NASAg03 said:
I'm expecting the defense to get expert testimony on resuscitating a suffocation victim vs. OD victim, how you do it, tools you use, and how the patient responds.
Typically with suffocation or obstructed airway, you can get the heart going, but the brain damage will occur. I don't know what happens with OD though, other than watching Pulp Fiction. Did they administer epinephrine in the ambulance?
In an arrest, you help avoid brain damage by quickly starting compressions (defib as necessary) and establishing oxygenation/ventilation regardless of root cause of arrest. The primary goal is return of spontaneous circulation.
EMS will follow ACLS algorithms. Basically quickly check for breathing/pulse, start compressions as soon as possible, put on pads, assess heart rhythm (give meds and shock as rhythm indicates), get airway in and get to hospital ASAP. Suspected opiate/opioid ODs can get Narcan, but 2015 AHA guidelines prioritize treating cardiac/airway and giving resuscitative meds per the algorithm. I believe he said he got epi in the ambulance, which is appropriate for asystole and PEA (the two rhythms he mentioned).
Quote:
https://www.emra.org/emresident/article/naloxone-in-cardiac-arrest/
- Standard resuscitative measures should take priority over naloxone administration, with a focus on high-quality CPR (compressions plus ventilation). (Class I, LOE C-EO)
- We can make no recommendation regarding the administration of naloxone in confirmed opioid-associated cardiac arrest. Patients with opioid-associated cardiac arrest are managed in accordance with standard ACLS practices.
"H's and T's" (causes of arrest) are usually checked once you have compressions going, establish vascular access, and are able to follow the algorithms. Because they had the compression machine they could have been doing several things simultaneously on the way to the hospital.