My daughter suffered from seizures. Other than supplying oxygen, transport during the seizure is not going to make any difference - in fact I would questioning moving the victim at all and if she was still seizing after 13 minutes I really don’t know what the hospital would have done. Maybe a doctor can explain how they would have stopped a 13 minute seizure.
Hospital when she is postictal? Of course.
Benzodiazepines
IANAD
Reading the replies to this thread, I take it many of you don’t understand that tonic-clonic seizure just don’t justify OMG they need to get to a hospital ASAP!!!111111 especially if EMTs are on the way. It is not like a heart attack or anaphylaxis reaction.
:eek:
CPR on a still beating heart?
Rules simply DO NOT APPLY to all situations and individuals need to use their leadership skills and training to make decisions in the field.
Even without knowing the circumstances, if a person can be transported to the hospital as quick or quicker than the EMT’s responding can arrive then it is a NO BRAINER that you should transport.
Fear of lawsuits have people afraid to make any type of decisions.
Of course not. To clarify, you do Basic Life Support. Appropriate cardiopulmonary resuscitation includes assessing whether rescue breathing alone is sufficient. If she is turning blue that means she is not getting enough oxygen. You will have permanent brain damage in about 4 minutes. They had a 13 minute trip. Their options were:
#1) Wait 13 minutes for the ambulance, meanwhile giving her oxygen and start rescue breathing for her if she is still not getting enough oxygen thus preserving brain function.
#2) Load her into an ambulance with oxygen on and hope she is able to breathe enough on her own to get oxygen to her brain (and watch her undergo permanent brain damage if she does stop breathing).
I was not there, but truly, the most important treatment in an acute situation is to maintain oxygenation and cardiac function before worrying about transport. That is not to say that quick transport is not important, just that it cannot be more important than keeping the brain oxygenated.
That’s utterly insane.
A fire tuck is not set up to transport patients. Nor are the firefighters trained for mid-transport crises.
It’s better to stabilize in place and wait for better equipped help to arrive.
It is easier to ask forgiveness than it is to get permission.
I’m a supervisor at a 9-1-1 center and have a family member with a seizure disorder.
A firefighter who did this should be dressed down. Severely.
It can be scary as hell to see a seizure if you are not accustomed to it. That is no excuse for disregarding directives of the responding ambulance.
Clear the area around the patient. Check breathing once the seizing stops. And if the patient is still seizing then the paramedics can administer medication to help bring that under control.
Especially when the results are favorable.
I’ve been an EMT since 2007. Over the course of that time, I have seen many seizures. So far, only one or two people in this thread have stated the correct treatment: let the patient seize. Make sure there’s no fall danger (get the on the floor instead of a bed). Usually, the seizing stops on its own. Keep an eye on the patient.
An ambulance can have medications on-board to help a seizing patient (in my area, paramedics carry them. Paramedics are in their own chase vehicle typically, and respond independently of the ambulance unless an EMT has called in, then the medic may be placed on the squad directly). They also have the ability to be on the horn with the hospital (whether by radio or cell phone), providing constant updates to the facility. If the patient worsens, an ambulance crew has the better chance of stabilizing them en route.
As far as handing the patient over to another crew, generally (again, in my area), the higher level of care will arrange an intercept. They will travel to a spot they specify, and wait for the other vehicle. The medic climbing aboard will either leave the chase vehicle there if he needs the EMT assistant. If not, that EMT takes the medic vehicle to the hospital. This is accomplished in a matter of seconds.
I understand what the firefighters were trying to do, and I can respect it. But if they declined an order to hand the patient off, then they seriously could have compromised the health of the patient.
This is troubling either way for me. My dad and grandfather were both career firefighters.
Bolding mine
That is the correct treatment by family and bystanders. The correct medical treatment is IV benzodiazepines.
None of us were there.
Seizures in children are very scary to watch, especially for parents. Sitting and waiting 10 to 15 minutes, while providing (limited) supportive care is difficult.
Given the amount of women who died in childbirth due to doctors infecting them with unwashed hands no, it’s not. Doctors used to go from the autopsy room directly to childbirth, no washing.
You may want to read up on Ignaz Semmelweis, not so much because of what he did but for the descriptions of what medical procedures were like (dude had the personality of a nail-covered baseball bat so he didn’t accomplish as much as he should have). He worked in a big teaching hospital and realized that the women who were attended by midwives or nurses generally survived, whereas those attended by doctors normally did not. The cases themselves weren’t different, what was different was that doctors didn’t wash (midwives only attended to pregnant or birthing women; nurses attended to all kinds of people but washed, unlike doctors).
Assuming you have the meds to push. In my area, a standard BLS crew doesn’t. In my EMT classes, we were specifically told to let the patient seize. Possibly because a basic crew doesn’t have those meds.
Well…why would they even send a fire truck to this kind of emergency, if they didn’t expect the people on board the firetruck to handle it? I’m honestly confused. It seems like the error was in dispatching a fire truck and the two firefighters should not have been suspended. However, if they handled it wrong, then it’s still the fault of whoever dispatched them and didn’t train them on what they should do.
Came in here to mention Semmelweis. Before the advent of handwashing, birthing mothers had a 10-35% chance of dying. Studies at the time showed that handwashing reduced mortality to below 1%. No way MRI machines save that many lives.
Most FFs are also EMTs or at least advanced first aid trained and there’s more stations than ambulances.
They can at least stabilize and evaluate while waiting for an ambulance.
Doctors and students would attend autopsies (often of women who’d died of puerperal sepsis), then proceed straight to deliveries.
If (As?) we lose the antibiotic arms race with bacteria and the modern antibiotic era closes, we will become more dependent upon the work of Semmelweiss and Lister than ever, if we want to continue to do fancy medical procedures.
That doesn’t mean much. If something was happening to my kid during an emergency and the firefighters said they were going to transport him, I wouldn’t argue because I’d assume that they were doing their job as trained. I wouldn’t know enough about the procedures or reasons for those procedures to argue. I’d also likely be in a mental state where I wouldn’t really be the guy to ask to make sound and rational decisions.
This is a fairly good example of the law existing to prevent abuse. If you knowingly ignore it then you are explicitly admitting that you’ve considered the ramifications of your actions and consider them worth being charged.
Then, outside the rush of the immediate emergency, we can stand back and see if they actually were justified.
Different system vary quite a bit on who they send out when they get a call. Sometimes it even depends on the neighborhood. When I call Chicago’s 911 system for an ambulance in a “bad” part of town, even though I give a clear medical report about the situation and the need for, specifically, an ambulance, I’m going to get an ambulance, a police car and probably a fire truck of some sort or another (usually not the big water spraying truck, but often a Rescue, which is where they keep the stuff to get into boarded up or heavily locked buildings). Partly to keep the ambulance crew safe, partly because they’re used to getting garbled reports, pulling up and finding out that police or Rescue are needed as well as an ambulance. If I’m in a “good” part of town, I’ll probably get an ambulance and maybe one of the others, but usually not all three.
In the small town where I most often have to call 911, the volunteer squad are usually listening on their scanners at home, and who shows up depends on who’s close, who’s officially on duty, and who is curious. I’ll get an ambulance eventually, but the fire truck might be closer and those guys may decide to come over and see if they can offer assistance. A whole lot of their “ambulance calls” end up being helping someone who has fallen stand up, or picking someone up out of a hole, at which point further assistance and transport is refused anyway, and the ambulance leaves empty.