Pulseless patients: shock or drugs

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When coding a pulseless patient in VT or VF do you generally shock them first or use drugs in your practice?

what good are drugs if there is no circulation?

Thats why theres the minute of CPR post med before your next shock. Its only about 20% of typical cardiac output, but thats better than none.

Came across a study that was still preliminary, but looked favorable that if the patient was an unwitnessed arrest of greater than a couple of minutes, then even if v-fib/vt present, CPR for several minutes prior to defib. Forget the actual minute parameters they used.

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Specializes in ICU, CCU, Trauma, neuro, Geriatrics.

Uhh, take ACLS then ask the question again, please.

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Remember doing alternating abdominal compressions also?

Uhh, take ACLS then ask the question again, please.
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Specializes in SICU-MICU,Radiology,ER.
"I agree with Biffs25, there is no reason that an RN shouldn't be allowed to gain prehospital certification quickly and economically especially after taking ACLS."

I believe you might be misrepresenting what Biffs25 was trying to convey. He didnt only say that a nurse should be able to gain "certification" after only an ACLS course. Rather he said:

"Becoming an EMT regularly only takes a couple months, if not only one month depending on the class shedule. It is the becoming a paramedic in a couple months that some people might not like the idea of. I personally feel that if an RN has years of critical care experience, ER and ICU specifically, and have been an EMT previously, there are not many skills that they would need to be trained with. Intubation, needle decompression, and a few other skills would need to be learned, but in general the assessment and management of patients are quite similar to the ER setting. Any ER nurse with a good amount of experience, with a couple months training, could make a GREAT paramedic...it all depends on the person and how they handle having to work on the street."

most DOT approved EMT-B courses are at least 144 hours long. Divided into 4 hour classes at three classess per week makes for about a 12 week course. Not to mention the training that EMT-P's recieve to safely control scenes that could and do have multiple trauma pt's while being the only advanced provider present.

Why dont you go to http://ems.creighton.edu/ , or any other provider and take their EMT-B course. Then you can tell us which is harder, the EMT-B written and practical exam, or your puny ACLS cert-

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shock-shock-shock

period

follow acls protocols

don't debate while the pt is dying

shock-shock-shock

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shock the patient by saying---------- something like "I am a closet thespian"

"To shock or not to shock, That is the question!"

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Specializes in Emergency/Trauma/Education.
Thats why theres the minute of CPR post med before your next shock. Its only about 20% of typical cardiac output, but thats better than none.

Came across a study that was still preliminary, but looked favorable that if the patient was an unwitnessed arrest of greater than a couple of minutes, then even if v-fib/vt present, CPR for several minutes prior to defib. Forget the actual minute parameters they used.

Yes, I've seen that research. Arrests that had an unknown downtime or 'x' minutes of downtime without bystander CPR fared better with about 3 minutes of vigorous chest compressions prior to defibrillation.

While I agree with the majority of responses (shock first for VT/VF!), I think as hospital providers we should remain open-minded regarding evidence-based findings that may change pre-hospital protocols.

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I am sorry that you misunderstood the subject matter discussed in this post. I am also sorry that you misunderstood an earlier post of mine. Maybe you can try to interperet again,

"I agree with Biffs25, there is no reason that an RN shouldn't be allowed to gain prehospital certification quickly and economically especially after taking ACLS."

Hope that helps.

Please with the "RN". As an LVN, I had ACLS, PALS, NRP, and set through ABLS, TNCC, took the CEN and CCRN exams, and passed them all, even though I didn't get credit for the last 4 because I was "just an LVN". When is everyone going to understand that TITLE DOESN'T MATTER, it's knowledge and experinece that counts!

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Please with the "RN". As an LVN, I had ACLS, PALS, NRP, and set through ABLS, TNCC, took the CEN and CCRN exams, and passed them all, even though I didn't get credit for the last 4 because I was "just an LVN". When is everyone going to understand that TITLE DOESN'T MATTER, it's knowledge and experinece that counts!

that's quite an accomplishment, being that the first requirement of eligibility for taking both the ccrn and the cen are unrestricted licensure as an rn.

did you lie on your application and submit a false rn license?

titles do matter, and not just in health care but in all aspects of life.

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that's quite an accomplishment, being that the first requirement of eligibility for taking both the ccrn and the cen are unrestricted licensure as an rn.

did you lie on your application and submit a false rn license?

titles do matter, and not just in health care but in all aspects of life.

I didn't do either, I stated that I would like to take the tests, acknowleded that I wouldn't get credit because I was an LVN, and paid the fees. It's not an uncommon practice to sit for exams just for the experince. The requirment for taking and getting credit for the exams are an unrestricted RN license, not for just taking the tests for experience purposes.

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that's quite an accomplishment, being that the first requirement of eligibility for taking both the ccrn and the cen are unrestricted licensure as an rn.

did you lie on your application and submit a false rn license?

titles do matter, and not just in health care but in all aspects of life.

Titles Do Matter, so you'd rather have a brand new RN-BSN graduate with no years of experience other than clinicals and fresh out of school versus an LVN with 5-6 years ED experience, ACLS, PALS, NRP? Titles Do Matter? YEAH RIGHT!

I'd take the LVN with my family members no doubt!

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no pulse with vf or vt?

shock 200

why do you ask?

Thats shock 200 monophasic...

200-300-360 monophasic

120-150-200 biphasic

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