Hello, with the changes to PCP medical cardiac arrest, since there is no longer a maximum number of analysis are we expected to continue to analysis the rhythm every two minutes on route to hospital if were transporting?. Seems like it would delay our arrival time a fair bit to pull over every two minutes especially in the county. Also, if a confirmed STEMI codes on route, should we be running a full 20 minute resuscitation before continuing transport, or would that be considered a reversible cause to transport after one analysis?. Thanks
Once you have initiated transport of a patient in cardiac arrest, you do not need to pull over every two minutes when assessing the rhythm. The practice of pulling over to fully assess the underlying rhythm is reserved for patients who have arrested enroute.
A confirmed STEMI would be considered a reversible cause and should be considered for early transport to hospital (as long as the underlying rhythm is not refractory VF/VT) regardless of whether the arrest occurs on scene or enroute.
Please note that the direction for a patient who arrests enroute has recently changed. Please see the updated direction (here) sent to SWORBHP paramedics June 22, 2023. The advised practice for a patient who suffers a witnessed arrest en-route to the hospital is to find a safe place to stop the ambulance and:
- Perform minimum one analysis.
- Utilize clinical judgement (utilizing multiple factors) to decide whether to stay and perform resuscitation:
- Perform one analysis and go (likely the majority of situations where rhythm is non-shockable)
- Perform three full analyses and go (ex. Persistent shockable rhythm)
- Perform three full analyses and patch for direction if it is believed the patient would benefit from ongoing resuscitation in a stationary ambulance (this would be a rare occurrence).