K_Z
Verified Anesthetist
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- Nov 8, 2010
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The EMS run report that we have been looking at for a couple days was available to any of the doctors caring for Max. It would have been available as soon as he was admitted. The paramedics clearly state that "no CPR was performed before we arrived." That would have been communicated verbally by paramedics at the scene to the base hospital, as well as verbally reported to the receiving docs and nurses at Coronado AND Rady.
Dr. Peterson, and all of Max's caregivers surely knew that from the moment of admission. No CPR in progress is no CPR till paramedics arrived. They would note this, and move on in their decision making process of caring for Max. They would not be wasting time wringing their hands over whether or not CPR was started and abandoned. That is just not how a busy ICU works.
I fail to understand why Dina or Nina would claim that days later the docs were still ruminating and musing about whether or not CPR was "done within 2 minutes", when the paramedic run report is far more important and definitive than any verbal report from Jonah or Rebecca. It simply didn't matter to Max's care or prognosis. However, it IS a detail that I think Dina and Nina have grasped as though it would have made a difference-- and have blamed Rebecca. There is no medical evidence we currently know of from Max's records that says it would have made a difference, and a lot of evidence that Max very likely would have had the same outcome even with expert CPR.
The paramedics documented CPR was not performed before their arrival, and was not in progress until they initiated it. It would not matter one bit to Max's in-hospital treatment whether or not some rescue breaths or a few compressions were done before paramedics arrived, because clearly it was not continued. There is nothing "different" that the docs would have done for Max if he had had CPR before paramedics arrived.
There were so many very serious issues that needed to be discussed between the docs and Max's parents that I cannot imagine that ANY time was spent in the first 24 hours discussing or debating whether or not CPR was done. It wasn't, according to the paramedics who were there.
Nina's claims that the docs were ruminating and musing about whether or not CPR was done before paramedics arrived are ludicrous, in light of the documentation by paramedics. Max's docs would have been consumed with details of managing his ICU care, and communicating that to the parents, along with the very likely prognosis that he would not make it. (Reference the trauma studies posted earlier in the thread.)
I also want to point out that Max's airway at the scene was quite compromised with secretions and regurgitated stomach contents, according to the EMS report. It could be that this was a deterrent and complication for Rebecca to initiate rescue breaths before paramedics arrived. Paramedics had suction equipment, oral and nasal airways, ambu bags and oxygen, EMS emergency airways, and endotracheal tubes and laryngoscopes, and they STILL had great difficulty managing Max's airway. So whether or not Rebecca gave, or attempted to give rescue breaths is not worth debating-- paramedics had great difficulty managing his airway. Why would anyone expect a layperson to be any more skilled than paramedics?
Dr. Peterson, and all of Max's caregivers surely knew that from the moment of admission. No CPR in progress is no CPR till paramedics arrived. They would note this, and move on in their decision making process of caring for Max. They would not be wasting time wringing their hands over whether or not CPR was started and abandoned. That is just not how a busy ICU works.
I fail to understand why Dina or Nina would claim that days later the docs were still ruminating and musing about whether or not CPR was "done within 2 minutes", when the paramedic run report is far more important and definitive than any verbal report from Jonah or Rebecca. It simply didn't matter to Max's care or prognosis. However, it IS a detail that I think Dina and Nina have grasped as though it would have made a difference-- and have blamed Rebecca. There is no medical evidence we currently know of from Max's records that says it would have made a difference, and a lot of evidence that Max very likely would have had the same outcome even with expert CPR.
The paramedics documented CPR was not performed before their arrival, and was not in progress until they initiated it. It would not matter one bit to Max's in-hospital treatment whether or not some rescue breaths or a few compressions were done before paramedics arrived, because clearly it was not continued. There is nothing "different" that the docs would have done for Max if he had had CPR before paramedics arrived.
There were so many very serious issues that needed to be discussed between the docs and Max's parents that I cannot imagine that ANY time was spent in the first 24 hours discussing or debating whether or not CPR was done. It wasn't, according to the paramedics who were there.
Nina's claims that the docs were ruminating and musing about whether or not CPR was done before paramedics arrived are ludicrous, in light of the documentation by paramedics. Max's docs would have been consumed with details of managing his ICU care, and communicating that to the parents, along with the very likely prognosis that he would not make it. (Reference the trauma studies posted earlier in the thread.)
I also want to point out that Max's airway at the scene was quite compromised with secretions and regurgitated stomach contents, according to the EMS report. It could be that this was a deterrent and complication for Rebecca to initiate rescue breaths before paramedics arrived. Paramedics had suction equipment, oral and nasal airways, ambu bags and oxygen, EMS emergency airways, and endotracheal tubes and laryngoscopes, and they STILL had great difficulty managing Max's airway. So whether or not Rebecca gave, or attempted to give rescue breaths is not worth debating-- paramedics had great difficulty managing his airway. Why would anyone expect a layperson to be any more skilled than paramedics?