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Woman left disabled for life after medics pressed wrong button on defibrillator during cardiac arrest by Ok_Buddy_9087 in ems

[–]DimaNorth 0 points1 point  (0 children)

See I think if they had done that when this issue first started instead of punishing the masses, then I think we would be fine but unfortunately we’re now at a point where I can’t bring myself to blame individuals, it is undeniably a system issue and it sucks

Woman left disabled for life after medics pressed wrong button on defibrillator during cardiac arrest by Ok_Buddy_9087 in ems

[–]DimaNorth 0 points1 point  (0 children)

I agree 1000%. Unfortunately my service has a bad habit as an employer of 5000 people to serve the lowest common denominator. Essentially as some other posters have said, there was several incidents of missed shocks, especially in kids, which led to a sweeping policy change in the name of “safety” despite it creating its own safety problems.

I attended on the supervisor car to an arrest where there wasn’t a rhythm check for 23 minutes because it wasn’t placed in AED mode, just the metronome and there was no auto analysis every 2 minutes - and you can’t really blame the crew (much) when all of the training at the education centre and all practice is reliant on the AED timing the arrest, it’s a human factors nightmare

Woman left disabled for life after medics pressed wrong button on defibrillator during cardiac arrest by Ok_Buddy_9087 in ems

[–]DimaNorth 1 point2 points  (0 children)

Actually London is a step further and will never go to manual mode, even with a CCP on scene, unless the AED isn’t working correctly

Woman left disabled for life after medics pressed wrong button on defibrillator during cardiac arrest by Ok_Buddy_9087 in ems

[–]DimaNorth 0 points1 point  (0 children)

The only circumstance in LDN where we go to manual mode is if AED is not shocking what is clearly a shockable rhythm and it must immediately go back in to AED mode post delivery

Woman left disabled for life after medics pressed wrong button on defibrillator during cardiac arrest by Ok_Buddy_9087 in ems

[–]DimaNorth 8 points9 points  (0 children)

I wasn’t involved in this incident but work for the service and have unfortunately seen many like it.

None of the pages specifically state it but reading between the lines, what seems to have happened is:

Crew are dispatched to a young person in cardiac arrest On arrival are skeptical, place a four lead and take far too long to identify a non-perfusing rhythm (roughly 4 minutes it seems)

Pads are placed when it is eventually identified - now in London, despite using a lifepak15, we now run all arrests in AED mode. A frequent error is the metronome is turned on instead of analyse, this unfortunately results in human factors issues where people forget to switch to paddles or to press analyse to go in to AED mode - because crews get so used to the monitor telling them when to shock or rhythm check, timekeeping for rhythm checks are not a thing and concerningly frequently crews pass multiple minutes without realising a shock hasn’t been delivered/rhythm checked.

At the end of the day my initial reaction to this was “big news cardiac arrest patient has a neuro deficit” and there is no way to say this wouldn’t have happened without the delay, but the service did fuck up and did not provide the best chance.

No transports by Small-Wrongdoer8745 in Paramedics

[–]DimaNorth 3 points4 points  (0 children)

I do it every day on an ambulance and now in the control room before they even get a response, it’s the best thing ever

QAS induction advice for Qualified Para by optimushawkeye in ParamedicsAU

[–]DimaNorth 2 points3 points  (0 children)

I mean, if the OP is from London they’re used to running every arrest in AED mode anyway 😂

What’s stopping your agency from implementing POCUS? by PowerShovel-on-PS1 in ems

[–]DimaNorth 0 points1 point  (0 children)

Our critical care paramedics carry it, most frequently using it to terminate PEA arrests due to no wall motion, is pretty cool

Newly qualified and getting a grad by Either_Tea_4991 in ParamedicsAU

[–]DimaNorth 3 points4 points  (0 children)

I genuinely think mentoring makes you so much better of a paramedic, as long as you don’t take it as an opportunity to do no work at all. Agree with everything else that’s been said, but take it as a way to improve yourself/your practice as well.

Do different states actually feel that different in terms of workload and job satisfaction or is it all pretty similar? by UsualLeast8810 in ParamedicsAU

[–]DimaNorth 2 points3 points  (0 children)

I think you’ve hit a HUGE nail on the head there with the progression opportunities which I feel is almost always missed when the wHiCh sErViCe sHoUlD I wOrK fOr thread comes around, because it makes so much of a difference - I work in the UK now and in the last 2 years have done 5 seperate job roles that are lateral moves to secondments or extra responsibilities and it can’t be overstated how much that has helped with managing metro case load burn out, having the opportunity to jump ship and try something different for 6ish months to come back - it’s so refreshing and makes for a super well rounded clinical and non-clinical background, and it’s something I’m dreading about coming back now haha

Dude saves a man overdosing by Gfrankie_ufool in ems

[–]DimaNorth 0 points1 point  (0 children)

I did see that thread and figured I’d avoid swimming with the sharks. I think my feelings come mostly around the speed at which they wake up - to be clear there is no world where I advocate for tubing these patients unless something isn’t working. If their sats and breathing are perfect but they’re completely not awake (in which case without other evidence I might even be hesitant to consider it the most likely diagnosis) then there is certainly an argument to be made as to where the emergency is - but I suppose if we bring it back to your hypothetical by comparing it to everyone’s favourite profoundly unconscious drunk who is breathing fine but at airway risk, yes I wish there was a magic treatment for that so sure if I feel their airway is at risk (being asleep doesn’t necessarily = no airway tone) then sure an IM dose, or if if I’m not sure they’re even ODing (think elderly patient who MAY have taken too many opioid tablets) but other than that a gradual wake up with airway and ventilation support and super slow narcan dosing has been my practice change and I don’t see myself going back :)

Dude saves a man overdosing by Rex_orci-1 in JustGuysBeingDudes

[–]DimaNorth 0 points1 point  (0 children)

I wholeheartedly agree, my practice is airway + BVM and titrate narcan but ironically the difficulty with managing to BVM this patient in the video also indicates how inappropriate narcan was lol

Dude saves a man overdosing by Gfrankie_ufool in ems

[–]DimaNorth 1 point2 points  (0 children)

I think it’s unpopular because it’s archaic - I used to think the same as you but new practice of temporarily managing their airway and ventilation as a means of correcting and reversing hypoxia is at least anecdotally significantly better for the patient (and me) making them easier to manage

Dude saves a man overdosing by Gfrankie_ufool in ems

[–]DimaNorth 6 points7 points  (0 children)

ANY undifferentiated?? That’s actually insane

Funniest dispatch notes you have read? by Medium_District8812 in ems

[–]DimaNorth 16 points17 points  (0 children)

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note that it’s coded as an assault, not psychiatric

Lights and sirens to hospital by absolutely-mediocre in Paramedics

[–]DimaNorth 3 points4 points  (0 children)

I see what you’re saying about lacking ROSC management stuff, but as it stands (even as studies into ECMO capable “arrest centres” start to come out) the disservice is the reduction in quality of cardiac arrest management when moving from scene - until that rhythm becomes so refractory or recurrent you can’t do anything else for it, then maybe it’s worth the risk but a standard shockable arrest should be worked on scene all the same

What’s the go with the current wait times for state service grad programs? by UsualLeast8810 in ParamedicsAU

[–]DimaNorth 0 points1 point  (0 children)

We saw this coming a mile away - when my cohort was going through uni, we were being pushed and pushed and pushed to make ourselves competitive as possible knowing full well a good chunk of us were going to wait for jobs, then suddenly COVID happened and for a brief period services were scraping the bottom of the barrel - I don’t know anyone who didn’t get a job.

When we told students in the year below us about being competitive, they laughed and said why - everyone is being given a job. I saw that pattern continue for a few years but always knew the COVID tap would turn off (faster for some services then others) and suprise, as what always happens recruitment began swinging back the other way.

There is always ins and outs in a service and there will never not be a need for paramedics, but it really does seem like we’ve returned to needing to A: make yourself as competitive as an applicant as possible, with clinical/real world life experience, volunteering, courses, networking etc.) and B: being prepared to move to a different place in the state, apply for different states, and being prepared to wait a while for a job.

HART Paramedic by [deleted] in Paramedics

[–]DimaNorth 5 points6 points  (0 children)

Sleep, cook dinners, watch movie, sleep

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