I was in an awkward situation once as a "Good Samaritan". While driving in New Zealand's South Island, came upon a traffic jam. I could see down the road someone was out on the road and a commercial van appeared to have driven off the road. When I got there they were on the phone with 911 (equivalent) dispatcher who was directing continuing with CPR. I replaced the person doing chest compressions for a turn, then realized this young black male was not really pulseless. On resuming chest compressions, he moaned and grabbed his abdomen. Weird, right? I gave this info to dispatcher but she was continuing her own protocol...so I continued. Eventually ambulance and paramedics came and took him away.
I'm pretty sure he was drugged out and told the paramedics that; don't know if they gave him Narcan or not.

EMS systems work great for most situations...but when drugs are involved they may give an inappropriate response IMO. Any of you EMT's feel the same?

^ Dispatch isn't on scene. They can't see what you see, are dependent upon untrained people to provide them with their decision-making information. They sit behind a desk and most of them, unless they work as a cop or EMS on the side, have never actually done CPR for real. They're working off a script and are typically going to err on the side of directing compressions. It's not perfect but having them get people started on CPR is usually better than doing nothing.

Even with direction from dispatch, when I get on scene I typically find somebody doing entirely inadequate compressions, or the victim is still lying on a soft surface like a bed or even seated in a recliner, and the whole body is moving every time they push.

Agonal breathing or snoring respirations can also be present with an overdose (I've seen it in other situations, too). You may get occasional, intermittent "snoring" gasps, but the person isn't really breathing and doesn't have a pulse. Typically if we suspect an overdose in those situations we give narcan and then if there's not an immediate change we start compressions. If they start breathing or get a pulse back (definitely if they wake up!) we stop. Occasionally you'll get that call where you show up and somebody's trying to do CPR on an awake and alert "victim", and they're typically pretty pissed about it .

As a cardiologist, I was usually "running the code", but there I was in another country, retired and unknown. I tried reading the local paper the next day to find out the outcome but didn't see anything.

You were definitely the best case scenario for that guy, then! Most of them don't get a heart doc showing up on scene! Usually it's some other doper, followed up by some cop like me, which isn't that much better (based on my record, if I'm doing CPR on you your chances aren't good). Our local FDs all have the autopulse now (electronic machine with a compression belt that we affectionately call the "geezer squeezer"). Once they get there with that and get it set up it's actually sort of effective....they've had a few saves.

I think that once chest compressions were started, the dispatcher didn’t have the authority to then direct their cessation. Curious, did you inform dispatch that you were a physician?

in 26+ years, I have done CPR once until the paramedics showed up, that guy survived.

I have used an AED 3 times, it has only advised to shock on the first guy. He didn't make it. The other two, the AED did not say shock them.


Has never been for a gunshot victim.

Last year we had a double homicide and the father was screaming at me to use my tourniquet. I said sorry, he's gone. My tourniquet is not going to stop multiple chest wounds and you need to stop trying CPR, you're just pumping blood out of him.

What I wanted to say was sorry your asshole sons got themselves killed but it was my third night in charge so I held my tongue.

quote:

Originally posted by Chowser:
My tourniquet is not going to stop multiple chest wounds ....

That’s an extreme example, but it’s the sort of thing I was pondering and that prompted my question concerning erroneous beliefs about CPR.

It’s been mentioned many times by other investigators, but most recently in a class I attended presented by a coroner’s office investigator she referred to the “CSI effect” and the mistaken beliefs the masses get from things like teevee shows. Since I don’t watch such things I don’t know if tourniquet use gets featured very much in the public awareness, but if nothing else even public announcements by LE agencies that they’re equipping all their cars with first aid kits can give some people the idea that their contents will miraculously save anyone they’re used with.