Not Worth Saving

Apparently some paramedics are likes gods, they can decide who deserves to live and who deserves to die.

Left to die

I’m pretty sure they made a judgement call, like they did every day.

reports of the telephone conversation content seem pretty damning- not nice.

did you read the article – doesn’t sound like there was very much judgement involved to me…

Yes i did read it, and based on some sloppy sensationalist news article, i don’t feel equipped to be Judge, Jury and executioner like you.

Care for some sweet tea 😉

The only mistake they made was getting caught.

What Steve-Austin, you don’t think comments on news stories should be made on a mtb forum ?

Or you think the news article shouldn’t have been published in the first place ?

kettles just boiled thanks.

How does forming an opinion on that article make me judge, jury and executioner? If it’s true then yes, I hope they get everything that the law can throw at them. This is pretty local to me and a close friend is an ambulance paramedic and he’s **** livid about it – it’s a hard job at the best of times and difficult decisions have to be made all the time but this doesn’t even come close to being a ‘judgement call’ IMO (or his, for that matter and he’s far more qualified to be angry about it)

from the telegraph:
Apparently their first reaction was to comment on the untidy and unkempt state of the house. Then they are heard to comment on seeing Mr Baker and allegedly saying that it was not worth bothering to try to carry out resuscitation to try to save him. They then are heard discussing what to tell ambulance control and allegedly decide to say that he was already dead when they arrived

Without a transcript it’s impossible to judge properly.

Still, hope they don’t get called out to me anyway.

That particular news story made more of the paramedics, than the issues at hand. did they decide they should not revive him? or did they decide they couldn’t revive him is the real issue.
I don’t know that, and neither do you.

Debating news stories is pointless, as they always slant towards the sensational to make readers interested in stories that are not always what they seem. So we can debate this issue, based on that news story. But all we are really debating is, a piece of writing. Its NOT based on fact.

My partner is an ex nurse and she is mad as hell about this she says it is drummed into you never ever make a personal judgement about a person you are treating YOU DONT KNOW ANYONES PERSONAL CIRCUMSTANCES YOU TREAT THE PROBLEM NOT THE PERSON

Sorry about the bold caps but she was quite angry.

But all we are really debating is, a piece of writing

And what’s wrong with that ?

Or should everything on here be debated as it would be in a court of law ?

did they decide they should not revive him? or did they decide they couldn’t revive him is the real issue

IMO the fact that the control center passed the matter over to the police seems to point to the latter being the case – in my experience the services are pretty supportive /protective of their own (sometimes too much so) and it’d take something out of the ordinary for action like this to be taken…

Don’t know anything abaout this story other than above. But in my experience when I do know something about something in the media from personal experience then it is usually substantially twisted or plain wrong.
So when I read anything in the papers I am inclined to disbelieve.

Feel compelled to reply to this…purely to balance the gutter intentions of ‘grizlygus’ by posting this purely to misinform and inflame.

I am a paramedic….and know the Paramedic involved,he’s a family man, has served his country in the army,and is a thoroughly decent bloke, oh and he also mountainbikes.

Unlike so many of my colleagues…I’m still sane,healthy, and haven’t yet burnt out.

I have witnessed more in life than perhaps the vast majority of people on this forum. From the first breath to the final gasp and everything in between.

I did not join the job to become a millionaire, nor did I ever expect to be abused by the public in the way that I have over the last 15 years….

The stresses placed upon our Paramedics, Police and ‘frontline’ nurses are phenomenal…isn’t it time we as a society started supporting these professions rather than slating them only when negative cases emerge?

IF… the news story is accurate and all the facts are clearly presented then these two will lose their jobs, the paramedic will be struck of the HPC and that is less than they deserve. However…

Has anyone seen a picture of the house http://www.guardian.co.uk/society/2009/jan/03/paramedic-arrests-brighton-barry-baker, Its a state. Before doing anything personal safety is the most important issue. Having worked in similar houses, I can assure you the stink of places like this is unbearable. Also, early reports suggested he was a big guy. Now, depending on your opinion of big, I wont try to life anyone over about 25stone (unconcious people feel a lot heavier). Its not clear if Mr Baker was obese but his medical conditions reported in the press would support the liklihood that this man was heavier than normal.

now for the science bit.

Once you initiate resuscitation you should not stop. CPR stimulates the heart into beating in a normal rhythm, if you stop, the heart stops and all you have done by starting ismoved oxygenated blood away from the brain and replaced it with deoxygenated blood, speeding up the onset of brain damage and ultimately death. There are situations where this is unavoidable but idealy, you don’t start CPR until you know you can get a patient to a centre of further care (I.E a hospital). If you can’t lift the patient, or there is no clear access and egress ten there is no way you can get the patient to a hospital, so it could be concidered that there is no point starting CPR (its not like on telly, people don’t just sit up and say “thanks for saving me”).

further more….

The recognition of life extinct protocols ( http://jrcalc.org.uk/publications/ROLE_Most_FINAL_March2003.pdf)suggest that if a patient has been aystole (no cardiac electrical activity) for greater than 20 mins then there is no need to commence CPR as the patient is dead.

Being as no one apart from teh crew know what hapened in that house, are the media sure that an ECG wasn’t carried out on this patient, which showed aystole with occasional artefacts (as dead people tend to do) and decided to wait it out until a 30 second strip could be obtained without artefact (as required by the police).

As for slating the guys house, and saying “he’s not worth saving”. Highly innapropreate and unprofessional, but how do you deal with dead people? As someone who deals with the recently dead, sometimes as much as several times a day I have a fairly warped sense of humour. some might say I’m disrespectful of the dead (have you ever had to sit in a room with a dead body, stinking of faecal matteer, with the heating on full, for and hour waiting for the police? would you not pick up a book and start reading?)

The people who work in comms (them on the phone) are very different to those that work on the road, and unless the entire phone transcript is made avaliable, its just words.

As I said at the begining, if these guys are guilty then they will bepunished. to be fair, if they are innocent they will be punished by “trial by media”. Just thought I’d share the reality of life on the road in an ambulance.

Jim

(the thoughts and opinions stated above are NOT the thoughts and opinions of Yorkshire Ambulance Service and should not be quoted as such!)

that has to be the best response stw has ever seen? succint, knowledgeable and balanced, well done that man i doth doff my cap.

agreed, excellent response.

i do not understand paramedic ‘gallows humour’ any more than the next person but i know that this doesn’t make it a wrong as it sounds to someone who isn’t an ambulanceperson possible out of context or incomplete. In the same way that i am sure you could cut and past together hours of damning mental health ‘humour’ if you cherrypicked some of the conversations i have had in the line of duty.

The public and indeed sometimes the ambulance service an police have great issues understanding the rationale of some of the clinical decisions i make in my job. That doesn’t necessarily make me bad at it.

what i mean to say really is that this case should be reported a bit more sensibly until it has been properly investigated and reviewed by other paramedics.

Meehaja, well said!

I have been in many a house as described in this situation, dealing with those who have recently or not so recently departed from this mortal coil.

Those who deal with death on a regular basis and disturbing situations develop a coping mechanism that would clearly be described as inapropriate by normal folk. A warped sense of humour that Meehaja reefers to is one way.

Nonetheless knowingly failing to discharge a public duty which may be the case in this situation is clearly wrong and if proven should and will be punished. Working within the emergency services as I do I can safely say this is thankfully a rare occurance, if not unheard of.

MUTDs

Every body in the world could say at some point they have not been generous BUT if you committ to do a public service and life saving role …thats what you do unconditionally.

Every person has a right to a chance of life, how can any other person chose if someone lives or dies

Time to leave the job

ruthie, read meehaja’s post again: it would suggest to me that there may well have been no point in carrying out any care on this man. In fact in emergency and critical care there are many situations where you could do something but the parameters and lielihood of success mean you don’t.

These are not personal judgements, but can be thought of as ‘flowcharts’ with steps that have been agreed by huge panels of experts. There is very little ‘choice’ in it if you follow protocol. This is why crash teams in hospital can cease or even do not initiate cpr, and this is why we do not have whole hospital wings full of patients in what the protocols rather sadly call ‘persistent vegetative states’.

The comment ‘not worth saving’ from one crew member to another could actually be verbal shorthand for “the situation, odds of survival and correct procedure have been considered. It would be inappropriate to commence CPR on this individual in these circumstances.” That may not be a ‘choice’ as to whether someone lives or dies but more of an ‘evidence-based clinical decision’.

I actually work offshore with a guy (our medic), who lives next door to this guy, and was called by police for witness statements and the like. bad case all round by all accounts, and especially as a medic, he is pretty damning of these paramedics.

There are many cases where CPR is not advisable. I personally would never CPR someone unless 02 was available and I actually saw them collapse. (assuming asytole)and I would defend that decision in court as my professional judgement. I have done CPR quite a few times and have never seen a positive result. unless continuing on a ventilator brain dead for a month is considered a positive result. Too often CPR is molesting a corpse. I’d rather die with dignity thanks. I am considering having “NFR” (not for resus) tattooed on my chest.

Survival rates post CPR are very low unless the person involved is actually in hospital when they arrest and there is an obvious and easily eversible cause.

On the surface it seems in this case the paramedics based their decision on social rather than medical factors – BUT WE DO NOT KNOW THE WHOLE STORY.

And all people in the medical world make these sorts of decisions all the time. I personally have done so – not just not to resus but to stop treatment or to use opiates to relieve suffering despite them hastening the end.

My own views are at one end of the acceptable spectrum but I am content within this. I will make these decisions according to my own beliefs, the known wishes of the person involved and those of their families based on a medical assessment.

I clearly remember one case of a chap in a nursing home whos family insisted that no effort be spared. This wish was respected. I found him one day obviously dying – not asystolic but clearly dying. 999 was called and paramedics attended – they asked me why I called them – I explained and the poor chap was intubated, dripped and carted of the A&E where he died. He did go asystolic in A&E and CPR was attempted but he died – as we all knew he would. What a horrible way to die. He could have died in peace in his own bed with his loved ones around him but instead died in A&E with folk jumping on his chest and with needles being poked into him.