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View Full Version : Paramedic jargon and stitches on a deceased person



inspiredbymusic
03-21-2013, 05:02 PM
1) If 911 is called and paramedics arrive at a house to find a patient who was briefly unconscious, not breathing, no pulse, but was revived by CPR and is now doing pretty well, what kind of things would the paramedics say and do as they move the patient to the ambulance to take her to the hospital?

2) If a person died during emergency surgery, would the stitches used to close an open wound (on the body of the deceased) be different than those used on a living person? If so, in what way would they be different?

Thanks for any and all help and advice!

Dandroid
03-21-2013, 07:04 PM
1. If I arrived on scene and the patient had been revived by a bystander I would assume that they never actually went into arrest...If I revived them merely from CPR I'd be taken aback...CPR in most cases doesn't cause the heart to resume beating, defibrillation does (assuming v-fib or pulseless v-tach). I have heard of patients that were found VSA (vital signs absent--the lingo we use for this type of call) but came to after compressions were commenced.


So for this scenario, I would say that the medics would be thinking "holy crap, please don't die on me before we get to the hospital, please don't re-arrest, wtf just happened, no one is going to believe she was VSA."

to each other: "you give the patch to the ER, I'm not."

ebbrown
03-21-2013, 11:00 PM
1) If 911 is called and paramedics arrive at a house to find a patient who was briefly unconscious, not breathing, no pulse, but was revived by CPR and is now doing pretty well, what kind of things would the paramedics say and do as they move the patient to the ambulance to take her to the hospital?

Post CPR support involves supportive measures. A patent airway needs to be maintained; if the airway is questionable the patient will be intubated (tube down throat and bagged to assist breathing until arrival at the hospital where the patient can be placed on a ventilator). Sometimes after CPR the heart rhythm is not stable; patients given medications like an anti-arrhythmic(lidocaine, for example) may need a continuous drip to maintain an effective heart rhythm. If the post-CPR patient is breathing on his own, he will at least be supported with bag-valve mask. Like Dandroid said, it would be unlikely to have a patient post-CPR that does not need some sort of supportive care.
That said, patients get CPR for different reasons; Cardiac arrest due to a massive MI (heart attack) may bring back a pulse (which will need supportive measures to maintain), but the cause of that issue is likely a BLOCKAGE to the heart which will not get better without intervention (cardiac catheterization). However, a patient who OVERDOSED on heroine, however, can be found with no respirations, no pulse/thready pulse, and looking quite blue and dead...yet if you give this patient one dose of Narcan, he wakes right up in about 30 seconds and wants to sue you to get his money back since you took away his high. You will see the naked backside of this patient as he/she is running down the hall screaming about signing out AMA, which is always an amazing sight when the patient was quite dead only a few minutes prior.
That said, strange things can happen, especially if you need it for your story. I had a patient go into v-fib as she was talking to me not too long ago. I started CPR immediately and called for help. We coded her for over 1 hour, during which we called the code at LEAST four times. That patient woke up after her 7th shock, clutching her chest. The priest at the bedside says I am forgiven for the curse words I used when she sat up.
It's not often a patient in true arrest will wake up and be able to talk.
Oh, another thing to consider, depending how medical-heavy your story is: Post-arrest patients who remain unresponsive will get hypothermia protocol treatment for post-cardiac arrest. This is a method of rapid cooling the body with the goal of preserving neurological function in a patient who has likely experienced a lengthy episode of hypoxia (lack of oxygen.) This is considered the gold standard of care in the US. We have post-arrest patients flown in to be cooled after a successful code. Something to keep in mind.

2) If a person died during emergency surgery, would the stitches used to close an open wound (on the body of the deceased) be different than those used on a living person? If so, in what way would they be different? Nahh, same stitches.

Thanks for any and all help and advice!.

melindamusil
03-21-2013, 11:29 PM
Things learned from watching too much CSI...
If a person died during surgery, most likely the surgeon (or at least a surgery resident) would be the person who closed the wound, so they'd use the stitches they know (regular surgery stitches).
However, if for whatever reason the person closing the wound is the mortician, those would be different stitches. The goal of a surgeon on a live person is to fix the problem and keep the person alive; the goal of the mortician is to make the dead person look as normal as possible for the visitation.

sheadakota
03-22-2013, 12:10 AM
A mortician works in a funeral home and prepares the body for viewing, he would not be in an operating room. If a patient t dies on the table with an open body cavity, the surgeon will simply close the wound with regular stitches. Now if the body requires an autopsy, the pathologist will close with a thicker thread than a surgeon would.

inspiredbymusic
03-22-2013, 05:46 PM
Thank you all so much for the very helpful responses!
I will probably be back with more questions soon. ;)

iLion
03-22-2013, 09:33 PM
To add my 2-cents....

The embalmers (they're licensed by the state) work for the funeral homes, and the stitch they use (in my experience) is called a baseball stitch. It's not meant to be pretty, because will probably be covered by clothes etc. and it's quick and easy.

Also, in the hundreds of autopsies I was involved in, I never knew a pathologist to sew a body closed. That, in my experience at least, was always left to the funeral home.