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Archive for July 1st, 2009

Too often, EMS crews feel obliged to bring unresponsive patient to hospital, study finds

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In the United States, paramedics treat almost 300,000 people with cardiac arrest each year. But despite what’s portrayed on TV, fewer than 8 percent survive, according to the American Heart Association.

The association’s guidelines include the recommendation that people who have not responded to cardiopulmonary resuscitation (CPR) and advanced cardiac life support in the field not be taken to a hospital. After paramedics have tried and failed to resuscitate a patient, they should stop, researchers say.

“Paramedics provide all the same lifesaving procedures that we can provide in the emergency department,” said the study’s lead researcher, Dr. Comilla Sasson, Robert Wood Johnson clinical scholar and clinical lecturer in emergency medicine at the University of Michigan Medical School.

“Once you have done 20 to 30 minutes of cardiac resuscitation, the best practice guidelines are to cease if a patient does not have a pulse,” she said. But the study, published online June 30 in Circulation: Cardiovascular Quality and Outcomes, found that several factors inhibit this from happening, including:

via HealthDay.

Most of the time when I get a patient like this, I find that the patient is ready to be declared dead within a couple minutes of arrival, but one is afraid the family will feel that no attempt was made if one stops that quickly.  The paperwork and burden of telling the family then falls on the ER doctor, who honestly knows very little about the case other than what the paramedics just told him.  I’m not sure what is the best option for this, but these cases can lead to significant crowding and disrupt the flow of the Emergency Department, and it would certainly be nice if they weren’t brought to the Department if it is not necessary.

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