Reaction to a tragedy. AED, BLS, CPR, First Aid, Stop the Bleed.

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  • Bassat

    I shoot Canon, too!
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    There is a concurrent post up about a Sheriff's deputy dying from an accidental discharge which caused a 'Leg' (most likely femoral artery) bleed. His death is a testament to the fact that each and every one of us can become the victim of such happenstance in an instant. Vigilance is demanded, yet it will never be enough. We MUST be prepared to respond to such an incident when (NOT IF!) it happens. I am personally encouraging all who read these pages to take a step to becoming better prepared to react to a medical emergency. I am a registered nurse, currently working in Elkhart General Hospital (EGH). My job requires me to maintain qualifications for AED (Automatic Electronic Defibrillator), BLS (Basic Life Support), CPR (CardioPulmonary Resuscitation), and ACLS (Advanced Cardiac Life Support - medical professionals only, I think), First Aid and Stop the Bleed training were obtained independent of my job.

    It is my well-considered opinion, that ALL able-bodied people should be at least qualified to use an AED, and to know BLS/CPR. First Aid and Stop the Bleed kits are available at most pharmacy outlets and certainly on Amazon.com. There is nothing difficult or mysterious about any of this stuff. I think most folks encountering an emergency just stand there looking stupid because they: 1.) Dont' KNOW what to do, or 2.) Think/Hope someone else will react. Training on all of these procedures/devices is available locally. Seek out training yourself, encourage your school or employer to help provide such training. EVERYONE should have a modicum of emergency response training, because ANYONE may become the next victim.

    Two personal stories that I hope will help encourage you to take this seriously. I was in my 20s at the time, at a hair salon getting a haircut while my wife got the whole nine yards. There were tanning beds in the basement. An employee runs up from the basement screaming, "DOES ANYONE KNOW CPR? HE ISN'T BREATHING!" I had military first aid training and COULD HAVE DONE SOMETHING. I sat there pretending I didn't know anything, hoping someone else would help. St. Joe Mishawaka Hospital was 3 blocks down the street. An ambulance came quickly. The gentleman did not survive. I watched them carry him out, covered. I don't know whether or not I could have helped him. I do know that I did not try. Forty years later, I can still hear the screaming and see the body on a gurney. Never again.

    Fast forward 40 years. I was admitting a patient to our unit at EGH. A routine admission question is: "What brings you here, today?" Could be doctor's orders, chest pain, short of breath, fainted, bad stress test, abnormal EKG, and a bunch of other reasons. This particular patient responded, "I am here because my grandson saved my life." I asked for the story. Seems the family was sitting around the table the previous evening enjoying dinner and good family company. All the patient remembered was, "I was eating dinner. Then I was in an ambulance." His grandson told me that Grandpa was eating as usual, with a forkful of food, he just froze for an instant, then fell out of his chair. The grandson yelled at his little sister to CALL 911, Grandpa is in trouble. She did so, while the 17 year old grandson had the presence of mind to clear grandpa's mouth of food, and start CPR, within seconds of him hitting the floor. He learned CPR in a high school health class. EMTs arrived, took over care, and got grandpa to the ER. The next day, I got him ready for the doctors to check him out. I don't remember what we did for him. But, I know we would never have gotten the chance if it weren't for his grandson's intervention. I do know he walked out of the hospital the next day.

    Get yourself qualified to use an AED. It really is self-explanatory, and no medical knowledge is required. Take a BLS/CPR class, the life you save may be someone you love. Buy a first aid kit, and a Stop the Bleed kit. They are not overly expensive. If you can't afford training, watch YouTube videos. Anything is better than nothing. If that deputy's death sticks in your craw, do something about it. Please.
     

    Colt556

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    I was an RN for over 20 years before my own health caused me to leave the profession, but during that time I’ve used my knowledge outside of the clinical setting 3 times in emergent situations.
    The first incident was while I was still in school and came upon a young mother with her daughter who were riding bikes and struck by a hit n run driver. My gf at the time came along right after the accident and while she treated the mother I took care of the toddler. I was scared shitless but you just do what needs to be done. There was no evidence of broken bones but she had several lacerations with the worst being a bleeding head wound. I held pressure and made sure she was breathing until the ambulance arrived. The mom was about 10-15 yards away and much more severely injured. They both were transported away on Lifeline. I never knew what happened to them.

    The second was on a flight home from Fort Lauderdale one night. Right as I was getting comfy mid flight the dreaded “Is there doctor on board “ announcement brought me back to reality. After the 2nd call for help I responded that I was a nurse. A passenger was complaining of chest pain and not feeling well. Another nurse showed up and as we were assessing him he goes out. After not being able to release the arm rest we lifted him over it and stretched him out in the aisle with his feet elevated. The AED was fairly new at the time and luckily I had just been in serviced on its use. As we were getting him hooked up he came around and didn’t need a shock or any further intervention other than our monitoring. I was called to the cockpit and spoke with a doctor on the ground via headset about his condition and if I thought they needed to make an emergency landing somewhere. As he was awake, pain free and had normal vitals we decided to carry on to Indy where we were met by paramedics and ambulance. I checked in on him later at the hospital and it was decided he had had a little too much fun n sun before he boarded the plane. It was pretty cool to see how well the flight was prepared for medical emergencies and to go to the cockpit to speak to the pilot and doctor on the ground.
    The sad part about the whole situation is how so many people were complaining and grumbling that they had to wait about 10-15 minutes while the EMTs removed the patient before they could deplane. Sheesh!

    The 3rd outside experience was a friend choking on a hunk of bbq. A simple Heimlich maneuver solved that issue.


    Sorry for the long post but I wanted to share my experiences and to stress how important education and preparedness can be. Please be safe and watchful at all times.
     

    92FSTech

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    This is a good thread! At least know enough to be a part of the solution, not part of the problem.

    I've done compressions more times than I can count. I've also shocked people with the AED a few times. Usually it doesn't work, but I'm also usually responding well after the fact. We beat the ambulance, but somebody still had to find them, call in, and wait for us to get there. If somebody on site starts right away the odds get much better.

    It's also vital to know how to do it. I can't tell you how many times I get on scene and a family member is weakly pushing on the patient's chest while they're still lying in bed. That's doing nothing. You need them on a hard surface, and if your compressions aren't breaking ribs, especially on an elderly person, you're probably not doing it hard enough. CPR isn't like the movies...it's violent and traumatic, and if they do manage to get you back you're going to have some significant healing to do just from the process itself.

    Also, come to terms with the fact that statistically, they're probably going to die. CPR success rates are not good. Their heart stopped for a reason, and often that reason is catastrophic and no amount of effort is going to start it again. But at least you know you did something and gave them the best chance possible. I've had a few at least make it to the hospital with a pulse, and one that I know is a healthy kid today because we got there immediately and got it done. I still get periodic email updates from her mom. Even if that's the only one I ever have with that outcome, it was totally worth it.

    Tourniquets are good, too. If you do it right, it's gonna hurt. Bad. The only one I've ever personally applied in real life was on a guy who tried to commit suicide. He was unconscious when we got there from blood loss, but when he woke up he was more pissed about how much that tourniquet hurt than anything else. It stopped him from bleeding out, though.
     

    Bassat

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    92FSTech,

    Thanks for the completely realistic assessment of CPR. It is HARD to do, and HARD on the recipient. I'm not sure where I heard this, most likely an ACLS class, but hear goes. Yes, most full blown cardiac arrest victims will not survive. The 'walk out of the hospital rate' for out of hospital cardiac arrest is disturbingly low, 7%. I am sure that rate could be improved, IF MORE PEOPLE WERE PROPERLY TRAINED, and responded immediately. And its not just CPR. Look at AED, first aid, and stop the bleed kits. But what you need most is the knowledge and confidence to respond immediately.
     

    brdhntr37

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    Well said. Since graduating college, I have been required to be cpr certified and maintain my certification. CPR has always been one of those things that I've always looked at as "I'll never actually have to use it". I had learned it, but only because I had to.

    I was at a shoot a couple of months ago where one of the guys had a heart attack after he came off the line. Cpr was performed (and AED used after medics arrived) and the gentleman is still alive today because of it. After that happened, I became a firm believer in everyone being able to do it (and do it correctly!!).
     

    Bugzilla

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    Many companies had (mandatory??) CPR training. This seems to be going by the wayside as the last 2 companies I work(ed) for do not. Have had CPR courses but not for several years.
     

    shibumiseeker

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    Many companies had (mandatory??) CPR training. This seems to be going by the wayside as the last 2 companies I work(ed) for do not. Have had CPR courses but not for several years.
    And my experience is that in many ‘mandated’ trainings, a large number of people sit there and mouthbreath because they don’t care. Boss says they have to be there, so they are there.

    I’ve been in rescue and emergency response my entire life and have taught it much of my adult life and it boggles my mind how many people not only don’t know the basics each of us should know, but also how many people actively resist learning them.
     

    Leadeye

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    While I understand if you need CPR there isn't a question, I'm curious to what it does if you have had a full sternotomy.
     

    92FSTech

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    While I understand if you need CPR there isn't a question, I'm curious to what it does if you have had a full sternotomy.
    Probably the same thing that happens if you don't...it breaks stuff. It probably depends how well the sternum has healed whether or not it gives first or the ribs do, but something is going to give.

    I'm no doctor and they've never directly addressed that in any of my CPR classes, but I can't imagine that it's altogether an uncommon situation. Most folks that end up having a heart attack have pre-existing conditions that caused it, and many have had procedures in the past.
     

    Bassat

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    While I understand if you need CPR there isn't a question, I'm curious to what it does if you have had a full sternotomy.
    A bit of first-hand knowledge here. DO IT ANYWAY. If the patient is in full blown cardiac arrest, what is it going to hurt? HIS HEART IS NOT BEATING. He will be completely and irretrievably DEAD in about 3 minutes if folks (nurses most likely) stand around and stare at him. WHO GIVES A FROG'S FAT ASS IF YOU MESS UP THE SURGEONS PRETTY WIRE-JOB???? About 7 years ago, I saw a patient fresh out of open heart surgery (sternotomy) go into complete cardiac arrest on a Surgical Intensive Care unit. Nurses on the unit did what they had been trained to do: GET HIS HEART GOING. Period. Plain-and-simple. End of story. (Well, hopefully not for the patient.)
     

    freekforge

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    I've taken 22 cpr aed first aid classes both community and professional Healthcare provider both aha and rc. And I plan on taking 2 more this year. I've spent a total of 8 years of my 29 year life in some kind of public service. I have used medical skills more off duty or not associated with a service more than I have while on duty. I knew from the 1st time I took a cpr class that I would have to do it. Not long after my first class I was at Aldi with my mom when a man collapsed and everyone was screaming for help. I bagged our groceries and walked out. That still eats me alive to this day. Since then I've made sure I have the skills and supplies needed. That first class and also the guilt from walking away have been blessings for me. They push me in the right direction. That guilt has saved lives. that guilt has allowed the family to be next to a clean loved one when they died instead of covered in blood and puke on the ground. It doesn't always work in fact in fails more than succeeds but I know I'll never feel that shame and guilt again. It's hard it's scary but it's worth it.

    I hounded my job to offer cpr classes and to get bls supplies and it finally paid off. Now I'm working on a new company policy regarding our 1st responder program. We're able to get over 20 employees trained for the first time last year.
     

    Leadeye

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    TAVR, or OHS?
    OHS, they did a LAA procedure as well. It was strangely familiar at my pre op interview with the surgeon, she talked about all the things she could do while she was in there, it reminded me of engine repair discussions I've done in the past. No coronary artery work required, the cath lab gave me an all clean OK.
     

    Bassat

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    OHS, they did a LAA procedure as well. It was strangely familiar at my pre op interview with the surgeon, she talked about all the things she could do while she was in there, it reminded me of engine repair discussions I've done in the past. No coronary artery work required, the cath lab gave me an all clean OK.
    I did the same in August. Mitral valve repair.
     
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