In defence of the EMT's we operate under a lot of challenges.
And given the system and scope of practice we given.....
dat is what I tinking....alyuh does even have a defibrillation in d ambulance..............because my ting is I see incidents reported that suggest accident victims and heart attack victims would survive in similar situations u describe, if they were in d states or other developed countries, Fabrice Muamba comes quickly to mind, is d same deal with we police only basic training AFAICT
Yes there is a defibrillator.
The window for survival after a heart attack is approx 15 min. In that 15 min you need the onset of CPR and Defibrillation. Hardly ever often you get both occuring at the same time. Keep in mind that unlike many countries...we dont have defibrillators in many public buildings for use in circumstances like these.
Also wrt the scope of practice..as EMT's we cant administer drugs. Paramedics have the ability to inject with adrenaline to help stimulate the heart...and along with defibrillation that increases the odds of survival. We can only do CPR and defib and rapidly transport. Legislation doesnt exist for Paramedics to function as that is considered Advanced Life Support and we provide Basic Life Support. Getting it implemented is a next long political problem...and ego-centric one because I could also tell you that in the eyes of many within the health service we seen as not deserving of respect.
So imagine we come on a scene as quickly as we can....and find a person laying on the ground and everybody standing up watching. No CPR in progress. No pulse. Asystole on the Defibrillator. In that stage there is nothing we could really do. Some may chance it..but speaking from personal experience....after you put down 15-20 min of CPR while using a BVM in the back of a rapidly moving ambulance over the Lady Young, and gotten 1 shock in because the machine wont shock unless it sees a shockable rhythm and rush into a hospital recuss room...and a doctor asks..."How long you doing CPR now? How long was the person unresponsive? Well then there's nothing we could do."...what again can we really do? Another time we were right around the corner from a call...total response time was 2 minutes.....I got two shocks in and we got to hospital in 9 minutes and they still pronouced her DOA. Our system allows us to do only so much.
To summarise:
1) Fabrice Muamba had defib access and quality CPR to do the work of his heart which was what helped bring him back. I remember hearing of one instance a paramedic got a heart attack on a scene and his partner had to do everything and he was without a pulse for 68 minutes. They had an automated CPR machine to do the compressions and deliver breaths and the AED along with the adrenaline injections kept the window open. It possible when all the things available. Not all the time all the options available.
2) There is a drive on to teach compressions only CPR on May 22nd locally. The company coming to your workplace to teach it as well. Check me for more info..because people have a habit of expecting us to work miracles when we really cant do anything. If cardiac arrest suspected...then at least give us something to work with. And trust me....delivering quality CPR isnt easy.
3) A defib doesnt start or restart the heart. Its a common misconception and people expect that from TV. A defib is just like pressing the reset button on a wireless router...it causes the heart to reset somewhat and regain normal rhythm. If a router has no power to it...pressing the reset button wont give it power. One time we went on a scene where a man hung himself. They found him and we reach 10 min after they found him. They were unable to say how long he was hanging there and expected us to shock and everything would come back to normal. In a case like that there's nothing we could do.
4) EMS is one of the most challenging and unappreciated services locally. Do it for a few months..or a year if you able...and yuh get to realise that it eh easy out there. And take it from me when I say while there are some who may appear lackadastical....there are some that despite trying their best stymied by how things are above our level and our scope of operation.
5) Coursera supposed to have a course on CPR and Resuscitation sciene starting in a few weeks. Check it out. I already signed up for it.
