Posted on 03/28/2018 2:41:40 PM PDT by Twotone
Actually (much to my chagrin) I have seen this happen — in our literature it called Lazarus Syndrome but unlike the two day linger described it is usually only about 3 - 5 minutes. And it does not matter if you recommence the code, the patient still goes on to pass. It is quite the thing however, when you call it quits, start cleaning up and there is a burst of something. Very well described in critical care literature with absolutely no positive outcome, and definitely an agonal event. But it does shake you the first time you see it...
There are of course three types of lies — Lies, damn lies and statistics presenting in a research project. I can devise almost any research project to be statistically analyzed to fit a preconceived notion. I think this study is very subjective and darn near impossible to validate. It certainly could not be randomized, blinded, or double blinded so I am not sure that to think about the actual work...
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Bump for later.
Not surprising - not a community hospital in the list - you know, where ‘real’ America lives.
I’m familiar with all of those listed (not their policy on DNR), particularly Stanford. Had a friend do a fellowship in cardiac CT/MRI there, unbelievable learning opportunity for him (he is brilliant to begin with) but he couldn’t wait to leave - the liberalism was ridiculous. It was a policy problem - not the staff - most of them are like you and I.
Seems like someone is out past their bedtime.
My Dad was a Paramedic. He was always full code. Sometime nurses and docs would want to argue about it. They would tell me how it was so much worse than you see on TV blah blah blah.
I just told them he was a tough old bird and a retired Paramedic, so I thought he probably knew what he was doing. Plus he was a volunteer fireman and veteran of WWII, and if he wanted to go down fighting, I figured he’d earned the right.
Call me when you are done with medical school and residency. Then I might be able to have a somewhat intelligent conversation with you. In the meantime please know that this behavior and your largely stupid statements are what gives EMS a bad name. Most EMS are good and decent people who do a great job. Some, like you, are frustrated doctor wanna be types and generally offer (their incorrect) opinion in order to somehow have people think they are something. We all have run into the likes of you and based your statements my guess is that you have harmed more than you have helped. Read your original post. Your first statement is that cpr is for people that have no pulse and no BP and that means they are basically dead. Dead people feel no pain. If you want to argue don’t be an idiot. Try to present some factually accurate data. There are others on this thread who have pointed out pain can be and frequently is felt despite altered loss of conscious. Of course if you give decent cpr there is blood pressure and rate which preserves neurological function. I am glad you can read an ACLS manual and think by regurgitating it somehow is gives your credence. It does not. It only makes you look foolish. My final response to you is the best advice I have ever heard. Never argue with an idiot ... for they shall reduce you to their level and defeat you with their experience. In the meantime if you wish to address me in disparaging terms at least use my proper title. It is Doctor to you Mister wannabe. Happily I will not waste any further time devoted to your tripe. You had opportunity to offer a cogent argument and three times failed to do so. It means you have nothin f to say useful. Good day
Yes, it the situation you describe you are right.
Ahead of time, you can still plan for other situations, with a durable power of attorney. Mine is on file with my doctor and either of the two hospitals I’m likely to need.
WOW this is great! It’s not every day you get to chit chat on-line with a a a a god!
No broken ribs? Burn marks from the paddles? Funky dreams from the jump start drugs? Brain damage from being out too long? Color me not believing a word of it.
It can also be a blessing. BIL who was 91 had advanced Prostate Cancer that had metastasized and was going downhill rapidly, was being given a sit down shower and his femur broke, chemo weakened his bones, his heart stopped on the OR table and of course at that age and advanced stage of cancer his affairs were in order and he had a DNR in place, saved him months of slow agony of dying of cancer and the pain that goes with it.
Mine has qualifications in it and only can be activated by my husband who has power of Attorney, as does his. Neither of us want to be the next Terri Shivo and dehydrated to death.
None of those things but I have to admit that getting all the tape and sticky things for the EKG off was quite painful and I did lose some chest hair, just not enough for a DNR though. Some might argue about the brain damage part but I swear I was like this before.
Actually I had a guardian angel working overtime that night. I had the heart attack and drove 20 miles towards the hospital. I called 911 to have an ambulance meet me part way to the hospital to save time. I got to the prearranged meeting place, parked my car and got into the ambulance. I went into V-fib about 60 seconds later. I wasn't very aware after that but everyone said that my heart did stop and that the guy did a heck of a job even though he didn't manage to break any ribs.
Whether you choose to believe it or not, I really don't care. That's what happened and I have enough of a pulse five years later to write about it.
You still don't get it. Each patient has the same condition. But a different age and presenting history. So here's a simple way to explain this to you.
Two pts enter the hospital for pneumonia. One has a DNR because she is 95 and also has COPD and CHF. The other is just 60 and has no DNR and neither of the two complicating conditions.
The elder one with the DNR dies. Yep she has a harder time recovering from the IDENTICAL CONDITION OF PNEUMONIA due to age and other things. The younger one survives the condition of pneumonia.
Hope this helps you to get it. There is no way on earth for them to control for each and every condition. Nor each med they take, etc.
Both of you have valid points. My point wasn’t about the validity of the research or how it was done, and I’m keenly aware of statistical manipulation. My point was that the journalist was reporting the results of the research (however valid or invalid). Hence objections to the journalism were unwarranted.
Great post...I can relate.
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