Paramedics performing c-section deliveries in field
Geoff K
alt.med.ems
If you go to DejaNews, you can look it all up there.
Geoff Scriver wrote in message <01bdf715$be203e80$9d975ed1@hal>...
>Hi all,
>
>I recently heard about a case which is probably fairly common knowledge
>about 2 paramedics in NJ that performed an emergency c-section on a patient
>in the field. From what I have heard, the pregnant mother was a trauma code
>and was obviously unworkable, so they contacted medical control who advised
>them to do what they could to save the baby. They did a c-section and the
>baby lived for a week. The paramedics subsequently lost their licenses to
>practice.
>
>what do you think of this? Were they practicing beyond their scope of
>practice? The only other option I could think of would be to work the mom
>and bring her to the ED so they could try to get the baby out.
>
>How could the situation be different to make their actions okay? What if
>the mother was decapitated so that the mother could not be coded? what if
>the medics saw the MVA take place so that the baby wasn't without
>oxygenated blood for a ridiculously long amount of time? What if the
>nearest hospital was 20 minutes away? What if they are left with a choice
>between doing the c-section and giving the baby a chance and giving it no
>chance?
>
>What if the baby had lived in this instance, would their licenses be taken
>away? Would they be heroes?
>
>Anyone have any more details on what actually happened?
>
>Just curious....
>
>
Geoff Scriver
Carey Gregory
>
> I recently heard about a case which is probably fairly common knowledge
> about 2 paramedics in NJ that performed an emergency c-section on a patient
> in the field. From what I have heard, the pregnant mother was a trauma code
> and was obviously unworkable, so they contacted medical control who advised
> them to do what they could to save the baby. They did a c-section and the
> baby lived for a week. The paramedics subsequently lost their licenses to
> practice.
This was discussed here at length some time ago. Some of your facts are off a
bit as I understand it (she was not a trauma code, and they did work her
initially). I have heard (but do not know) that the med control doctor who
authorized it was fired.
You'll get a range of opinions on the matter. My personal opinion is they did
what they had to do. They put life as the first priority and paid a heavy
price for doing so.
--
Carey Gregory
karl brennan
paramedics are alive and well after a 3 month suspension although 1 doesnot work
at Jersey city MC no more.both recieved didactic and clinical training during
their hiatus.Both are still practicing paramedics in NJ, the MCP was fired.One
particular paramedic was voted paramedic of the year in NJ so Good Job and Good
Luck to Both.We will not beat this one any more Thanks
Karl Brennan NS MICP NREMT-P
HUMC MICU
Will Dunn
> I recently heard about a case which is probably fairly common knowledge
> about 2 paramedics in NJ that performed an emergency c-section on a patient
> in the field.
>
> what do you think of this? Were they practicing beyond their scope of
> practice?
Clearly this was beyond scope of practice.
The real question, IMHO, is, does having the direction and blessing of medical
control absolve the medic who did practice outside protocols?
I wonder what would have happened if those Jersey medics had refused to carry
out the procedure? Would they have lost their certification for failure to
follow medical direction?
--wwd
phil wilken
however, I believe they did what they thought they had to to save that baby.
I believe if there was no chance of saving that mother they did exactly what
they should have done. We are suppose to be trained to save lives and that
is what they were trying to do. I'd be willing to bet that if that baby had
lived these two would have been hailed as heroes. God bless them for trying
it's better than not trying at all. I would think the father would be
grateful to have had the one week with his child he would have been denied
had they not tried.
Lori Wilken
Will Dunn wrote in message <3624AE0B...@cherryvale.org>...
ParaPoot
> We are suppose to be trained to save lives
I agree, but *I've* never cracked the chest of trauma patient to cross-clamp
his aorta "to save his life". They performed surgery. I just recerted and I
don't remember them saying anything in there about the fact that Paramedics can
do surgery now.
True, I wasn't there (and thank God for that!), but I think the fact is that
the medical control physician who told them to do it was wrong to even suggest
it, and the Paramedics were wrong to practice beyond their scope.
Everyone in medicine has a scope of practice, CNAs, LPNs, RNs, PAs, EMTs...
even EMT-Ps! Just like intubating a patient is beyond the scope for an EMT in
Houston, cutting into a womans abdomen is beyond the scope for a Paramedic
ANYWHERE!
I also disagree with the fact that the paramedics would have been hailed as
heros had the baby survived. The press, perhaps, would have hailed them as
heros. But I believe every medical director in the U.S. would be shaking their
heads praying that none of their paramedics would do the same thing. Wrong is
wrong, no matter how you sugar coat it.
Joel
Houston, TX
Ste/Van
protocols are there to guard us, as well as the patient, and I have heard
where these protocols have been breached, usually to the well-being of the
patient...but to perform surgery, I think is beyond our scope....in fact I
find the whole story unbelievable, but, if it did happen then the crew might
be 'wannabee' Doctors.....a very dangerous frame of mind!!!
thanks
Steve
Ps
To be honest.....where do you start.....abode obviously, but
where???...No!!!!! this is crazy,
karl brennan
not know how we could or should of acted.Emergency C section in the field was
addressed by the AHA and in an article by JEMS. If this had been Bosnia or
Kosovo I doubt anyone would of not at least attemted the proceedure under
similar circumstances.Un fortunately the situation brings up a loophole in our
care arena. People should work to address this loophole and not second guess
other paramedics. So since this has happened how many services have addressed
the need for protocols in similar situations?......
I await with baited breath.
Karl Brennan NS MICP NREMT-P
HUMC MICU
Unknown
"wannabee doctors"???
An interesting comment from somebody who admittedly knows little or
nothing about the facts in the case.
I communicated with a couple of folks directly involved (including at
least one of the principles and his lawyer), had a debate on the topic
with a couple of others in front of a very stoned faced and silent
Director of NJ OEMS and was awakened TWICE at 6 am by some idiot
reporter from the Star Ledger (a paper which DID make these medics out
to be heroes, BTW) looking for comments on their actions.
Despite having gleaned a considerable amount of what I consider to be
reliable information from these sources during that time, I would not
presume to venture a guess as to the states of mind, at the time of the
incident, of the medics involved, much less call them "wannabee
doctors." For you to do so sans any first hand knowledge of the event is
both unfair and unprofessional.
While I don't necessarily agree with the decisions made during this
incident, I can say that anyone ever involved NJ ALS would have to know
the shit storm that doing what they did was going to cause. To know the
personal problems it would bring and do so anyway in an attempt to save
the child says volumes about the character of these 2 individuals and
that doesn't include "wannabee doctors."
Ste/Van wrote:
>
> If the story is true?, then I think that the crew went to far, I know that
> protocols are there to guard us, as well as the patient, and I have heard
> where these protocols have been breached, usually to the well-being of the
> patient...but to perform surgery, I think is beyond our scope....in fact I
> find the whole story unbelievable, but, if it did happen then the crew might
> be 'wannabee' Doctors.....a very dangerous frame of mind!!!
> thanks
> Steve
>
> Ps
> To be honest.....where do you start.....abode obviously, but
> where???...No!!!!! this is crazy,
>
> .
--
Keep safe!
=====================================================================
Kevin M. Agard, BS, EMT-P Carlstadt, NJ
=====================================================================
Director | System Administrator
Emergency Medical Training Associates | National Association of EMTs
Board of Directors | mailto:aga...@cybernex.net
National EMS Memorial Service | mailto:sysa...@naemt.org
=====================================================================
Opinions expressed in this post are mine and mine alone.
Ste/Van
by my comment that paramedics are not Doctors! I am paramedic in the UK, we
do not need confirmation from any other source about the treatment we are
about to give to a patient, whether invasive or otherwise, if a Doctor on
scene or via radio were to instruct/advise to perform surgery, my response
would be no! My comments are not meant to be taken personal, but where does
it end? Opening the thoracic cavity to relief cardiac tamponade?...get real,
we are not surgeons..........and by the way I do not think that here in the
UK this scenario would ever occur, and I would appreciate comments off other
USA paramedics as to whether they could envisage this happening to
themselves!
cheers
Steve
Ps...like I said this is only a personal comment.........flames welcome
tho'.
Edward Getman
trauma 500 in which we believe the infant may still be viable (known to be
close to term, etc.) in my paramedic training...
Carey Gregory
>
> Like I said I don't know whether this incident is true or not, but I stand
> by my comment that paramedics are not Doctors!
Quite correct. But a doctor is not required for a dead person, which is what
she was. You're aware she was dead, right? You're aware she was "worked"
vigorously with no result, and that the on-line med control doctor terminated
resuscitation efforts, right? You're also aware that they were a long way
from the hospital, and that the paramedics had no transport unit on scene
initially, right?
> I am paramedic in the UK, we
> do not need confirmation from any other source about the treatment we are
> about to give to a patient, whether invasive or otherwise, if a Doctor on
> scene or via radio were to instruct/advise to perform surgery, my response
> would be no!
I too would refuse an order to perform surgery. But surgery is performed on
living people. She was not living.
> My comments are not meant to be taken personal, but where does
> it end? Opening the thoracic cavity to relief cardiac tamponade?...get real,
> we are not surgeons..........and by the way I do not think that here in the
> UK this scenario would ever occur, and I would appreciate comments off other
> USA paramedics as to whether they could envisage this happening to
> themselves!
Several people have said it before, and I'll say it again.... You weren't
there, and I wasn't there. You don't know what you would do, and I sure as
hell don't.
If I had such a choice before me with no clear answers, I hope I would follow
the principle of "the greatest good for the greatest number." With one
confirmed dead and a second guaranteed to be dead without immediate
intervention, ask yourself what those paramedics could do that would produce
the greatest good for the greatest number....
--
Carey Gregory
R Werner & S Blundell
Carey Gregory wrote in message <3627FCCA...@gw-tech.com>...
>I too would refuse an order to perform surgery. But surgery is performed
on
>living people. She was not living.
And that makes it okay...so what would you call it then...an autopsy?!
Miller and Keane calls surgery "that branch of medicine which treats
diseases, injuries and deformities by manual or operative methods...the work
performed by a surgeon" (3rd ed.) Nothing mentioned about the status of the
patient's life...and I believe that a c-section by common definition and
understanding could safely be considered "surgery"
only my opinion...
M. Hellstrom
to make an opinion, I would ask anyone who may have anything
resembling the actual history of events to PLEASE post this
documentation to the group. From what I have learned (and granted,
this is an interesting case), the pregnant female was deceased after
resuscitation attempts were made *and* medical control was contacted
by the *non-transport capable* crew.I've found that "Monday-Morning
Quarterbacking" can often lead to arrogant statements made by
enthusiastic non-participants who, more often than not, were sound
asleep in cozy beds while the crew in question was doing their job.
Mark the Patient (not THE patient, but quietly waiting...YOU know what
I mean!) *G*
-Never trust a ventriloquist
dummy with teeth.
-Me
Ste/Van
are really quite simple= once you start BLS/ALS, whether Amb Tech/ Amb Para
you can only stop under 5 conditions...
1....patient recovers
2....Dr instructions to stop
3....handing over to competent personnel
4....hand over to medical staff
5....exhaustion
Now come on,get real.....where doe's it end????
This is a road I don't want to go down, I am not a Doctor I am a paramedic,
I do not have the experience to perform c-sections and neither does' any
other paramedic I know.
To be perfectly honest I do not believe that the incident occurred, it is so
off the wall!
What surgical instruments were utilised? what aseptic tech were used for
baby?
No sorry......and yes I was not there and so I have no right to comment? why
does' this ng exist?, to bounce ideas off each other/make comment or
opinions?of course it is and I still stand by my comments that paramedics
are not surgeons/morticians!
It would be interesting to know what surgeons would have to say about this
alleged incident!
cheers
Steve
Ste/Van
so should not comment!!
balls, we are all entitled to an opinion based on the facts available,
Steve
Unknown
No one said you should not comment. And as I recall, you were not
lambasted for not being there but rather for not being there and
therefore having no factual basis for your "wannabe doctor" crack. As
subtle but significant difference.
Carey Gregory
>
> The protocols here in the UK as to 'working' on a patient who has deceased
> are really quite simple= once you start BLS/ALS, whether Amb Tech/ Amb Para
> you can only stop under 5 conditions...
>
> 1....patient recovers
> 2....Dr instructions to stop
> 3....handing over to competent personnel
> 4....hand over to medical staff
> 5....exhaustion
Number 2 applied in this case.
> To be perfectly honest I do not believe that the incident occurred, it is so
> off the wall!
It occured. It is documented fact whether you want to believe it or not.
> What surgical instruments were utilised? what aseptic tech were used for
> baby?
You seem to have a hard time grasping the basic situation. The baby had zero
chance of survival if they didn't do an emergency c-section. Concern for
aseptic technique in such a situation is like concern for a fracture when the
patient has no airway.
> No sorry......and yes I was not there and so I have no right to comment?
You can comment all you want, but CRITICIZING when you don't know the facts is
inappropriate, unprofessional, and just plain rude.
--
Carey Gregory
P.J. Geraghty
<rands...@xtra.co.nz> wrote:
As could needle decompression of a chest. Arguably, IO infusion couls
also be considered a surgical procedure.
--
P.J. Geraghty
Transplant coordinator, paramedic, firefighter, husband and father
gera...@visi.net
http://users.visi.net/~geraghty
Ste/Van
it hard to believe that this surgery took place...some have said it is well
documented, where can I see this documentation? and come to that do USA
paramedics carry scalpels in there kit??
cheers
Steve
Carey Gregory
>
> Carey Gregory wrote in message <3627FCCA...@gw-tech.com>...
> >I too would refuse an order to perform surgery. But surgery is performed
> > on living people. She was not living.
>
> And that makes it okay...so what would you call it then...an autopsy?!
It was an extrication.
> and I believe that a c-section by common definition and
> understanding could safely be considered "surgery"
I don't think that's such a safe assumption at all if the mother is dead.
Were it so, all morticians would be guilty of practicing surgery.
Surgery is not practiced on the dead... not by any definition.
--
Carey Gregory
Carey Gregory
>
> I cant believe the come back of the comments I made, I still say that I find
> it hard to believe that this surgery took place...some have said it is well
> documented, where can I see this documentation?
A web search will no doubt turn it up. You're welcome to do your own
research.
> and come to that do USA paramedics carry scalpels in there kit??
OB kits contain scalpels.
--
Carey Gregory
Dan Karlin
Carey Gregory wrote:
> It was an extrication.
Unknown
>
> I cant believe the come back of the comments I made, I still say that I find
> it hard to believe that this surgery took place...some have said it is well
> paramedics carry scalpels in there kit??
>
> Steve
Steve, what you choose to believe is completely up to you. If DeJaNews
goes back that far (it's been just a bit over a year) you can probably
find the discussions it caused at the time.
And yes, Paramedics and even EMTs here carry scalpels. It's a standard
part of an OB Kit.
M. Hellstrom
>it hard to believe that this surgery took place...some have said it is well
>documented, where can I see this documentation? and come to that do USA
>paramedics carry scalpels in there kit??
>
>cheers
>Steve
Will you RELAX?? I found the article on my own and have it
attached to the bottom of this message. It did happen, and I find it
hard to believe that *you* can't believe it. With all the calls made
to 911 (or Rescue/EMS/what have you), it was only a matter of time
before this scenario came up. Scalpels are *routinely* carried in
every OB kit I've ever seen. What is used in the UK to cut umbilical
cords?
Now, after the case is read, think about this:
What if the mother was a trauma patient...and the trauma
occurred in front of the fire/ambulance station...and she was
decapitated? *Please* don't tell me a C-section wouldn't cross your
mind. Um, no pun intended....
After reading the case, and still acknowledging that I was
*not* there, I feel they did the right thing. At least they *tried* to
save the baby (I believe she died after 3 weeks). By the time they'd
packaged the mother (this *was* a cardiac arrest) and transported, it
would have been well over 15 minutes (generously). Reportedly, the
mother had been down for close to 10 minutes before any help arrived.
By ACLS guidelines, she was already deceased. That's a minimum time of
25 minutes the baby would have been without O2, and even a newborn
won't recover from that kind of hypoxia.
N.J. Paramedics Face Inquiry Over Emergency C-Section
By DAVID W. CHEN
9/27/97 The New York Times
New Jersey health officials are investigating the actions of two
paramedics
who performed an emergency Caesarean section on Thursday to deliver
the baby
of a woman in North Bergen who was in cardiac arrest and could not be
revived.
The paramedics acted while consulting by radio with emergency room
doctors
at Jersey City Medical Center, officials said, but state health
regulations
forbid paramedics to perform surgical operations. The emergency
workers said
they believed the procedure was their only hope of saving the baby.
The full-term baby girl survived but is in critical condition; the
mother,
who was 37, died.
The two paramedics were placed on desk duty, with pay, pending the
outcome
of the state investigation, which officials said should be completed
next
week.
"This was so unusual," said Dr. Leah Ziskin, the deputy commissioner
of the
state's Department of Health and Senior Services. "Our review is not
complete."
But to hospital and volunteer officials, the only thing clear was that
the
two paramedics were heroes, in spite of the rules.
"These two people, a man and a woman, they've gone through probably
the
most traumatic situation of their professional career, so light duty
is more
than appropriate," said Bill Dauster, a spokesman for Jersey City
Medical
Center. "We probably didn't need the state to tell us to do that."
The events, according to spokesmen from the Jersey City Medical Center
and
the North Bergen Volunteer First Aid Squad, unfolded as follows:
At 5:30 a.m. Thursday, the North Bergen squad received a 911 call from
someone in a residential neighborhood in the uptown section of North
Bergen,
saying that a woman was not breathing. Two volunteers, who were on the
midnight-to-7 a.m. shift, arrived a few minutes later, finding the
woman in
cardiac arrest, with no heartbeat and no sign of breathing. They tried
to
revive her, said Mary Ellen Cleveland, the president of the first aid
squad.
A few minutes later, two paramedics from the staff of Jersey City
Medical
Center arrived at a house in the neighborhood from their base in
Weehawken.
The woman had still not been resuscitated; the baby was lodged in the
birth
canal.
"They made a determination that she was dead," Dauster said. "And then
they
said, 'Oh my God, we have to do this."'
In a telephone consultation with doctors at Jersey City Medical
Center, the
paramedics and the doctors made a "joint decision" to try a Caesarean
section, he said. The two paramedics, both of whom were described by
Dauster
as seasoned, delivered the baby just after 6 a.m.
The baby had no pulse at birth but was revived by the paramedics.
Another ambulance from West New York then came to assist, and the
woman and
the baby were taken separately to Palisades Medical Center in North
Bergen.
The woman was pronounced dead at the hospital. The baby was later
taken to
Jersey City Medical Center.
Officials said they had not yet determined what caused the woman's
heart
attack.
Friday, a woman who answered the phone at Palisades Medical Center
said the
hospital had no comment on the incident. Dauster and Ms. Cleveland
declined
to give the names of the family, the paramedics or the volunteer
emergency
medical technicians from the North Bergen squad.
It was the first time anyone at Jersey City Medical Center could
recall
such a case, Dauster said. But he added that everyone was proud of the
paramedics.
"What they did was step over what regulators have outlined for them
into
the moral arena," he said. "Most people are going to view this as an
act of
heroic endeavor; that's how we're viewing it."
The baby, he added, was named Davida by the nurses at Jersey City
Medical
Center. She weighed about 10 pounds.
I truly believe I would've done the same thing, but I don't
think I ever want to find out. *G*
Mark
Andrew Remuzzi
"morticians". An a i agree with him wholeheartedly...
along the lines of what is surgery....
I thought it might interest every one to know that is some portions of the
US PARAMEDICS do perform surgery. Having done this procedure in the field
on LIVE patients it suprises me that no one else has mentioned this
procedure. This procedure is in the the DOT curriculum and i am sure most
ALS providers here have heard of it. In fact owing to the large body of
expierence here I am sure that someone else has done SURGERY on a LIVE
patient.
In fact this procedure is also listed in the ACLS text.
Still stumped eh ? Disbelieveing hmmm...Well we have a protocol here for a
procedure called " SURGICAL CRICOTHYROTOMY"....
Having done this i can say :
1.) it is surgery ...get over it
2.) it is accepted as a PREHOSPITAL procedure.
Now i was not there ( and glad for it) but please people... the situation
was extreme and a life was at stake. Please tell that some of you don't
get into these situations and say " well not in the textbook ...nothing WE
can do".
Hell if this attitude were prevalent the "Science" of auto extrication
would have never been developed and we would have a lot dead people in
cars.
Now for these rather freaky situations where our limited medical knoledge
is confounded we have contact with a a DOCTOR who is our "guiding light".
In the case discussed which ,did indeed happen, the doctor approved this
procedure and the PARAMEDICS ON THE SCENE while consulting with a doctor
made the decision to try and save a life....which is why we are all out
there in the first place.
Fact there are times when we as EMS providers will come across situations
where the body of knowledge and the guidlines DO NOT APPLY. In these
situations we rely on medical direction from the ER doctor.
now having vented...
i will say in closing i am GLAD i was NOT there...but please the biggest
thing holding paramedics back is the paramedics themselves. As long as we
are not open to the possibility of broadening our horizions we will always
be 2nd class medical citizens.
--
Andrew Remuzzi
NREMT-P
Sti...@patriot.net
Henry Troup
>
> People commenting on this case are being lambasted for 'not being there' and
> so should not comment!!
>
> balls, we are all entitled to an opinion based on the facts available,
>
> Steve
Right!
My opinion is that I'm glad I wasn't there.
--
Henry Troup h...@nortel.ca Nortel Public Carrier Networks
My personal position or opinion should not be taken for
the official position or opinion of Nortel
Ed Shanks
>
> I cant believe the come back of the comments I made, I still say that I find
> it hard to believe that this surgery took place...some have said it is well
> documented, where can I see this documentation? and come to that do USA
> paramedics carry scalpels in there kit??
>
> cheers
> Steve
Steve - I'm a firefighter/first responder, and *I* have a scalpel in the
kit on my fire truck! (It's included in the OB kit we carry, and is to
be used to cut the umbilical cord when we respond to a childbirth.)
--
Ed Shanks - DoD 2005, RKMC-MAL, IAFF 1176
\ XVZ1300 / \ E-4-A /
EShanks01(at)sceinet(dot)com
More alphabits available upon request
Jason Kinley
claimed to have first hand knowledge.
1. Is it true that the hospital was only 5-6 minutes away ??
2. Is it true that the in charge paramedic had previously bragged in
ACLS class that he would like to perform this procedure some day ??
3. Did the Med Control doctor actually suggest the procedure, or did
the medics persuade him to do it ??
Just a few questions which should be answered ......
No opinions here .... but a very interesting case to use while
teaching legal/ethical issues class.
Charles S. Krin, DO FAAFP
Hellstrom) wrote:
>
>At 5:30 a.m. Thursday, the North Bergen squad received a 911 call from
>someone in a residential neighborhood in the uptown section of North
>Bergen, saying that a woman was not breathing. Two volunteers, who were on the
>midnight-to-7 a.m. shift, arrived a few minutes later, finding the
>woman in cardiac arrest, with no heartbeat and no sign of breathing. They tried
>to revive her, said Mary Ellen Cleveland, the president of the first aid
>squad.
>
>A few minutes later, two paramedics from the staff of Jersey City
>Medical Center arrived at a house in the neighborhood from their base in
>Weehawken. The woman had still not been resuscitated; the baby was lodged in the
>birth canal.
On re reading this article, it would be interesting to find out if the
mother suffered her arrest from an amniotic fluid embolism.
>"They made a determination that she was dead," Dauster said. "And then
>they said, 'Oh my God, we have to do this."'
>
>In a telephone consultation with doctors at Jersey City Medical
>Center, the paramedics and the doctors made a "joint decision" to try a Caesarean
>section, he said. The two paramedics, both of whom were described by
>Dauster as seasoned, delivered the baby just after 6 a.m.
If there was an amniotic embolus, then the child might have been in
severe distress due to a partial placental abruption for a while
longer, also contributing to the bad outcome.
ck
--
Charles S. Krin, DO FAAFP,Member,PGBFH,KC5EVN
Email address dump file for spam: reply to ckrin at Iamerica dot net
F*S=k (Freedom times Security equals a constant: the more
security you have, the less freedom!)(Stolen from Alt.Fan.Heinlein)
Unknown
>
> Just a couple questions for the person who posted to this thread and
> claimed to have first hand knowledge.
Well, I don't believe anyone who was there or claimed to be there at the
time has posted to this discussion therefore there is no "first hand
knowledge" presented. At best it's been second or third hand.
> 1. Is it true that the hospital was only 5-6 minutes away ??
Yes, Palisades Medical Center was @ 5 minutes away (Give or take a
ninute depending on traffic)
> 2. Is it true that the in charge paramedic had previously bragged in
> ACLS class that he would like to perform this procedure some day ??
I had not heard that before.
> 3. Did the Med Control doctor actually suggest the procedure, or did
> the medics persuade him to do it ??
My understanding was that the Doc made the original suggestion but I
have never actually heard the tape so. . . .
> No opinions here .... but a very interesting case to use while
> teaching legal/ethical issues class.
Indeed it is.
MedicBoy75
>trauma 500 in which we believe the infant may still be viable (known to be
>close to term, etc.) in my paramedic training...
I was taught the same thing during the pregnancy lecture in our ATLS
portion of my paramedicine program.
-- Dave
Michael C. Ulrich
usually don't respond to many threads in the newsgroup, but I've been
following the EMS newsgroups for over three years. If any one incident
stretches the limits of our profession in those past three years, this
has been the one.
I also posed this question to my paramedic class and to my Paramedic
partners. Not an easy question to answer.
Risk of prosecution and loss of licensure must be the primary topic of
concern. From what I remember from the previous posts from over a year
ago, the doctor in medical control recanted any permission that he may
have given the paramedics for doing this procedure. Basically, he left
them out to dry and fed them to the wolves. I feel this is abominable
and unforgiving.
I must agree that I don't think I would've wanted to been there, but if
the circumstances were in my hands and I were forced to make a difficult
decision such as this...I would've done the same as the paramedics on
scene.
My job is to protect and preserve life. We in the EMS community do not
have the luxury of sterile enviroments and predictable outcomes or a
pharmacy afforded to the Doctors and RN's of the Emergency Centers. We
rely on protocols that have been time-tested under sterile and easily
maintained enviroments. We do not work with those luxuries. We do our
job under abhorent conditions and hope for the best of outcomes. We also
work under the very observing and emotional eye of patient's relatives
and friends. All considerations what they are, we do a hell of a job
under the direst and worst of circumstances.
Morality is the one factor that we cannot control. No matter what we or
our instructors do to ensure we learn the protocols that we work under,
we are forced to deal with the morals, values and the religious beliefs
that we grew up with and cherish.
Is our job worth the risk to provide life to someone who might not have
that chance without our help? Maybe, but if not, are you willing to live
with that decision eating, gnawing at you for the rest of your life?
I would've done it and would have been proud to have giving that baby a
chance, regardless of the legal consequences of my actions. I would not
shirk and deny my involvement (if that is what the doctor did) but
embrace my decision and live with it and its consequences. I only have
one short life to give to you and the rest of my country and the world I
live in.
Thank you for your time,
Comments freely welcomed and encouraged.
Michael Ulrich, EMT-S (I for you non-Michiganders)
--
Michael C. Ulrich
michael....@usa.net
ICQ: 13075210
The only stupid question is the one never asked.
If you learn something everyday, then it's been a good day.
Freedom is our greatest national resource. Protect it!!
Carey Gregory
>
> Jason Kinley wrote:
> >
> > 1. Is it true that the hospital was only 5-6 minutes away ??
>
> Yes, Palisades Medical Center was @ 5 minutes away (Give or take a
> ninute depending on traffic)
Isn't it also true there was no transport unit on scene at the time?
--
Carey Gregory
Jack McCaw
:
: Is our job worth the risk to provide life to someone who might not have
: that chance without our help? Maybe, but if not, are you willing to live
: with that decision eating, gnawing at you for the rest of your life?
:
: I would've done it and would have been proud to have giving that baby a
: chance, regardless of the legal consequences of my actions. I would not
: shirk and deny my involvement (if that is what the doctor did) but
: embrace my decision and live with it and its consequences. I only have
: one short life to give to you and the rest of my country and the world I
: live in.
I am impressed, and a bit humbled by your statements mate. I
think you have neatly summed up why many of us are emergency workers.
I am a volunteer (our whole Bush Fire, and SES is based on volunteers) so
financial considerations are just not there.
Thanks for re-affirming my faith in human kind.
Scott Speckhart
performing surgical crics...while I haven't performed one our service has
had 5 crics performed this year and all patients survived the experience.
While I don't envy the NJ medics and I pray I never get faced with their
decision, I ask this simple question," In the world of EMS and medicine is
everything black and white?" While we are not physicians we do assist the
doctors in the "art of medicine" which one doctor told me during my
clinicals that means the EMS field is dynamic and fluid never static and a
medic who cannot be dynamic and fluid shouldn't be in the field. Plus as i
leave this forum for supper think about the expanding roles Paramedics are
being asked to take the role of Expanded Scope.
Take care out there all
Scott Speckhart EMT-P
Ste/Van
are sterile scissors which we use to sever the umbilical cord.
cheers
Steve
Robert Tauken
the internet didn`t exist but it still stured up a bit of a ruckus
anyhow, sorry.
Carey Gregory
No, you heard a story about a *different* incident 15 years ago. The incident
in New Jersey last year is documented fact.
--
Carey Gregory
Unknown
discussion of this incident that I mentioned earlier was Bill Brown
(from NREMT) who mentioned that a similar incident occurred some time
previous to the NJ c-section. I think it was in Ohio, Cincinnati
perhaps? Maybe that is the one you heard about.
Robert Tauken wrote:
>
> sorry to say , but i heard a version of this story about 15 years ago,
> the internet didn`t exist but it still stured up a bit of a ruckus
> anyhow, sorry.
--