A noted EMS physician once said if we “scoop and run” on a cardiac arrest patient, all we are doing is delivering a dead body to the hospital

Prompt 1: 

A noted EMS physician once said if we “scoop and run” on a cardiac arrest patient, all we are doing is delivering a dead body to the hospital.

• What are two valid, evidence-based reasons for EMS providers to stay on scene and work a cardiac arrest rather than immediately transport?
• What is one challenge to EMS providers remaining on scene to work an arrest?

Prompt 2: 

Chest Pain and Difficulty Breathing are two of the most common reasons for dispatch, and often present together. 

Name two disease processes that might cause a patient to present with chest pain and dyspnea, and how you would differentiate them in the field. *Instructor’s note* DO NOT USE ANXIETY. We should NEVER assume anxiety in the field.

• Disease 1
• Disease 2

Name a third that cannot be differentiated in the field, and explain how are they diagnosed in the hospital?

• Disease 3

Prompt 3: 

You are treating a patient complaining of chest pain. Upon placing a 4 lead EKG you identify the patient to be profoundly bradycardic with a narrow QRS, and complete disassociation between the QRS and P waves. You inform your partner this patient is in a third-degree heart block, but your partner disagrees and states that third-degree heart blocks must have a wide QRS. Your partner proceeds to call a STEMI alert and asks you to start loading the patient. The QA process later investigated this call and discovered that your partner was incorrect about pretty much everything.

• Explain how a third-degree heart block can have a narrow QRS.
• Why do you think it’s such a common misconception that third-degree heart blocks can only be wide?
• Why is it inappropriate to call a STEMI alert on this patient?
• What should have been the appropriate treatment plan?
• Should this patient have been a “load and go?”