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Aclaración: La presente publicación, como cualquier otro medio de información electrónico o escrito no pueden, ni deben reemplazar la adecuada formación del alumno, cosa que solo  se obtiene en los cursos teórico - prácticos bajo las normas de certificadoras con estándares internacionales.
 
 
¿Hasta cuando reanimar?
 
Durante las clases de RCP queda en claro que el auxiliador debe continuar con las maniobras de RCP hasta que llegue el SEM y lo reemplace, o se agoten sus fuerzas. En caso de haber dos o más auxiliadores se pueden ir rotando para evitar el agotamiento.
Hay circunstancias especiales que sugieren que el final de la RCP debe ser hospitalario. La amplia bibliografía de RCPs prolongadas y exitosas en la hipotermia, ahogamiento y en niños así lo respalda.
Por la posible omisión de esta recomendación un paramédico y su empresa, de USA, se encuentran en problemas legales.  El día 30 de julio pasado fue en auxilio de un instructor de buceo que al finalizar una clase con SCUBA se hundió y varios minutos después fue rescatada del fondo por otro buzo. No quedó en claro la causa de su hundimiento. Doce minutos después de su rescate fue asistida por un paramédico durante 22 minutos, tras lo cual la habría considerado fallecida. Al reportar la novedad al hospital el médico de emergencias que recibió el llamado le ordenó recomenzar la RCP y trasladarla al hospital. Allí murió cuatro días mas tarde.
La demanda afecta a la companía que tardó doce minutos en llegar siendo que solo estaba a 3 kms.
La causa habría sido que estaba recibiendo los llamados del 911 por vía telefónica, por tener sus computadoras en reparación.
 
 
                                                                                                                    Dr. Omar Sanchez.

Diver's death spawns lawsuit against county, ambulance group.
Aug 2 2003 12:00AM By DAVE BROOKS 

The family of an Aptos scuba diving instructor who drowned last summer has filed a lawsuit against Monterey County and a local ambulance company for their handling of the incident. 
On July 30, 2002, Mollie Suh Yaley was returning to shore after giving a scuba diving lesson near Cannery Row when she slipped underwater and didn't emerge for several minutes. No one knows what caused her to go down. 
Yaley was soon brought back to the surface after a diver found her body on the ocean floor and rushed her to the shore of San Carlos Beach where she was attended to by waiting fire and police personnel. She had no pulse at the time. 
Twelve minutes later, a paramedic from the American Medical Response ambulance company reportedly arrived and unsuccessfully attempted to revive Yaley. She died four days later from brain damage sustained during the incident.
Yaley, 26, moved to Mariposa, a suburban enclave between Merced and Yosemite, as a small child after she was adopted from a Korean orphanage. She moved to Santa Cruz County to attend Cabrillo College and had also taken classes at the University of Colorado in Boulder. According to Mariposa County High teacher Betty Bryant, who instructed Yaley, the young girl was very athletic and outgoing and enjoyed traveling.
Her father and mother, William and Arlene Yaley, still live in Mariposa. William wouldn't comment for this story, but his attorney, Brian Evans of Walnut Creek, said the lawsuit alleges that the ambulance paramedic and the 911 dispatch center acted negligently and inadvertently caused Yaley's death. In his lawsuit she also charges that the county had ineffective protocols in place to deal with medical emergencies involving drowning. 
According to Evans and news reports by the Monterey Herald, the paramedic who responded to the accident spent 22 minutes attempting to revive Yaley. He then declared her dead at the scene and called a local hospital to report what had happened. An emergency room physician who received the call ordered the paramedic to resume CPR, which he continued to do until he arrived at the hospital with Yaley. 
"The paramedic in charge made the determination to cease resuscitation without checking with the hospital," Evans said. "There was nothing in the protocol at that time that talked about dealing with hypothermic patients." 
Evans also alleges that it took 12 minutes for the paramedic to arrive, despite being stationed only two miles away at the Pacific Grove Fire Department. According to Evans, the ambulance company had turned off its computer system for repairs and was taking 911 dispatches via telephone. Evans said that whoever received the 911 call for Yaley first attempted to contact AMR using the computer system, before realizing, nearly eight minutes later, that their dispatch had not gone through. 
Evans contends that he has consulted medical experts about the case and they told him that if the ambulance had arrived sooner and the paramedic hadn't ceased resuscitation efforts, Yaley likely would have survived. "She was only under water for a few minutes," Evans said. "There's every indication that this was a survivable case." 
The county has since revised its protocol on dealing with drowning victims. According to Monterey County Counsel Dick Barelli, "a paramedic must now call the hospital and get a physician's authorization to stop (administering) CPR." Evans contends that the new protocol is also flawed.
Despite the change in policy, Barelli contends that neither the county nor AMR were liable for Yaley's death. "They obeyed the protocol in existence at the time," he said.