How to Save a LifePosted: August 8, 2013
as the resident medical professional i thought i’d pass on some knowledge that is useful in everyday life. what will be the biggest challenge is keeping it simple for non-medical types to relate to. i spent almost 12 years as a trauma management, minor medical procedure guru. i worked for several years as an instructor of EMT, Prehospital Trauma Life Support, and Basic Life Support (CPR). i’d highly recommend taking a CPR class.
and i was VERY good at it. but for most people who don’t deal with this on a daily basis, they will blank out in an actual emergency, so i’ll try and keep it simple.
now, i am no longer a licensed instructor. but i can pass on some basics that can help you keep someone alive until the professionals get there. it’s as simple as A.B.C.
let’s start with airway. if they can talk, or are screaming in pain: they have a patent airway. if they are unconscious: look, listen and feel. look to see if their chest rises and falls, feel for breathing. if you don’t get any signs of the above, tilt their head back, pinch the nostrils shut, and give 2 breaths. if the chest rises and falls- you’re good. if not, retilt the head, and try 2 more breaths if you get any resistance….the airway is not patent. open the mouth and look for an obstruction. if you don’t see anything straddle the waist, interlock your non-dominant hand on top your dominant hand and interlock your fingers. place the heel of your hand 4-6 inches below the chest. push inward and upward in a J-like motion. (youtube Heimlich maneuver). give 10 thrusts then open the mouth and look for something in the mouth. if you see something, remove it and attempt to give 2 breaths again. continue until you have a patent airway.
if there is a witness or a bystander, have them call 911.
let’s say they have a patent airway. time to move on to B- breathing. are they breathing. again: look, listen and feel. place the side of your ear my the person’s mouth, feel for breathing, look for the chest to rise and fall, and listen for sounds of breathing. if they aren’t breathing, well, you need to breathe for them. you want to do around 5-6 rescue breaths. do not go crazy, give the breaths 1 per second.
remember, the purpose to the airway is to take in oxygen, the breathing circulates oxygenated blood throughout the body. circulation perfuses the oxygen rich blood to the vital organs. do not move on to B until you secure A, and don’t move on to C until you secure B. it’s as simple as that.
so, circulation. you secured the airway, you’re rescue breathing for the patient (5-6 rescue breaths, followed by 60 chest compressions- though it may have changed since i last taught it). the purpose of chest compressions is to beat for a heart that isn’t beating. before you start feel for a pulse (take your first 2 fingers in the center of the patients throat, slide it slightly to the side, you should feel a small channel -practice feel for your own neck) take about 10 seconds to feel for a pulse. if they have a pulse, just provide rescue breaths. if you don’t feel a pulse, do chest compressions (again, check youtube). NOTE:proper chest compressions WILL fracture ribs. but a cracked rib or 2 is better than the person dying.
chest compressions, rescue breathing, chest compressions, rescue breathing. continue until you are exhausted (and trust me, 15 minutes of CPR is a fucking workout), or someone else more qualified takes over. i’ll cover legal aspects at the end.
these basics will help more than you could possibly imagine. i’ve gotten on scene where someone’s unconscious for almost 10 minutes and it meant it was going to be highly unlikely i’d be able to save the person. even if imperfect CPR is given, it helps a medic IMMENSELY.
choking- youtube Heimlich maneuver. now…….if someone is grasping their throat and looking around desperately, ask them if they need help. if they DO indicate they need help, use the Heimlich maneuver as demonstrated on youtube or in the class you take. if they don’t tell you they need help- DO NOT TOUCH THEM. that’s assault.
we have a saying in EMS, “if you won’t give me consent to assist, i’ll just wait for you to pass out, then i have implied consent to touch you.” don’t get yourself in trouble. BUT again, i’ll discuss the legal aspects at the end.
-bleeding. this fucks up most people. it’s gruesome to you non medical types, well…..i’m immune to now. bleeding is dealt with by: direct pressure, elevate the lacerated area above the heart, cold compresses. DO.NOT place direct pressure then remove the bandage to check the wound. you’ve just reopened a cut that coagulated blood was stopping, and you have to start over. scalp wounds are the big one. the scalp is VERY vascular. i had a foot locker fall on my head, caused a 1/2″ laceration and it bled like a stuck pig. i just put a t-shirt on it, and walked to BAS. venous bleeding is dark red and oozes- direct pressure. arterial bleeding is bright red and pulses out in spurts. this type of bleeding is SERIOUS. apply direct pressure to the wound and elevate the area as best you can. place a cold compress if possible.
the mistake many non medical types make is they see blood and immediately focus on it and try to stop it. all bleeding stops….eventually. if you see significant bleeding. have someone place direct pressure and go to your A,B,C’s.
follow the above and you will improve an injured patients chances well enough to sustain them until the professionals show up.
CHILDREN and INFANTS
this is where many people get spun. most infant/toddler issues deal with choking. google infant/child CPR and check out the videos.
my last serious call was an 2 week old that had an allergic reaction to formula was was BARELY breathing. longest 15 minutes of my life getting the baby back to the hospital (this was in Sicily). if you have kids, i’d strongly recommend you look into this part of BLS (basic life support).
the good samaritan law states that a person acting in good faith to try and save a life cannot be held liabe if they acted to the best of their ability. meaning, i’d be held more accountable (due to military medical training) to a higher standard than a lay person. can you be sued- yes. will you successfully be sued; never heard of a case where someone acted (within their abilities and not trying some crazy shit they aren’t trained to do) being successfully sued. i know i have a few lawyers reading, go ahead and chime in if you’d like.
i could EASILY go into more detail, but for the lay person, what i’ve told you are the basics and the rationale behind it. truth is, unless you have long term, adequate training, stick to the above so you don’t get sued. i’m qualified to do an emergency cricotomy, but i’d NEVER perform one on a civilian and outside a war zone.
remember, i’ve done this for almost 20 years. it would be impossible for me to bring you up to my level in a single (or many) post/s. my intent was to give you a basic understanding of how to keep someone going until you can get a professional there to take over. and trust me, even in the field, i’ve lost people…just do your best and realize unless you utilize this frequently, you’ll probably freak out IF you need to use it. just step back take a deep breath and think- A,B,C and DO.NOT let bleeding divert you from the ABC’s. have someone apply direct pressure; if you don’t have another person, just tie something around the wound.
please feel free to email me with any questions.
my primary preceptor and crew chief in navy ems told me, “you know what happens when you stare at Death for long periods?”. i simply said, “no”. he stared me dead in the eye and said, “she stares back at you.” i never understood that until years later. but now i get it. Death knows me, comes to me. it’s not a bad thing per-se; just a road i can’t get off of.
aaaaah, the life of a corpseman.