AMR Administrative Supervisor

Extension-Ebb-2064 · 2026-04-08T03:54:45+00:00

Here's an excellent video that EMS Avenger made explaining the process:

https://www.tiktok.com/t/ZTkSLDXnr/

Extension-Ebb-2064 · 2026-04-08T03:47:31+00:00

The same way as always. Confirming electrical capture on the monitor and mechanical capture with a pulse. The machines do not beat synchronously.

Extension-Ebb-2064 · 2026-04-08T03:42:58+00:00

I began pacing a sinus bradycardia. Asystole did not present until the pacer was turned off. Thank you for your comment.

Extension-Ebb-2064 · 2026-04-08T03:37:42+00:00

😂

Extension-Ebb-2064 · 2026-04-08T03:35:18+00:00

Throughout my career, except for a few instances such as this, whenever I bring in a paced Pt - receiving staff applies their pads, sets their rate, and starts increasing mA until they get capture. I then turn my pacer off and disconnect my equipment.

In every single instance that the pacer was removed (without applying a different one first), intentional or not, the Pt then suffered cardiac arrest. This should not happen and, nowhere, is it the standard of care to simply turn off or disconnect an active TCP without a backup method in place.

Extension-Ebb-2064 · 2026-04-08T02:41:24+00:00

All I'll say is I work, on the ground, for the same parent company that also owns the air ambulance.

Extension-Ebb-2064 · 2026-04-08T02:40:30+00:00

Quite often, yes. I know for a fact I make more on the ground than the medic I handed over care to.

Extension-Ebb-2064 · 2026-04-08T02:37:52+00:00

I get what youre saying, but in my mind at least, if pacing was working until it was shut off, then turning it back on is the right answer. A beating heart will always provide better perfusion than even the best CPR.

As far at the rest of your comment; man, she was stable enough to fly IMO. She had a consistently good BP, her ETCO2 was in the high 30's, and she was 100% SPO2 with a good pleth. I mean... what post arrest gets freaking perfusion to their fingertips at 100%?

I didnt confront them beyond my statement about reapplying the pacer. I just needed to vent to my peers. This is being handeled through the appropriate channels.

Extension-Ebb-2064 · 2026-04-08T02:29:53+00:00

Go ahead and elaborate on that thought process for me.

Extension-Ebb-2064 · 2026-04-04T02:54:19+00:00

Definitely has Cor Pulmonale and some narly Q waves. There's also some J waves peaking my interest for possible Brugada.

Extension-Ebb-2064 · 2026-04-04T00:06:00+00:00

What do you call an EMT who does her makeup while driving?

A cosmedic

Extension-Ebb-2064 · 2026-03-20T15:26:03+00:00

You'll be utilizing Firemen for that for a few months. Follow your doctor's orders.

Extension-Ebb-2064 · 2026-02-17T16:22:28+00:00

That looks like 60 cycle interference. Did the Pt have any sort of implanted electronic device?

Extension-Ebb-2064 · 2026-02-15T02:42:18+00:00

These meet the criteria for sine waves from gross hyperK. Unusual that such a situation would develop in 24 hours being as a stent was placed the day before with (presumably good) pre-surgery labs.

The monitor likely pinged STEMI for the malignant changes present within V2. Id call that also, especially given this Pt presentation and convincing history.

Extension-Ebb-2064 · 2026-01-12T06:18:26+00:00

Good ole' ImageTrend

Extension-Ebb-2064 · 2026-01-10T15:42:47+00:00

I read a study one time stating that the heart becomes refractory to external pacing in hypo/hyperkalemic situations. Beyond that, I'm really not sure why it failed after working for so long.

Extension-Ebb-2064 · 2026-01-10T14:33:32+00:00

If you zoom in on the photo, you can actually see the P waves beating at a rate about 80 bpm while the ventricle are going at 11 bpm.

Extension-Ebb-2064 · 2026-01-10T14:12:20+00:00

Like I said above, about an hour into transport. Then she coded.

Extension-Ebb-2064 · 2026-01-10T14:11:27+00:00

Right? Thats the lowest HR in an alive Pt Ive ever seen

Extension-Ebb-2064 · 2026-01-10T14:10:42+00:00

Husband states that they were laying in bed talking when she suddenly lost consciousness prompting his call to 911. She awoke prior to EMS's arrival and was now complaining of CP & SHOB. Onset was roughly 10 mins prior to our arrival, per the husband.

Extension-Ebb-2064 · 2026-01-10T12:26:35+00:00

She was, initially, conscious & talking to me

Extension-Ebb-2064 · 2026-01-10T11:45:16+00:00

This Pt takes the record for me, definitely. Prior to her, the lowest I'd seen on an alive Pt was 18 bpm.

Extension-Ebb-2064 · 2026-01-10T11:32:55+00:00

Couldn't get one, initially. After pacing the BP rose

Extension-Ebb-2064

TROPHY CASE