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My dad could still be alive, but he's not

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367 points DustinEchoes | 7 comments | 13 Nov 25 02:17 UTC | HN request time: 0.863s | source | bottom
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captainkrtek ◴[13 Nov 25 02:49 UTC] No.45909911[source]▶
My condolences, very sorry for your loss.

I work as an EMT (911) and resourcing is certainly a problem. In my small city, our response time is around 5 minutes, and if we need to upgrade to get paramedics, that’s maybe another 5-10.

However, if we are out on a call, out of service, or the neighboring city is on a call, now the next closest unit is 15+ minutes away.. sometimes there can just be bad luck in that nearby units are already out on multiple calls that came in around the same time, making the next closest response much further.

for a heart attack or unstable angina, the most an EMT will do (for our protocols) is recognize the likely heart attack, call for paramedics to perform an EKG to confirm the MI, administer 4 baby aspirin to be chewed and/or nitro (rx only), and monitor closely in case it becomes a cardiac arrest. If medics are far away we will probably head immediately to a hospital with a catheterization lab, or rendezvous with medics for them to takeover transport.

The few goals though:

- recognition (it could also be something equally bad/worse like an aortic aneurysm).

- aspirin to break any clots, assist administering nitro if prescribed.

- getting to a cath lab.

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1. frenchman_in_ny ◴[13 Nov 25 03:33 UTC] No.45910251[source]▶
I'm coming at this as someone who had an MI at a relatively young age:

For the goals -- and this may differ between EMT / paramedic & protocols -- but I would really wish that there was a blood draw done in the field. Before they bring you to the cath lab with a suspected MI, the ER is likely going to draw blood to get troponin levels at a 2-hour interval. You could save some time & heart muscle by getting a blood sample (containing initial levels) in the field.

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2. captainkrtek ◴[13 Nov 25 03:38 UTC] No.45910291[source]▶
Certainly protocol dependent, and likely more in the paramedic realm.
3. DrewADesign ◴[13 Nov 25 03:48 UTC] No.45910372[source]▶
Maybe paramedics, but basic EMTs don’t even start IVs where I am— It’s the sort of thing you can get certified to do in a few weeks and pays about as much as entry-level fast food work. Phlebotomy is a lot more nuanced afaik.
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4. jaggederest ◴[13 Nov 25 04:01 UTC] No.45910457[source]▶
There's a lot of interesting research on paramedics vs emts (I believe the term of art is basic life support vs advanced cardiac life support). In areas where there is a good ER, it's better to have low level basic life support and break the sound barrier to the ER than do significant intervention on site but slow arrival at the hospital, as far as I am aware.
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5. ◴[13 Nov 25 04:18 UTC] No.45910569[source]▶
6. ◴[13 Nov 25 04:27 UTC] No.45910627{3}[source]▶
7. captainkrtek ◴[13 Nov 25 04:37 UTC] No.45910679{3}[source]▶
There is a chain of things that need to be done

- early recognition - early administration of aspirin and/or nitro if indicated - activation of, and transport to, a hospital with catheterization capabilities.

If medics can show up and do multiple ekgs to confirm and en route, thats even better. But critically the blockage needs to cleared, and they need definitive care (cath lab).