asked 1 month ago
We were transporting a pre-arrest pt who on route went VSA. Pt had no known reversible causes, and we were 6 mins from hospital. We pulled over and began resuscitation efforts. Does this pt still get 20 mins of CPR then transport (due to not calling for a TOR as it was a witnessed arrest) and no shocks advised? Or early transport and work pt on route?
1 Answers
answered 1 month ago
Thank you for your question. VSA arrest route to hospital is a regular question. Our companion document states the following:
For a witnessed arrest, in the back of the ambulance, paramedics should use clinical judgment to decide whether to stay and perform resuscitation or proceed to hospital. Paramedics should perform three full analysis and then proceed/patch or provide one analysis and go. The paramedic should provide at minimum one analysis. The decision to do one analysis vs three is based upon proximity to the hospital. If you are close- in this case 6 minutes- it would be acceptable to do one analysis and then continue transport. If a patient goes VSA due to ventricular fibrillation than immediate defibrillation is the answer so one analysis is a must. If the patient remains in ventricular fibrillation is where the grey area emerges- immediate transport vs stay and provide the second and third analyses - in my opinion the latter option would be an appropriate choice, because the answer to ventricular fibrillation is electricity and CPR. If they are in a non shockable rhythm however there is nothing to be gained from providing further analysis because definitive care is what is required and that is provided in the ED.
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