Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Cardiac Arrest Video – I

There has already been a bit of blogging about this on-camera cardiac arrest. Another soccer player experiences sudden cardiac arrest on camera at Prehospital 12 Lead ECG, Salamanca Soccer Player Miguel Garcia’s Sudden Cardiac Arrest at Dr. Wes, as well as Sudden cardiac arrest in a soccer player – a happy ending at Electrophysiology Fellow.

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Ignore the guy on the ground at the beginning. The guy behind him, kneeling and tying his shoe is the one to pay attention to.

The NYT article that Electrophysiology Fellow links to is an important read. The Indelible Pain of Watching an Athlete Fall.

Were there sufficient safety and security measures in place, considering that no official apparently noticed Crippen’s distress and that another U.S. swimmer, Christine Jennings, said she had raised her arm for assistance late in the race (after having vomited earlier) and gotten no help, not from a safety boat nor officials on jet skis?

The safety officials did not even find the dead guy until after the race, after one of the other swimmers told officials Crippen was missing.

We seem to do a very poor job of recognizing signs of serious medical problems.

Maybe these videos can help point out that things can change quickly. All of the other soccer players seemed to be aware of the seriousness of the medical condition. Videos can also point out the benefits of prompt action for a witnessed arrest. While it is difficult to tell what is going on with all of those people there, less than 4 minutes after a cardiac arrest, he apparently has pulses back. From

This is also one of the benefits of having audio recording of every arrest. This is the best way to learn. Yes. some states do have laws against this, but this is just one more reason to have these laws thrown out. also, the importance is in reviewing the call afterward, not in calling medical command for permission to do something. One is competent oversight. The other is not.

“He was dead for 20 seconds,” Garrido told reporters after embracing Calero.

This is confusing. Most likely, he was dead when he hit the ground. While it is difficult to tell what is going on most of the time. From about 1:30 to 1:55 somebody is doing compressions (for some reason there seems to be an attempt to apply a cervical collar at this time), then there is a pause, then more compressions. At around 2:40, compressions stop and everyone moves back a bit. Probably a shock is delivered, but it is followed by more compressions after 3:00. Was he resuscitated, but then arrested again? The statement is from the team doctor, not from one of the players, so there should be more than a layman’s understanding of the medical term dead.

This is also an example of too many people on scene. They aren’t going to use up all of the oxygen, but they will get in the way. Then they run off the field? Running with a patient endangers the patient.

This is one of the reasons we give so many drugs during cardiac arrest. It gives more people things to do to look busy.

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Comments

  1. If you don’t run, then how will untrained observers know that you are doing your job?

    I used to work a at place that put out a memo advising that our biggest complaint was that we didn’t look anxious when arriving on scene: “So remember, when you get out of the ambulance, think heads up, alert facial expressions, and heads swiveling around.”

    • Matt,

      If you don’t run, then how will untrained observers know that you are doing your job?

      This is one of the big problems with EMS, we pay a lot of attention to what we claim is the appearances of good patient care, at the expense of good patient care.

      I used to work a at place that put out a memo advising that our biggest complaint was that we didn’t look anxious when arriving on scene: “So remember, when you get out of the ambulance, think heads up, alert facial expressions, and heads swiveling around.”

      Just what we need – Bobble Head EMS.

      I had a complaint last night for not using lights and sirens.

      His son was declining pain medicine before we arrived at the hospital.

      Did Dad say, Thank you for treating my son’s pain?

      No. He seemed upset that he didn’t get to race along behind us in his car and run red lights. He was genuinely worried about his son, but he doesn’t know anything more than, Go fast!

      These are not the people whjo should be making decisions about EMS.

      Administrators should not pay attention to these comments, if these administrators cannot be remediated, they should be fired.

  2. Write more, thats all I have to say. Literally, it seems
    as though you relied on the video to make your point. You obviously know what youre
    talking about, why waste your intelligence on just posting videos to your site
    when you could be giving us something enlightening to read?

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