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Home > Topics > Ambulances / Emergency Vehicles

Maine medics triple cardiac arrest survival rate

Paramedics have started treating patients on the scene instead on en route

Seth Koenig
Bangor Daily News

PORTLAND, Maine -- Portland paramedics have nearly tripled their success rate in the past year of saving patients who have suffered cardiac arrest, in large part by providing emergency services on the scene and avoiding time-consuming ambulance rides to local hospitals.

The latest data, shared with city first responders Tuesday during a regular monthly review of best practices, provide statistical reinforcement to a new wave of emergency medical protocols being implemented statewide. The trend of treating patients on-site -- instead of en route -- has become the latest standard in Maine, but until now, there was only anecdotal evidence of its effectiveness widely available.

Full story: Maine medics triple cardiac arrest survival rate

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Kevin VanDaele Kevin VanDaele Thursday, November 29, 2012 4:39:48 PM This is common practice in Southeast Michigan .... we don't transport unless we get pulses back ......
Jen Turner Jen Turner Thursday, November 29, 2012 5:03:16 PM Yeah, I don't really see how this is a big deal. They are doing the same thing I've been doing for 6 years, I'm in MI, too. We don't transport anyone unless they have a pulse, period. I've had to have "the talk" with many, many families.
Todd Wadsworth Todd Wadsworth Thursday, November 29, 2012 5:09:16 PM We are just ahead of the game in Michigan. I am glad that they have made the changes necessary to improve patient outcome.
Jack Ahern Jack Ahern Thursday, November 29, 2012 5:18:29 PM Matt is a great doc, had the pleasure of working w him while he wwas in Boston!
Paul Barson Paul Barson Thursday, November 29, 2012 5:29:59 PM We hav
Chris Dye Chris Dye Thursday, November 29, 2012 5:51:14 PM One of the best continuing-education sessions I ever got to be a part of was all about how to deliver this sort of news. Should be a part of everyone's training.
William Weq William Weq Thursday, November 29, 2012 6:04:39 PM How many walk out of the hospital?
Mark Sachen Mark Sachen Thursday, November 29, 2012 6:05:07 PM We work our codes on-scene as well. I agree with Chris Dye.......delivering bad news is something everyone should be trained in.
Rod Sholty Rod Sholty Thursday, November 29, 2012 6:29:54 PM We were doing this in 1997 in Palm Springs, California. A few rounds of em. Not trying to sound cold but dead is dead.
Melinda Teaster Williams Melinda Teaster Williams Thursday, November 29, 2012 7:19:59 PM I guess being from a rual EMS system we have been doing this for the 13 years I have been working. The first time I had to tell the Family I also had to then turn and say by the way the only way to get your family to our ambulance is going to be with that back-hoe. The Bridge had been washed away.
Zoey Bear Tur Zoey Bear Tur Thursday, November 29, 2012 8:24:55 PM L.A. City and County has been doing this for 30 years.
Ray Pope Ray Pope Friday, November 30, 2012 5:58:13 AM We just started introducing this in our county and have already noticed an increase in ROSC. It works period.
Jeff Dodge Jeff Dodge Friday, November 30, 2012 6:07:28 AM Working medical arrests on scene has been standard in Ontario for quite some time. We run the whole ACLS protocol (for Advanced Care Paramedics). With BLS Medics, they run 3 "non-shock" analysis before calling for termination. We really only transport ROSC's and non-asystolic trauma VSA's that are close to a hospital.
Don Leuchtag Don Leuchtag Friday, November 30, 2012 6:19:56 AM What they are doing makes sense. What I would however is some type of mechanical CPR device. We use the Life Stat units and have one on each truck. Once these units are applied and an airway is placed it takes over everything. We can litterally transport with one person in the back of truck. We have also gotten AED's in the police cruisers of the communities that we serve. They will always get to the scene befor we do. Rapid CPR and AED application are key to increasing survival.
Bob Kellow Bob Kellow Friday, November 30, 2012 6:55:10 AM ROSC is not "survival."
Friday, November 30, 2012 10:31:49 AM Who works a code, outside of trauma, only enroute anyway? Everywhere I've been we set up shop and work them. A couple other concerns: 1. Are the "on scene pronouncements being counted as a code failure or not? Or is it only those transported being counted? This will greatly impact the saving of "3 times as many." 2. What is the success criteria? Is it return of spontaneous pulse? That last one has always concerned me. There's an assumption we are altruistic and honest, but the egoist, in order to find favor and have saved a successful code could chart a pulse on arrival at the er and no one would ever be the wiser. I worked for a very large service once and for a short while they had this "code save" catergory as points contributing to the yearly pay raise evaluations I immediatelt argued that this can't be a criteria as we're rewarding some for pure chance - codes are not disbursed among all the paramedics - and since 100% chart audit was one of my duties we saw an increase in "saves" after that was posted and a save is return of spontaneous pulse - or having a pulse arriving at the ER. uh uh.....yeah no one one would cheat on that. We had a one paramedic one basic EMT system and fire were not paramedics, so it was the paramedic and the paramedic alone that made that call and charted. And they went up when it meant money. Were they more aggressive? I don't think so. Were they "feeling" a pulse now - who knows, but they were writing it down more. Reminds me of Obamascare policies - rewarding doctors if their patient "loses weight" or quits smoking, etc and I say if a pen from a pharm rep supposedly influences a doctor, do we not think the bonus money will. Bet many docs start charting much more in the way of success (fraudulently I mean) since only they really know and most patients don't ever see their own charts to debate that - same with obamaites and teachers - reward "successful" teachers with money.....well if I'm a teacher my kids are all miraculously passing now.
Scott Hughes Scott Hughes Friday, November 30, 2012 3:22:48 PM I am a former paramedic in Wake County North Carolina and we have also been doing this for years with great results.
Daniel S. Syme Daniel S. Syme Saturday, December 01, 2012 6:22:09 AM I see how this works in an urban professional system where numerous highly trained responders are nearby but I still believe that in a rural or rural-suburban setting where the paramedic may be the only paramedic within 10 miles or more and most of the responders are volunteers with limited experience load and go is still the best protocol.
Kim Tackaberry Kim Tackaberry Saturday, December 01, 2012 1:45:18 PM We have been treating MI's on the scene since the early 90's. I am totally baffled that this is something new. That's why we were called Mobile Intensive Care Units.
Christopher Maloney Christopher Maloney Monday, December 03, 2012 3:57:16 PM I'm with Don, get a "geezer squeezer"..saves a ton of fatigue and saves the available crew for drug and IV therapy. In these 2 person crews, we need all the help we can get. As far as family notification, leave it to the hospital, transport anyway..what are ya going to do, toss em back off and leave?

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