Discussion:
pericardiocentesis
newton
2004-02-18 04:56:49 UTC
Permalink
Hey all
This subject was brought up back in July with only a few
responses...Are there any flight programs out there which allow nurses
or paramedics to perform pericardiocentesis???? Any information would
be greatly appreciated. Thanks

Andrew Bartkus, RN, etc.
University of New Mexico Hospital-Lifeguard
kimberly mcintyre
2004-02-18 16:58:00 UTC
Permalink
I wanted to get back to you in regards to pericardiocenteses. We practice
this in our flight program although it is something only the RN is able to
perform by our protocols. We practice this skill every other month in a
cadaver skills lab and then have a written and clinical test on this
procedure once a year. I hope this helps you out. If you have anymore
questions I would be happy to answer them.
Take Care,

Kim McIntyre, RN, etc
CareFlight Air /Mobile, Dayton, Ohio
----- Original Message -----
From: <newton at unm.edu>
To: <flightmed at flightweb.com>
Sent: Tuesday, February 17, 2004 11:56 PM
Subject: pericardiocentesis
Post by newton
Hey all
This subject was brought up back in July with only a few
responses...Are there any flight programs out there which allow nurses
or paramedics to perform pericardiocentesis???? Any information would
be greatly appreciated. Thanks
Andrew Bartkus, RN, etc.
University of New Mexico Hospital-Lifeguard
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RNBK117
2004-02-19 05:40:44 UTC
Permalink
Either the RN or the Paramedic may peform a pericardiocentesis when indicated for a patient in cardiac arrest (medical or trauma) with PEA and other causes have been ruled out. For other circumstances we can contact Dr. Duke to let him know what the situation is and what we feel is necessary (either radio contact or phone).

Lori Ortiz RN, BSN, LP
Memorial Hermann Life Flight
Houston, Texas
Wendland, Barbara
2004-02-18 17:01:19 UTC
Permalink
Yes, st Stanford Life Flight we are allowed to perform pericardiocentesis, however only in traumatic arrest situations. We maintain competency via cadaver labs.

Barbara Wendland, RN, MS

Acting Chief Flight Nurse

Stanford Life Flight/Dispatch Center





Hey all
This subject was brought up back in July with only a few
responses...Are there any flight programs out there which allow nurses
or paramedics to perform pericardiocentesis???? Any information would
be greatly appreciated. Thanks

Andrew Bartkus, RN, etc.
University of New Mexico Hospital-Lifeguard
PT Minead
2004-02-20 04:52:49 UTC
Permalink
WOW!

I spoke with one of my trauma surgeons with over 30 yrs experience - he has seen only 5 work ( under ultrasound guidence) If you are doing prehospital pericardiocentenesis with "frequent success" - This is a trauma milestone and your experiences with this procedure should published in a major medical journal.

PT Minead EMT-P


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AAFLTMEDIC
2004-02-20 16:25:21 UTC
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Katrina,
Could you give a little more description about your statement "We have
done a fair amount of them with success." I don't intend to second guess your
comment, it is just very contrary to my own experiences. I think there is a
tremendous opportunity for adjusting the practice of aeromedical care in the
future using evidence based medicine, so I am particularly interested in this
type of information and how it might lead to a true EBM project in the future.
Thanks in advance.

Chris Poulsen
DramaDivaDeb
2004-02-21 03:31:58 UTC
Permalink
well, to add discussion and trivia...
I was on a flight where the other nurse on board performed this procedure and
bought us time to get back to our base. The outcome was not positive
overall, however the patient did survive the flight and make it to the OR and then
the ICU.

HOWEVER,
a few years later I was required to testify on the stand at a legal matter
not related to this flight, but to the surgeon that was over the trauma service
at the time...I was TORTURED mercilessly by the attourney for the surgeon
about our legality to perform this procedure. WHICH we were clear to perform by
training, and our protocol. This did not stop the attourney from trying to
skewer me. (even though I was the secondary nurse on the flight.)

SO please be confident in your rationale and performance. Controversial
procedures leave you open for great scrutiny

d. krupa
UFGatorD
2004-02-21 15:21:26 UTC
Permalink
as far as doing a pericardiocentensis, in my 9 years in paramedicine i
have done the procedure once in a last ditch effort to reverse a trauma patient
in PEA with all other means exhausted. even though, to my knowledge, the
procedure was what i expected, it did not change or improve the outcome. my
experiences have seen that this is not only a rare occurrence, but not an entirely
successful one, even for surgeons (in reference to emergent care and not
surgery). i believe that if even one person can possibly be saved by this procedure
that it should remain until we prove that it is iatrogenic to the people we
serve. to say this intervention is fairly successful, i agree with a previous
response in that you should document it as it is a major revelation in not only
prehospital care, but in medicine as a whole. i think that we are an advanced
forum to the prehospital and critical care setting and that some people should
be more careful as to what they are saying. we are here to learn, not to
impress or impose superiority. on a more serious note, we have recently lost some
members of our flight community and i send my condolences to their friends and
families. i hope that everybody else has a safe year.

respectfully,
derek hunt nr/ccemt-p, pncct, fp-c
ufgatord at aol.com

ps- we use labatelol in 10mg increments up to 80mg. i've been told that 20mg
is the therapeutic dose. i have great fondness for the drug and i think it
works very well.
PT Minead
2004-02-21 17:51:43 UTC
Permalink
While we are on the subject of low yield procedures.... I know that there are some flight programs that claim "post mortem c-sections" as one of their authorized procedures.

I was wondering what type of training is required?


PT Minead


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