Pearl #9 Don’t Be Prisoner to the Clock

Don’t be held prisoner to the clock. Stay and work the patient as long as believe you have a shot. There is nothing magic about twenty minutes. I have on several occisions shortly after the 20-minute limit was talked about, gone into another room or out to the ambulance to call medical control for permission to presume only to return and find the patient has regained pulses. That’s epi for you. Our state protocols now, use a guideline of 60 minutes for some patients.

I met a man the other day who had survived 50 minutes of CPR, and while he said he felt mentally slower, he could walk, talk, drive a car, work a job, pay taxes, and live and love and enjoy his extended family. I worked with an old partner of mine who had been out of EMS and was back now. At 20 minutes, he started pointing to his watch. By 30 minutes, he finally, said, Pete, we gotta go, we’ve been here a half an hour. I looked at him and said, we’re not going anywhere. 10 minutes later we had pulses.

Not everyone who has extended CPR is going to have a good outcome, but people who get concentrated unhurried CPR are likely to have a better outcome that those who get strapped to a backboard and rushed down two flights of stairs with compressions on the landings.

 

1 Comment

  • David Bowden says:

    I had a ROSC pt who was coded for 4 hours. When I walked in, he was looking at me and trying to talk with a tube in his mouth. Granted, he coded in a PCI capable facility.

    My GF worked with a woman who was coded for an hour and, while she won’t go back to being a firefighter, she will be able to go back to a meaningful, less physically demanding, job.

    Great write up.

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