How to Save a Life

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.

a- airway

b- breathing

c- circulation

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).

Legal Issues

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.

stay up.

the blogger as a 21 yo Sailor/Corpseman.

the blogger as a 21 yo Sailor/Corpseman.

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.


15 Comments on “How to Save a Life”

  1. CLG says:

    Good Samaritan laws- Just remember folks, the default question of whether or not you have a duty to act, or if your actions will hold you liable is RPP- Reasonable Prudent Person Standard. I just took the NY Bar (last week actually), So I can not give advice yet in a legal capacity to anything in particular until i am admitted, but when in doubt, use common sense and think “would a reasonably prudent, cautious, law abiding person act in the same way I am acting?” When in comes to rescuing…. KNOW WHAT STATE YOU ARE IN. states differ on when you HAVE to act vs. when you are protected from jumping in and what standard you are supposed to adhere to. so know your local law.

    Also, and this sounds cruel, but you don’t have to jump in. Unless there is a special relationship (i.e. Parent-Child, etc.), you generally only have to act if you or your actions put the person in that position in the first place (again varies state by state, so check your local laws). otherwise you can generally stand there 10 feet away and watch the person drown. People dont go to prison only because they happened to stand near something bad that happens (maybe in Syria, but not in Merica).

    This kind of goes for everything: you dont have to tackle the Bank Robber. You dont have to talk to cops when they arrest you, you dont have to volunteer information on your perspective of whether or not the traffic light was green. You have to do basically three things: Pay your taxes, Comply with the properly enforceable laws of your area (town, state, country, etc.) and exist.

    so before you go defending that girls honor from her supposedly abusive boyfriend (she could be lying, she could have attacked him, she could have gotten the black eye by falling off a bike and is mad her bf cheated on her), Hell before you even bother to tell your Contractor why you think the kitchen reno is being delayed, do two things: Shut up and stop doing everything (talking, moving, etc.) and find a licensed attorney in your state and ask for advice. If you want to jump in and rescue someone, then you are going to do it anyhow and the legal consequences are probably secondary to you (I know who I would jump in to save regardless of the aftermath). but if there is no “girl has 10 seconds left of breathing” or “I pushed that kid into the pool and now he is drowning” or whatever, Stop and get some good legal advice. the wrong move could cost you more than a 30 second phone call and a couple of bucks.

  2. Young Hunter says:

    A lot changed in the latest guidelines. Now the recommended sequence is C-A-B, with at least 100 compressions per minute, and no rescue breaths when performing single responder CPR.

  3. Young Hunter says:

    Not trying to derail this, just contribute.

    • dannyfrom504 says:

      Nah no worries. I got burnt out on all that trauma shit. So I went into radiology just to learn that I simply want out of patient care all together.

      Sent from my iPhone

      • Young Hunter says:

        I’m with you sir.

        Here in the interior of Alaska the patients either need not be inpatient to begin with, or are too fucked up to survive the medivac down to Anchorage or Seattle. The only legitimate ones are the alcoholics (liver failure, GI bleeds, etc.) and overdoses, which are a different kind of losing battle altogether.

        • dannyfrom504 says:

          The post was hard to write because I was REALLY trying to keep it simple. I’m trained to do shit only doctor’s do.

          • Young Hunter says:

            That whole “press hard, press fast” thing has simple down quite well, but there it is really hard to gauge how to give further advice on it. The mindset is important, but discussing it might just weigh down someone when the moment comes if they never have had to use it before.

  4. Vicomte says:

    Take a minute to learn the paths of all the major arteries.

    This information is useful in a number of situations.

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