're failing certain motor skills over and over and over again. We do have one FD that transports (Petaluma) and another city only sends an ambulance (no FD) for calls (Rohnert Park) but for the rest of the county, that's generally how it goes.


We have the exact opposite problem in one of the local cities. The local Fire Department medics in that municipality are under the impression that they own the patient, and the transporting Paramedic is just there at their beck and call. There is no team work. I've actually refused to work in this municipality because there is unbridled hostility towards us. There's no method for correcting errors or deficiencies in patient care - anyone who speaks up about it is reassigned to another municipality. One shift I worked there we had a drug error that caused no patient harm, and by the next day their command staff was trying to get me to take the blame for it, and trying to get me to sign legal paperwork outside of my employer.

I've had patients who they have not even given me a report on, and time-sensitive patients who they have spent far too much time on scene with doing things that could be done in transport, or are blatantly unnecessary.

Please don't get me wrong - I'm far from against Fire Departments providing EMS care by any means. I just think that EMS, like every other country in the world, should be its own unique branch of emergency services.
 
2013-02-22 05:17:58 PM

cretinbob: I Havent Killed Anybody Since 1984: Also, in the video, why did they call an ambulance, only to later transport the person in the helicopter?

May have been answered, but there is probably a local hospital within 10 minutes or so ground transport. If he were not stable, that is had his vital signs not improved and his EKG still looked bad, it would be better to take him there for further treatment and stabilization before taking him to a big hospital that would have the capability of doing angioplasty or other immediate invasive procedures.
The fact remains, most people who suffer from cardiac arrest die, even if advanced CPR starts right away. WHen the heart is starved of oxygen by a blocked artery the muscle dies and you get what is called an infarct. That dead tissue generates an electrical charge that if it gets big enough, disrupts the normal electrical charge that makes the heart work correctly. If that area of dead muscle is too big then we can correct the electical problem (the arrythmia) but the physical problem can't be overcome.
By god I'll try though.


It appeared that there was no crew at the time for the helicopter, so the called a back up ambulance.  As the ambulance arrived, they were able to get the helicopter out ("fastest ever" said in video) and a crew assembled, so they chose the helicopter for the straight route.

All in all, if you're going to have a massive heart attack, being surrounded by paramedics with a chopper on hand is the best way to do it.  Only way better is to actually have it in the ER.

Many times, the first warning you are about to have a heart attack is sudden death.  Seriously.  More people just die than ride it out.
 
2013-02-22 08:00:33 PM

dramboxf: Back in 1998, I was living in Tucson, AZ. I was 33 years old. I was about 100lbs overweight. I fell asleep one night on my left side, fully dressed. Side note: My father died of a massive MI when he was 47.

I woke around 2:30am, feeling very hot and sweaty and dizzy with my left arm hurting. I felt a tightness, a pressure in my chest.

I had my roommate drive me to the ER since the hospital was only about 3 blocks away. Walked into a triage nurse yakking on the phone. She points to a chair. I shake my head. "Chest pain, left-arm pain, sweating." She directs me to a treatment room. They get me hooked up to the 12 lead, and as I'm shifting on the gurney to make myself more comfortable, I let out a belch that probably rattled the 3 floors above me. ER resident comes in, sees my EKG is a nice NSR (if a touch tachy, LOL) and correctly determines that my left arm hurts because I slept on it, my chest is tight because I have gas, and I'm sweaty because I fell asleep in Tucson fully dressed.

....thiiiiis close to getting discharged and she asks some personal history questions. "Both parents alive?"

"Dad's dead...47, MI."

"Welcome to an overnight stay in our telemetry unit."

FARK.

Stress test 3 days later revealed I have the heart of an Ox. My doctor now hates me. My bloods are great, my EKG is fantastic, and I'm still 75lbs overweight. (Losing quickly though...) My resting bp is usually 110/80 or so.


Good luck.
 
2013-02-22 08:05:54 PM

kim jong-un: Good luck.


It was in 1999. Or, 14 years ago.
 
2013-02-22 11:44:53 PM
Why hasn't anyone talked about how fake this is?
 
2013-02-22 11:48:45 PM

blackySM2: Why hasn't anyone talked about how fake this is?


Because it's actually not.
 
2013-02-23 01:56:11 AM

cretinbob: dramboxf: cretinbob: Happens in station more than you might think. B

Laws, yes. M-O-O-N spells "Firefighter/medics drop in station all the damn time." And on the fireground, too.

We've lost 5 or 6 firefighters/EMTs/Medics in station or on a fireground in the last 7 or 8 years. One guy was the last you'd ever think had heart issues. Ran marathons, didn't eat anything that cast a shadow, trim, about 5'8 and 140lbs, dropped on the golf course. 39 years old. Standing chatting with his guys (he was a Captain), his eyes rolled back and he went down like a sack of potatoes.

There was a medic who was transporting a patient around here who went into sudden cardiac arrest and died.
I also had a patient who was having a massive cerebellar stroke, and the closest hospital that could deal with it (requires surgery) was about an hour and a half away, so of course we flew him out. Came to find out later they had just finished working one of their own they found deceased in his bunk at the station.

But again, everyone thinking they need to go out and buy an AED, it was the chest compressions that did the most good here. It was a witnessed arrest and he was in a rythm that could be interupted. An AED will not reverse asystole or restart your heart. There was a lot that was cut out of this, and my only complaint is that the editing made it look too easy.

Why yes, I expect to die in the back of an ambulance myself. I just hope I'm not transporting at the time.


I've had a couple of codes in the ICU on patients with arterial catheters, which allow you to actually see how effective your compressions are.  First, it's damn hard to get up to a MAP of 55 or so.  Second, when you finally adjust your compressions to reach that rate, you really DO get tired as hell after about three minutes.  You can keep going for longer, but you can actually see your compressions are no longer as effective.

I'm in pretty decent shape.  I run to work with 10 lbs on my backpack, up a few hills and average 8 minute miles over three miles.  Even I can't do more than 3 minutes of CPR without breaking into a sweat and sucking air.

/good CPR is frickin' exhausting.
 
2013-02-23 01:58:09 AM

blackySM2: Why hasn't anyone talked about how fake this is?


if it's fake, it's incredibly, incredibly well done, down to the most minute detail.  Easier explanation is that this is real.  And yeah, this is how calm and collected well trained helicopter paramedics are in emergencies, even with their friend on the floor.
 
2013-02-23 10:13:10 AM
I was on a Boy Scout hike last year and went into SVT/AVNRT in the mountains of New Mexico.  The ranger team got me to pavement where an ambulance met me for the ride to the hospital. I was treated very well by everyone along the way.  Heroes all in my case.

The care these lads gave their friend and coworker made me a bit emotional.  Heroes is too light a word.
 
2013-02-24 11:52:22 AM
Nice find, BronyMedic.  Very informative.  And somewhat scary.
 
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