SF medics at Duke

[Muppet]

I got mixed feelings. Technically they did everything well (and by the way, external paddles can go down to 5 joules on a manual defibrillator, and intracardiac defib starts at 25 joules). From a systems standpoint that a lot of resources going into someone who was going to die. But people will say, "but Devil Doc, how do you know he was going to die?" Because traumatic arrests from penetrating trauma has less than a 3% of survival, if the arrest occurs within 10 minutes of an OR; and the fact they had to do CPR that long. Between not oxygenating his noodle, his kidneys, his lungs, the hypothermia, oh, he was destined to die.

That said: big, clanging brass balls for a non-MD to do an open thoracotomy. Gold claps.

Absolutely agreed

 

[TLDR20]

I got mixed feelings. Technically they did everything well (and by the way, external paddles can go down to 5 joules on a manual defibrillator, and intracardiac defib starts at 25 joules). From a systems standpoint that a lot of resources going into someone who was going to die. But people will say, "but Devil Doc, how do you know he was going to die?" Because traumatic arrests from penetrating trauma has less than a 3% of survival, if the arrest occurs within 10 minutes of an OR; and the fact they had to do CPR that long. Between not oxygenating his noodle, his kidneys, his lungs, the hypothermia, oh, he was destined to die.

That said: big, clanging brass balls for a non-MD to do an open thoracotomy. Gold claps.

I coded a traumatic arrest as a SOCM student on rotations. It was unclear if he had an arrest and crashed or the crash caused the arrest. He was fucked. The paramedics just used it as an opportunity for me to train. IO, tried to intubate, King LT, CPR, needle Decompressions. I got to do a lot of valuable training on that guy but he was dead as fuck. The trauma docs called it in .02 seconds when we arrived.

 

[Devildoc]

I coded a traumatic arrest as a SOCM student on rotations. It was unclear if he had an arrest and crashed or the crash caused the arrest. He was fucked. The paramedics just used it as an opportunity for me to train. IO, tried to intubate, King LT, CPR, needle Decompressions. I got to do a lot of valuable training on that guy but he was dead as fuck. The trauma docs called it in .02 seconds when we arrived.

We'd call those patients "skills lab" if we had a trainee. If I drove I drove routine traffic, no lights, no siren. I'd tell folks you had a higher chance of being hurt in an ambulance accident than that patient getting ROSC.

If in the ED we didn't see any muscular movement on US, we'd call it.

 

[Muppet]

I coded a traumatic arrest as a SOCM student on rotations. It was unclear if he had an arrest and crashed or the crash caused the arrest. He was fucked. The paramedics just used it as an opportunity for me to train. IO, tried to intubate, King LT, CPR, needle Decompressions. I got to do a lot of valuable training on that guy but he was dead as fuck. The trauma docs called it in .02 seconds when we arrived.

Where did you ride?