the man looked pretty good for someone who had just had fifteen minutes of cpr.
out of hospital vf arrest. bystander cpr until the ambos arrived. four shocks to get back into sinus rhythm. there were massive tombstones on the ecg. we thrombolysed him but his chest discomfort and ecg changes persisted. time to get him out of here. fast.
if you live in mildura and have a cardiac arrest, on average your outcome will be worse than if you lived in melbourne. it's closer to adelaide but they'd rather you sent your patient to melbourne, even if its almost twice the distance, because after all mildura is in victoria. even if you always send your cardiac patients to adelaide because there is a more integrated, easier to navigate cardiology service there and your boss has mates there. even if the patient has already been accepted and has a bed waiting for them in adelaide. even if your patient has failed thrombolysis and is rapidly developing q waves.
sorry fellas, but i don't give a shit whether mildura is in victoria or south australia. it might as well be in afghanistan or on the moon if you are going to keep acting like dickheads. this man needs a hot plasty and he needs to be retrieved. end of story as far as im concerned. but in the end, it took as long to resuscitate and stabilise my patient, talk to the family and admit another two patients, as it took the retrieval guys to dick around and try and handball responsibility to each other, until finally they dumped it on the rfds.
it's just not good enough.
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