Relatively Obscure: The more you eat the more you fart: Diaf.My experience has literally saved hundreds of lives, farkwad.Dont talk about things you have no.actual knowledge about.The more you eat the more you fart: but you CAN bring a braindead person back with it.Take your own advice.
The more you eat the more you fart: So...shenanigans for YOU as well, for making assumptions about a situation that you know nothing about. Very apparent that you are completely unfamiliar with what it is like working in a hospital or LTC facility.
lizyrd: Yeah, I don't always get along with hardinparamedic, aka BronyMedic. Mostly about the role of my union in the EMS field. But he's pretty damned knowledgeable about the healthcare industry as a whole and EMS specifically. He's demonstrated this more than once. I wouldn't go around accusing him of ignorance when it comes to stuff like this.I think you're missing the word "successfully" in his declaration about no one being successfully sued for performing CPR when indicated. I'm not prepared to call you a liar about your friend getting sued, but did he lose? If he won the lawsuit, then he was not successfully sued. I've been unsuccessfully sued because someone hit the parked ladder truck I was driving, it was a big waste of my time but didn't cost me anything else.
The One True TheDavid: nmemkha: [Y]our(sic) not a 87 year old having a heart attack, nor are you standing there watching your mother die.Saying you would now is easy.If letting my mother go was called for I'd have no problem with it. Why cave in her fragile ribs and maybe leave her brain damaged from lack of oxygen? She's miserable enough already.That remind me, I've got to update my Final Directive to make it VERY clear they should "Just let me die damn you!"How many languages should I have "Do Not Resuscitate" tattooed on my chest in? English, Spanish and Chinese sound obvious, but there should be no doubt.
WhoGAS: Good to know all the differences around the region. Three years ago, the CPR classes taught here in Poway were just teaching and certifying with no breaths.
BafflerMeal: RandomRandom: JMacPA: That's great and all, but is CPR going to make her any deader? What exactly are the negative aspects of an attempt?It's torture, it breaks ribs, it doesn't work.The vast majority of retired physicians in nursing home end-of-life situations do not sign releases for CPR. They know it doesn't work and have no desire to be tortured by the practice in their last moments of life.It's not evil or cold to deny CPR to the nursing home population. Given that it doesn't work on them, absence of CPR is just more compassionate.I have broken so many ribs in my time with CPR. From infants to elderly I have never seen CPR work. Cracked chest or not. Anecdotal to be sure, but people outside of health care still seem to think it's magic.
hardinparamedic: Dictatorial_Flair: A lot of people in this thread have not seen the aftermath of being "saved" by CPR. I hope you never have to.I've had a person walk up to me, shake my hand, and tell me thank you for doing CPR on them two years after I did it.I've seen a 17 year old athlete survive after two hours of CPR while being crashed to ECMO for myocarditis, neurologically intact.I've also seen people live long enough to have their family say goodbye to them, and die in the surrounding of their loved ones rather than alone in the middle of the grocery store.And I've seen people end up in the nursing home from it.That's not going to stop me from doing my job, and doing it for people who need it. Because I don't get the choice to play God, and decide who's going to have a CPC outcome of 1 when they walk out of the hospital. I do what I do because I know it's the best chance that patient has to survive, and I act on the assumption that they would want to live until proven otherwise, or it's proven to be futile to resuscitate them.No healthcare provider gets to make that choice, and even Doctors have to justify why. The thought that people wouldn't help another human being because it "might not work" is sickening, and contrary to the oath every healthcare provider - nurse, RT, MD, DO, Paramedic - takes when they enter their profession.CPR doesn't work every time, for a myriad of reasons. Some reversible in the field, some not. It's not a magic bullet like TV portrays it, but it is the best, and only chance for survival in a patient who is in a non-perfusing rhythm.
hardinparamedic: Also, thanks finnished for the month of TF!
hardinparamedic: lizyrd: Yeah, I don't always get along with hardinparamedic, aka BronyMedic. Mostly about the role of my union in the EMS field. But he's pretty damned knowledgeable about the healthcare industry as a whole and EMS specifically. He's demonstrated this more than once. I wouldn't go around accusing him of ignorance when it comes to stuff like this.I think you're missing the word "successfully" in his declaration about no one being successfully sued for performing CPR when indicated. I'm not prepared to call you a liar about your friend getting sued, but did he lose? If he won the lawsuit, then he was not successfully sued. I've been unsuccessfully sued because someone hit the parked ladder truck I was driving, it was a big waste of my time but didn't cost me anything else.Check your email. :)I'm not trying to call him a liar. I just think that he has the facts of what he's saying incomplete, or there is something going on that he was not aware of.It'd be pretty ground-breaking to see someone in healthcare successfully sued for providing the standard of care without malpractice or negligence for something like CPR. I don't think it would be something that would have been kept local either - it would have made national news, if not in trade publications, then in the mass media.
lizyrd: Almost as bad as the lawsuit fearmongering is the attitude that "it doesn't work, and she was old, so why bother?" Certainly, I may be DNR at that age and situation, but who am I to tell anyone else what quality of life is worth living compared to death?
1. Put snakes on plane: hardinparamedic:Hey. Just wanted to say I appreciate what you do, both here and out in the real world.
hardinparamedic: And, to be fair, you CAN get a veggie back by doing CPR
FarkinSneakyBastage: Can I please have the freedom to choose how and when I die and not rot to death in one of these depressing shiatholes they call a retirement community? That'd be great, thanks
Relatively Obscure: hardinparamedic: And, to be fair, you CAN get a veggie back by doing CPRNot if they've suffered legitimate brain death.
nmemkha: BarkingUnicorn: nmemkha: BarkingUnicorn: nmemkha: Don't Troll Me Bro!: It's hard for me to blame someone for deciding not to throw away their job (possibly career) to keep an 87y/o "alive" for a couple more years at most.What if it was your mother? Or you? Would you feel the same?Yes, I would. An 87 year-old who survives such an incident is very unlikely to enjoy her remaining days.Much of the dying's suffering is caused by their survivors.You say that now, but your not a 87 year old having a heart attack, nor are you standing there watching your mother die.Saying you would now is easy.Yes, it is easy now. My mother died in 1995, as I watched. It was the best thing that could have happened to her, and I'd have been a poor son had I clung to her.Did she die alone and sacred on the floor of some two-bit care facility as people just stood and gawked at her?Would you have been pissed if she had?
catzilla: Comedy gold right here....
Dictatorial_Flair: A lot of people in this thread have not seen the aftermath of being "saved" by CPR. I hope you never have to.
hardinparamedic: starsrift: Ahhh. Didn't see that one, both TFA and and the local story didn't mention she was DOA as that sentence suggests, only that she "later died".I'm not trying to be an asshole to you, either. Sorry if it comes off as such. I'm getting off a 24 hour shift, so mondays and all.The problem is, and it's been pointed out over the course of the thread, that the nurse didn't just tell the dispatcher that she disagreed with him, and that she felt he was breathing adequately, if not in distress, but rather that she absolutely refused, and she's on tape as saying her facility policies will not let them perform CPR.The facility is going to stand behind her now because they have to circle the wagons with that statement being public knowledge. By now, I'm willing to bet the State Nursing Board, as well as the Long-Term Care facility licensing board have begun an investigation into the matter.
BarkingUnicorn: Under California law, unlike at a nursing home, staff members at independent living facilities are not legally required to provide medical aid, according to Mary Winners, an expert on senior care."It's really more like a hotel where they will offer you concierge services, you'll get meals, they'll have housekeeping, they'll change your bed, but you can't even get care," she told TODAY.As for the nurse, she has no legal obligation to put herself at risk of losing her job. We might admire her for doing so or scorn her for not doing so, but that has nothing to do with her license.
hardinparamedic: 1. Put snakes on plane: hardinparamedic:Hey. Just wanted to say I appreciate what you do, both here and out in the real world.I really appreciate you saying this, but, there's a lot of people on FARK that deserve that. Not me. Medic Zero, Lizyrd and many others also do the same job as I do, and they deserve it just as much. As much BS and crap as Lizyrd puts up with being a Fire/EMT, I'd say he deserves a lot more.I may rib him because he's a damn union hosejock (:P), but he's a good guy.I just do what I'm good at. I come off as an asshole at times to people, but eh. Everyone does.
Dumski: Ps. I always enjoyed the old macho Fireman/Paramedic rivalry. What a hoot. I hope you know where my support lies. ;)
Dumski: Don't forget that the source is a news story. "Facility policy" is a bit of a stretch. More likely that is part of the directives for staff, residents and family that they (resident/family) agree to when admitted.Also, I'm glad you said that you actually worked in a care facility as a CNA. So many paramedics have no idea what working in a health facility is like, and therefore have no business giving judgements on the abilities or skill levels of the staff. We are all in the same business of caring for sick people.
hardinparamedic: Dumski: Ps. I always enjoyed the old macho Fireman/Paramedic rivalry. What a hoot. I hope you know where my support lies. ;)Since you worked in the ER, I'm going to assume with whatever one you were sleeping with at the time. :P
Dumski: Your descriptions of what you encountered are not good. I guess I am talking about the hospital employed Nurses rather than LTC ones. I live in Canada, and everyone is working with bigger patient loads and sicker patients. As we Baby Boomers start the downward slide, the system will get even more bogged down. I'm glad I'm out.
hardinparamedic: Considering the failure to provide CPR when indicated constitutes gross negligence or incompetence, depending on the situation, if what is being portrayed here is true then this woman has a good chance of losing her license if her actions were put to the reasonable nurse standard.At any rate, this woman has no future in nursing. No place will hire her after a foul-up this big.
BarkingUnicorn: Oh, I think any employer that wants employees to follow orders regardless of their personal feelings would have a look at her.
BarkingUnicorn: The nurse might lose her license if she was performing the job of nursing at the time, or representing herself as a nurse to residents who reasonably relied upon her representation to their detriment. A nurse is under no obligation to render aid while she's moonlighting as a stripper. It appears that the old lady's contract specified that no medical care would be provided. The old lady's daughter, who is also a nurse, seems to understand this.
BarkingUnicorn: Do you understand that a doctor has no obligation to give you CPR if you collapse on the street while he's walking by
BarkingUnicorn: or even if you stagger into his office without an appointment?
BarkingUnicorn: Now, a doctor in an ER is holding himself forth as someone prepared to treat strangers at any time; but in a private practice, a walk-in is a trespasser to whom no duty of care is owed automatically.BZZZT. WRONG. Big Whammy, no money on that stop. He has a legal obligation to provide basic-level care and stabilization to the extent of his abilities, while awaiting the arrival of an ambulance to transport the patient to a hospital. If you stagger into a doctor's office and he refuses to even just call 911, he's failed to fulfill his duty to act - created when you said you needed help in an office which advertises a physician service.That MD does not have to see you and treat you in his office, but he does have to ensure you are sent to equal or higher level of care if you collapse in his office.At any rate, these are completely unrelated situations.BarkingUnicorn: You are strangers; no relationship exists which creates an obligation to you.
erewhon: Abacus9:Hmmm... I take your word for it. I've heard though that once the heart stops, they're already dead, so you can't really harm them any further. Although I guess that depends on the case and their wishes. Sounds like a rough thing for the patient, but also for the paramedic to have to do.I guess you get used to it, I really never expected to have to use the training. But so far, three arrests and a Heimlich under my belt. The Heimlich was the most gratifying in that I popped that chunk of food about 4 feet when I hit the right spot, and the guy was immediately better. The CPR episodes were more like and 15 and 16 and (crack) oh my god and 18 and 19 (crack) jesus palomino and 21 and...Of course, when the guys got there and relieved me it was "well, he was dead anyway" but still, it's sort of stressful to do to someone you aren't mad at.The really odd thing was the bystanders, you get the wildest suggestions. "Here, stick this candy in his mouth!" Well, no, I'm pretty sure this isn't hypoglycemia...
digitalrain: Abacus9: Lady Indica: To my knowledge (and I could easily easily be wrong here) there's times where breathing alone is called for. I would think this would be one. Drowning is another. Other than that AFAIK, chest compress is most important (to the tune of Stayin' Alive).Oddly, "Another One Bites The Dust" also works (roughly the same beats per minute)...But its not nearly as optimistic...
hardinparamedic: BarkingUnicorn: Oh, I think any employer that wants employees to follow orders regardless of their personal feelings would have a look at her....The Nuremberg Defense?
thehobbes: Actually a doctor in a private clinic is under no obligation or legal responsibility to act. Morally, yes, legally, no. EMTALA does not apply to non-emergency facilities. It is his liability, business policy, as well as a possible BSI concern as to whether or not chooses to act. I've been to multiple doctor's offices and some urgent care centers for patients who were not going to be seen by that clinic due to the lack of accepted insurance.
thehobbes: I've walked into many arrests that went to hell (arrested) on us as we walked in
thehobbes: If patient was breathing, then odds are they were perfusing the brainstem. Any respiration will negate an BLS response.
thehobbes: Those respirations won't last long, and when they stop, BLS/EMR responses will go into play. Admittedly I've seen high quality CPR w/ advanced airway actually cause spontaneous respirations over 50 minutes after BLS efforts started.
thehobbes: Read my earlier post about CPR and ALS interventions if you need.
thehobbes: People can be sued, dispatchers are medics who can't hack the streets IMO, so quit trying to persecute them.
thehobbes: 87 year old people won't meet most ER Doctor's criteria for progressive therapy. you know that.
thehobbes: My service allows us to pronounce if dead when we arrive....
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