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Top 10 signs your agency’s cardiac arrest protocols need updating

Do your agency’s cardiac arrest protocols make it possible for your patients to achieve ROSC and later attend a survivor celebration?

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If you still use one of these, it may be time for a change.

Image Greg Friese

In a recent Facebook post linking EMS1’s article on 10 tips for organizing a cardiac arrest survivor celebration, I jokingly commented, “Step 1: Have survivors,” and went on to point out that if you still routinely transported cardiac arrest victims to the ED with CPR in progress, or intubated every arrest victim early in the resuscitation, or believed that antiarrhythmics are the key to an effective resuscitation, you’re not likely to have many survivors.

And then I said to myself, “Self, some agencies actually still do operate like that, and their crews are none the wiser.”

So if your last cardiac arrest save dates back to the days when the ACLS course was on 35mm slides and the books had white covers, I give to you the Top 10 Signs Your Agency’s Cardiac Protocols Need Updating:

10. You still repeat to yourself, “Little shock, big shock, everybody shock.”

9. Your procedure for treating cold water drowning arrests includes rolling the patient over a barrel.

8. Your supply officer complains that it’s getting hard to find code drugs with intracardiac needles these days.

7. Your defibrillation procedure includes the phrase, “Twenty-five pounds of paddle pressure.”

6. Your supraglottic rescue airway is an Esophageal Obturator Airway.

5. Any crew members at your agency under the age of 40 know what an EOA is.

4. You stock more tourniquets than any other agency in your state … because you need at least three for every CHF patient, to rotate around their limbs.

3. Your dosing guidelines for nitro and morphine are in grains.

2. You’re the most progressive agency in your county because you administer fibrinolytics in the field … and the fibrinolytic you use is streptokinase.

1. Your medical director consults with his colleagues over the ongoing drug shortages, but none of them seem to know of an alternate source for Bretylium.

Got any of your own? Share ‘em in the comments!

Kelly Grayson, AGS, NRP, CCP, has been a critical care paramedic and EMS educator for over 30 years. Kelly is a passionate EMS advocate and a frequent regional and national EMS conference speaker, podcaster, and contributing author to several EMS textbooks. He is the author of the bestselling “Life, Death and Everything In Between,” trilogy of EMS memoirs, the editor of the “Perspectives” emergency medicine and public safety anthologies, and many short stories and fiction novels. He lives in the North Country of New York where his patients constantly ask him about his Louisiana accent.