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

[Amishman44]

I was a Certified Athletic Trainer / high school biology and health teacher / and Volunteer EMT for 26 years...and now teach Emergency Trauma Response skills through the USCCA!
The two biggest immediate threats to human life, in the event of a traumatic emergency response, is blood loss and a lack of oxygen to the cells. Training for the stopping of bleeding (GSW, knife wound, and open fracture) and circulation of oxygen (if needed) are the two most important things that need to be taught, understood, and practiced.

 

[Ruger_Ronin]

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.

Very much agreed. Well said.

 

[Ruger_Ronin]

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.

I can attest to this. Responded (as civilian) to a cardiac arrest at a restaurant last year. 2.5min of CPR is a lifetime, and exhausting. I fatigued close to 3 min, and tagged in an untrained waitress. She performed well, not having ever taken a single class. I sang the BeeGees to her at volume on a crowded street. For another minute and half she kept compressions while I directed. Happy to say we were successful.

 

[Amishman44]

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.

As a volunteer EMT (26 years) I've been involved in providing CPR on 7 different occasions...none made it, but the most difficult one (physically) when I joined the flight crew and flew back on Samaritan helicopter to provide chest compressions. Performing chest compressions during the 7 minute flight, I was completely exhausted by the time we landed and a trauma response team member took over.

 

[freekforge]

As a volunteer EMT (26 years) I've been involved in providing CPR on 7 different occasions...none made it, but the most difficult one (physically) when I joined the flight crew and flew back on Samaritan helicopter to provide chest compressions. Performing chest compressions during the 7 minute flight, I was completely exhausted by the time we landed and a trauma response team member took over.

I think tv has given people the wrong idea about cpr. My wife was watching grays anatomy and I saw on of the surgions doing cpr at 5 compressions to 2 breaths with about 1/2" deep compressions. And the patient woke up. And the surgeon didn't act or look tired at all. I believe people have died because the good samaritan has the wrong idea. I also think good Samaritans have suffered mentally because what they seen on TV didn't happen to them.

At work I've been talking with our 1st responders about how hard it is. When I did it for 25minutes alone in July it destroyed me physically. I broke down in tears as soon as I was alone with my wife because my lower back was killing me and I tore up my own chest due to a surgery I had 11 years ago. Fast forward to November and my back was so bad I couldn't walk. People need to understand it is a VIOLENT FIGHT for life.

That was the all around hardest for me both mentally and physically.

 

[Bassat]

I think tv has given people the wrong idea about cpr. My wife was watching grays anatomy and I saw on of the surgions doing cpr at 5 compressions to 2 breaths with about 1/2" deep compressions. And the patient woke up. And the surgeon didn't act or look tired at all. I believe people have died because the good samaritan has the wrong idea. I also think good Samaritans have suffered mentally because what they seen on TV didn't happen to them.

At work I've been talking with our 1st responders about how hard it is. When I did it for 25minutes alone in July it destroyed me physically. I broke down in tears as soon as I was alone with my wife because my lower back was killing me and I tore up my own chest due to a surgery I had 11 years ago. Fast forward to November and my back was so bad I couldn't walk. People need to understand it is a VIOLENT FIGHT for life.

That was the all around hardest for me both mentally and physically.

My wife and I are both BLS, and ACLS certified. She is also PALS (Pediatric Advanced Life Support) certified. Both of have used these skills on real people in real situations. Both of us agree the TV does a HUGE, MONSTROUS disservice to reality when CPR is depicted. It boggles my mind that on TV: The bad guy gets shot once in the chest with a mid-caliber handgun and flies 30 feet in the air, through a tempered glass 48th floor window... you know the scene. CPR is depicted as something an arthritic 97 year old 85-pound great-grandma can do, for hours. Good training involves changing compressors every two minutes. Standard is 100-120 2" compressions per minute, for 2 minutes. How much could you bench press 240 times in two minutes? It IS exhausting.

 

[freekforge]

My wife and I are both BLS, and ACLS certified. She is also PALS (Pediatric Advanced Life Support) certified. Both of have used these skills on real people in real situations. Both of us agree the TV does a HUGE, MONSTROUS disservice to reality when CPR is depicted. It boggles my mind that on TV: The bad guy gets shot once in the chest with a mid-caliber handgun and flies 30 feet in the air, through a tempered glass 48th floor window... you know the scene. CPR is depicted as something an arthritic 97 year old 85-pound great-grandma can do, for hours. Good training involves changing compressors every two minutes. Standard is 100-120 2" compressions per minute, for 2 minutes. How much could you bench press 240 times in two minutes? It IS exhausting.

When the incident in July was over my wife said "that's nothing like what's on tv". I think you should have to watch real cpr on video for the class just so you have a realistic idea of it instead of watching some crappy animation.

I tried to protect my wife and handle it all myself but looking back that wasn't the best idea and wasn't the best care we could provide and that's regrettable and i still feel the physical effects well. That was the hardest thing I have ever done mentally and physically. Everything hurt all I wanted to do was stop and relax. I start gagging when my kids would spit up as newborns but I was so beat down that I sat with a strangers puke on me for a couple hours because I didn't have the energy to get into the shower.

That said I'm glad it happened because it helped bring me to God.

I sent the information in to get into emt classes at ivy tech with the hopes to get on with county as either a volunteer or part time then later down the road as an emt for our hospital system. It'll be a paycut but it's a righteous cause.

 

[Amishman44]

I think tv has given people the wrong idea about cpr. My wife was watching grays anatomy and I saw on of the surgions doing cpr at 5 compressions to 2 breaths with about 1/2" deep compressions. And the patient woke up. And the surgeon didn't act or look tired at all. I believe people have died because the good samaritan has the wrong idea. I also think good Samaritans have suffered mentally because what they seen on TV didn't happen to them.

At work I've been talking with our 1st responders about how hard it is. When I did it for 25minutes alone in July it destroyed me physically. I broke down in tears as soon as I was alone with my wife because my lower back was killing me and I tore up my own chest due to a surgery I had 11 years ago. Fast forward to November and my back was so bad I couldn't walk. People need to understand it is a VIOLENT FIGHT for life.

That was the all around hardest for me both mentally and physically.

I agree...TV CPR is a joke compared to real life...no one is smiling or cracking jokes, and in real life you will feel it when you break the ribs on the patient when chest compressions are done correctly! I'm zero for seven (0:7) with CPR...including a 4-month old (who was born 8 weeks premature) who had underdeveloped lungs...SIDS was the official statement on the DC.
It's important to note that once one starts CPR, they are obligated to continue until a) someone takes over, b) the scene becomes 'unsafe' (fire, water, electrical lines, etc.) and, c) fatigue. One can legally stop performing CPR, and not be sued, due to physical fatigue. Many people don't understand the term 'heroic efforts' in describing the traumatic 'fight-for-life' that CPR actually is! It is last ditch DESPERATION to save someone! Most people don't make 10-12 minutes under the fatigue statute. At the most, 15 minutes is considered 'beyond' human limits, when it comes to performing CPR, and that includes those who're super physically fit!

 

[92FSTech]

When I did it for 25minutes alone

Holy cow man, that's impressive. The longest I've ever gone alone was getting close to 10 minutes, and that was with breaks for the AED to analyze. By that point we'll say I was pretty unhappy with fire and medics who were taking their sweet time getting there. They had legitimate reasons, but none of those mattered to me at the time! 25 minutes would be brutal.

These days fire has the autopulse. It takes some of the effort out of it, although getting it set up right can sometimes be a challenge, especially in a tiny overcrowded trailer. The band is overly fragile, it can only accommodate people up to a certain size, and batteries are finite. Supposedly it has a better save rate than manual CPR because it's more consistent than a person can be. I haven't personally witnessed that, but "better" is also kind of a relative term when you're only talking 3-5% for manual.

 

[Amishman44]

I can attest to this. Responded (as civilian) to a cardiac arrest at a restaurant last year. 2.5min of CPR is a lifetime, and exhausting. I fatigued close to 3 min, and tagged in an untrained waitress. She performed well, not having ever taken a single class. I sang the BeeGees to her at volume on a crowded street. For another minute and half she kept compressions while I directed. Happy to say we were successful.

Performing CPR falls into the 'anaerobic' (non-oxygen) sport category and even the 'fittest' of individuals, due to it's high-intensity physical activity, burn out quickly! The newest version of CPR (chest compressions only, no breathing required) runs 100-120 BPM very quickly becomes a physically demanding exercise.
Glad to hear you were successful in your endeavor!

 

[Amishman44]

Holy cow man, that's impressive. The longest I've ever gone alone was getting close to 10 minutes, and that was with breaks for the AED to analyze. By that point we'll say I was pretty unhappy with fire and medics who were taking their sweet time getting there. They had legitimate reasons, but none of those mattered to me at the time! 25 minutes would be brutal.

These days fire has the autopulse. It takes some of the effort out of it, although getting it set up right can sometimes be a challenge, especially in a tiny overcrowded trailer. The band is overly fragile, it can only accommodate people up to a certain size, and batteries are finite. Supposedly it has a better save rate than manual CPR because it's more consistent than a person can be. I haven't personally witnessed that, but "better" is also kind of a relative term when you're only talking 3-5% for manual.

I'm not always a big believer that everything 'electronic' is better...although there are always designers, who come up with an idea with the goal of selling a product to make $$, who will say differently!

 

[freekforge]

Holy cow man, that's impressive. The longest I've ever gone alone was getting close to 10 minutes, and that was with breaks for the AED to analyze. By that point we'll say I was pretty unhappy with fire and medics who were taking their sweet time getting there. They had legitimate reasons, but none of those mattered to me at the time! 25 minutes would be brutal.

These days fire has the autopulse. It takes some of the effort out of it, although getting it set up right can sometimes be a challenge, especially in a tiny overcrowded trailer. The band is overly fragile, it can only accommodate people up to a certain size, and batteries are finite. Supposedly it has a better save rate than manual CPR because it's more consistent than a person can be. I haven't personally witnessed that, but "better" is also kind of a relative term when you're only talking 3-5% for manual.

It was horrible but I'm a better person because of it. I sent my wife and the man's wife to try to find help or a cell signal. I went 20 alone with about a minute break when I had the wife and a bystander try to help but they werent going deep or fast enough and i kicked them off and took over. then the dnr security guard came with an aed I stopped to breath just long enough to cut his shirt off then started again. I know we should have maintained compressions but I needed that split second break. We went for another 5 minutes with me doing compressions before police and rescue came. A deputy got an attitude with me because for the last couple of minutes I was going about 130 compressions a minute. I was at my breaking point and all I could do was go fast I tried to slow down but when I did I couldnt get deep enough. It was my last burst of energy and you get what you get and don't throw a fit lol.

They put a Lucas device on him beat the snot out of him. He was flatline then PEA then flatline then PEA then out of nowhere a pulse. It was on and off then they kept a pulse long enough to fly him out. They ran cardiac drugs through an IO which was cool to see.

 

[92FSTech]

I'm not always a big believer that everything 'electronic' is better...although there are always designers, who come up with an idea with the goal of selling a product to make $$, who will say differently!

The good thing about it is that if it stops working for whatever reason, you just go back to manual, so you're not really losing anything by trying it.

One of my medic buddies said their save rate has increased since we implemented them in our county, and he sees a lot more cases than I do and also gets to see the outcomes, which I usually don't, so he's better informed on it than I am.

 

[92FSTech]

A deputy got an attitude with me because for the last couple of minutes I was going about 130 compressions a minute.

Tell him to sub in and take over then, if he can do it better. He's not doing any good standing around talking while the guy who's been at it for 20+ minutes is doing all the work!

Our new AEDs have a puck that senses depth and rhythm of compressions, as well as a tone to help you follow the rhythm. It'll yell at you if you start to get out of rhythm or aren't pushing hard enough, and it'll even say "good compressions" if you're doing it right, because apparently we millennials need lots of encouragement. It is actually kind of helpful, though, especially after you've been going a while and are starting to get gassed.

 

[Ruger_Ronin]

Performing CPR falls into the 'anaerobic' (non-oxygen) sport category and even the 'fittest' of individuals, due to it's high-intensity physical activity, burn out quickly! The newest version of CPR (chest compressions only, no breathing required) runs 100-120 BPM very quickly becomes a physically demanding exercise.
Glad to hear you were successful in your endeavor!

Thanks you. I am happy to say tha,t although I don't know long-term,I was told an hour after the event by local PD he wasin ICU critical but alive. I'm just glad I was there at that moment.