Signs of catastrophic events

[Guest guest]

Many of us have seen a patient who went into witnessed cardiac arrest and we

observed that there was a " wave " of color change from the nipple line to the

top of the head, purple/blue, and no matter how well we did CPR, it never

changed, and the patient did not survive no matter what electrical and

pharmacological interventions we did.

The patient's upper torso, neck and head remained completely cyanotic and

never changed color even with aggressive CPR. Pupillary response was zero, and

pupils were fixed and dilated no matter what we did.

We generally ascribe that to a disastrous happening of some sort, aortic

dissection, saddle pulmonary embolism, massive stroke, myocardial rupture, and

so

forth.

My question is this: How many of you have observed this? For the

physicians, is this a recognized syndrome that is addressed during your

education?

For the nurses and paramedics, have you witnessed this?

If so, did you have a " name " for it? Is it a recognized syndrome?

Do any of you have explanations for this based upon research or any sort of

medical evidence?

GG

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[Guest guest]

Hey Gene

Yes I can think of one specific one that still sticks in my mind after

approx. 20 years(long ago..... lol)

I wasn't a medic, got a 911 call to an apartment complex, North end of the

county i.e. longer response time, little or No first response, found an 40 ish

yo male lying supine in bed with the prior described coloring, warm to touch,

no pulse ,no resp.-- family friend/family preacher doing CPR, the whole

situation, circumstances were " strange " , however no signs of any trauma or

suspions of other things--- so packaged Pt. and loaded up--- 30 mins CPR by

hand to

the Hosp., me , paramedic and a driver---- Could not call it, due to age and

no Hx etc., never got anything back en route, turned over Hosp. worked and

then pronounced-- only reason we know what happened is because autopsy/ME

case, and then went straight to my EMS director for a meeting ( family

suspected

problems)---- when you back up to the dock and the family is screaming in the

parking lot to the wife that she killed your Pt. hmm?---- Death ruled ---

Not sure of proper name " venal cava' shutdown--- the Dr, explained that this

was the reason behind coloration with a normal body temp----

Dawn

ps just got off shift hope it makes sense.

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[Guest guest]

All the ones I've dealt with have always shown to have had a PE at post mortem.

-MH

________________________________

From: texasems-l [mailto:texasems-l ] On Behalf

Of wegandy1938@...

Sent: Thursday, October 16, 2008 3:30 AM

To: texasems-l ; Paramedicine ; WEGandy@...

Subject: Signs of catastrophic events

Many of us have seen a patient who went into witnessed cardiac arrest and we

observed that there was a " wave " of color change from the nipple line to the

top of the head, purple/blue, and no matter how well we did CPR, it never

changed, and the patient did not survive no matter what electrical and

pharmacological interventions we did.

The patient's upper torso, neck and head remained completely cyanotic and

never changed color even with aggressive CPR. Pupillary response was zero, and

pupils were fixed and dilated no matter what we did.

We generally ascribe that to a disastrous happening of some sort, aortic

dissection, saddle pulmonary embolism, massive stroke, myocardial rupture, and

so

forth.

My question is this: How many of you have observed this? For the

physicians, is this a recognized syndrome that is addressed during your

education?

For the nurses and paramedics, have you witnessed this?

If so, did you have a " name " for it? Is it a recognized syndrome?

Do any of you have explanations for this based upon research or any sort of

medical evidence?

GG

**************

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[Guest guest]

Gene my first two codes when I got into EMS were that way. I have

seen a few more since then as well. My first one was when I was an

ECA and a Paramedic said basically something exploded inside and you

do not get those codes back. He had given me more medical terms but

summed it up that way so as an ECA with no real medical education I

could understand.

The explanation I have been given since basically comes back to that

as well. I do look forward to the doctors on here providing us more

explanations and proper terminology.

Renny Spencer

EMT-I

Paramedic Student and hopefully only injured reserve for a couple of

more weeks.

>

> Many of us have seen a patient who went into witnessed cardiac

arrest and we

> observed that there was a " wave " of color change from the nipple

line to the

> top of the head, purple/blue, and no matter how well we did CPR, it

never

> changed, and the patient did not survive no matter what electrical

and

> pharmacological interventions we did.

>

> The patient's upper torso, neck and head remained completely

cyanotic and

> never changed color even with aggressive CPR. Pupillary response

was zero, and

> pupils were fixed and dilated no matter what we did.

>

> We generally ascribe that to a disastrous happening of some sort,

aortic

> dissection, saddle pulmonary embolism, massive stroke, myocardial

rupture, and so

> forth.

>

> My question is this: How many of you have observed this? For

the

> physicians, is this a recognized syndrome that is addressed during

your education?

> For the nurses and paramedics, have you witnessed this?

>

> If so, did you have a " name " for it? Is it a recognized

syndrome?

>

> Do any of you have explanations for this based upon research or any

sort of

> medical evidence?

>

> GG

>

>

>

>

>

>

>

>

> **************

> New MapQuest Local shows what's happening at your destination.

> Dining, Movies, Events, News & amp; more. Try it out

> (http://local.mapquest.com/?ncid=emlcntnew00000002)

>

>

>