What Do I Tell My Friend To Do If They Have An Asthma Attack?

Posted on May 3rd, 2013 by Roy Shaw

This question came in via RoyOnRescue email.  They asked, what should I tell my friend to do if they have an asthma attack?

Here’s my answer.  I hope it helps.

Hi S,

Asthma stinks!  But what’s worse is when we have an attack.  There’s no better treatment than management to prevent an attack.  Avoiding triggers, maintaining regular preventative medications and always having a rescue inhaler available that is not expired and not empty.  If a person is having signs of an attack, it’s never a bad idea to call 911 and then begin to treat the symptoms with their medications.  If the attack ends, becomes manageable and everything is fine, then the ambulance leaves and there’s no problem.  If the attack is persistent and the medications don’t work, one will never regret having called for EMS backup.   Remember,  you can always send them away, but we can never make up for lost time.

If a person is having trouble with their asthma(wheezes in or out or both, short of breath, tightness, having small attacks, more albuterol use than normal, has congestion or feels like their not able to move as much air(maybe they have a peakflow meter and it’s reading lower than normal) they should call their doctor.  Again, if they’re having an attack, call 911.  Don’t rely on home remedies and cold air.  Hope this helps.

Roy

Tags: Asthma, asthma at home, attack, first aid for asthma, help, how to treat an asthma attack, no meds, royonrescue

Can A Person Be Struck By Lightning On A Porch?

Posted on May 1st, 2013 by Roy Shaw

In this episode, we take a look at what areas are safe to watch a thunderstorm from.  A question was asked about the safety of watching lightning from under a porch attached to a house.  They wondered if it was grounded just like the porch.  After researching a bit, I found that it is no more safe than being in a tent, a shed, or under a tree.  Take a look at this vlog and find out why it’s not safe to be outside when you hear the roar of thunder.

Tags: by, electricity, lightning, porch, royonrescue, safe place, safety, strike, struck, thunder, thunderstorm, tree, Vlog

Fellow Workers Credited For Saving Co-Workers Life With CPR

Posted on March 26th, 2013 by Roy Shaw

This video covers a story of how a person’s life is saved because others cared enough to try CPR. Watch this video and be encouraged that you never know when you may need to use CPR skills. If you want to learn CPR today, go to www.profirstaid.com and click on the training tab at the top of the site. Then watch the videos for free, and learn what to do in case of an emergency. It really can make a difference! It did in this person’s life.

Keep On Rescuing,
Roy

Tags: bystander CPR video, CPR, CPR Saves Lives, CPR video, CPR works, Life Saved, men save life with CPR, Postal worker saved by CPR, ProCPR, ProFirstAid, Real life CPR save, Roy Shaw, Roy W. Shaw, royonrescue

Nurse Doesn’t Give CPR To Elderly Resident, Did She Do Something Wrong?

Posted on March 6th, 2013 by Roy Shaw

Hello Rescue Fans,

Today I was made aware of a story that is on fire with debate.  Should CPR have been given to the elderly person or not?  Should the RN be charged?  Should the family sue the “Nursing Home?”  actually independent living residence.  How does the blah blah blah association feel about this?  How does the National Board of Registered Nurses feel about this?  On and on and on!   What I can’t believe is why everyone is blaming a non medical facility, which has pre-aranged agreements with it’s residents that don’t want any CPR for calling 911 and then simply doing what the resident and the management agreed to do?  Okay, so there wasn’t an actual DNR(Do Not Resuscitate) which can lead to a lot of miscommunication and ambiguity…I give you that but come on, guilty of neglect?  Charged for not administering CPR?  I know what you’re thinking right now.  Roy has flipped his lid!  Here he is, the RoyOnRescue host that is always talking about how we should get involved in order to try and save a life and now he’s sticking up for this non-caring facility that let this “poor” women die!

You’re right, I am all about saving lives when they can be saved, but I’m also all about death with dignity when the time is right and it’s in line with the wishes of the patient themselves.  What’s more is that this debate is not about the wishes of the patient, which has already been confirmed by deceased family members, this is about a 911 dispatcher who thought that the person at the end of the phone should care enough to begin CPR, regardless of the rules and regulations by which the employee was mandated to follow.  Yes, the caller should probably not have said that they were a nurse which could be interpreted as a skilled nursing center instead of an independent retirement community.   Yes, the nurse and the dispatcher could have been more calm while explaining that the patients wishes were for no resuscitation and that the community agrees to no resuscitation prior to living in that facility.  But in the end, the mainstream media has gotten wind of this story and blown it way, way out of proportion.  I’ve dealt with so many of these calls that I predicted what the problem was before I even read the story. And after reading not one, but many accounts, found that it was just as I thought. In short, lack of communication, lack of paperwork and lack of privacy.  You put all those together and what do you get?  A hot story that takes off like a wild fire!  Watch the video for my thoughts and then give me your feedback.  Especially if you disagree.  I love a good debate.

Tags: 87 year old, 911 dispatcher, Bakersfield, CA, California Woman Denied CPR, CPR, CPR not Given, Denied CPR, dies, Elderly Resident, Family, No CPR, No Intervention, Nurse, Nursing Home, RN, Statement, Told not to do CPR

Watch A Real Cardiac Arrest and Survival! Plus Patient Interview Post Resuscitation.

Posted on February 18th, 2013 by Roy Shaw

I wanted to share this video with you.  We know sudden cardiac arrest happens almost every 2 minutes to someone in the U.S. but we rarely get a chance to watch a real cardiac arrest occur, see the rescue caught on a security camera and then hear the patient talk about his experience so that everyone can learn from it.  If you or someone you know does not know how to provide CPR, please go to www.profirstaid.com and watch the free CPR training by clicking on the training video tab.  Or simply click here after  you watch the video below.

Tags: AMR, Cardiac Arrest, CPR, CPR in progress, interview, paramedics, patient, ProCPR, ProFirstAid, Real CPR, Roy Shaw, royonrescue, see cardiac arrest, survival

Should CPR and AED’s Be Required In Schools?

Posted on February 12th, 2013 by Roy Shaw

Every couple of minutes, someone suffers sudden cardiac arrest.  95% of these victims are dead before they make it to the Emergency Room doors.  In North Carolina, the Governor is trying to change that statistic.  She’s signed a bill that requires all highschoolers to be CPR trained prior to receiving their diploma.    Is it a good or bad idea and why do you feel the way you do?
Keep in mind that ProTrainings.com has already implemented a program that offers CPR training and certification to all high school students for FREE! ProTrainings.com and the StudentsTrainFree.com program reported that over 3000 high schoolers this year alone have already been trained and certified. If you know of any school desiring to implement a similar program, please contact ProTrainings.com and ask for the Student CPR department.

Tags: aed, AED required, CPR, CPR law, Diploma, governor, High School, North Carolina, required, Roy Shaw, royonrescue

Why Put On Personal Protective Equipment(PPE) Before Checking For Consciousness?

Posted on February 11th, 2013 by Roy Shaw

Hello Rescuers!

I just received a question via our ProCPR customer feedback that read: 

Dear ProCPR, “Question 16 says you have on PPE (personal protective equipment)  already, then you check for
responsiveness. Why would you put on your PPE before you check consciousness?

- Anthony

In case anyone else may have asked the same question I though I’d address it.  First, Question 16 is the number this person was on while taking the ProCPR.org test.  This is the online portion of the Health Care Provider level BLS certification training in case anyone was wondering.

Okay,  now for the answer.  As professional health care providers, we should always be thinking about cross contamination.  We don’t want to catch what the patient may have and we don’t want to give the patient anything that we may have!  Remember, PPE works both ways.  Can anyone say, nosocomial infection?  Even if the patient isn’t in obvious distress or obviously infectious, we should be thinking about the fact that the person seems to be in need and may require medical treatment.  This means that we may need gloves, CPR shield with one way barrier, goggles, face mask, respiratory protection etc.   This is why it’s so important to think about PPE  whenever we encounter a situation that may call us into action.  Not just when the person is unconscious or not breathing.

Forever, I’ve battled the problem with health care professionals short cutting PPE while giving care or even thinking about care.  We really do need to consider the two way protective properties related to infection control as it relates to appropriate personal protective equipment.

When it comes to layperson rescue, one of the top five reasons that laypeople will not intervene when a person is in distress is the fear of disease!  If the rescuer is approaching a victim and dons their gloves early as well as ensures that they have a CPR shield available, the fear of catching a disease is greatly diminished.  This will  increase the chances that the Good Samaritan may actually get physically involved in the rescue.

Now I know what you may be thinking…”Roy!  Do you really think that I’ll have one of those rescue kits on by belt all the time?  You may be a “Rescue Hero” type but the feasibility of me having PPE on my person when I’m at the beach, shopping, walking, vacationing, or even at a business meeting is slim to none.”  Well, I have to agree!  Unless you are a professional rescuer on duty, you probably won’t have your jump kit, glove pouch or a one way valve mask bag swinging from your belt loop.  So how will you have the PPE you need at the time you need it?  The best way I’ve found is to have a key ring rescue kit.  The catch is having it be small enough to not get in the way and large enough to carry your gloves and a one way CPR shield.  The reason I say a Key Ring style, is that I think that keys are the one item that most people have with them most of the time.  If they don’t have them with them, then they are usually close at hand.  And if we have our keys, we’ll at least have gloves and a CPR shield.   So make sure you get one and then the PPE problem is out of the way.  Still don’t think that PPE is needed?   Well, that’s why the AHA endorses “hands only” CPR!  It’s really not that compression only CPR is better than full Cardio PULMONARY resuscitation, it’s that there are so many non PPE toting people afraid that they may catch a disease if they do mouth to mouth rescue breaths that we had to design a new form of  bystander CPR.  Since implementing  “Hands only” CPR, there has been an increase in rescuer involvement.  And when people get involved and provide CPR, lives are saved!

PPE should be on every rescuer’s mind…and key chain, lay or professional and when we begin to think about PPE as the first step in rescue, lives are saved and infection is prevented more often!

Hope this helps.

Tags: CPR and disease, cpr mask, CPR shield, goggles, HBV, HCV, HIV, infection, infection control, nosocomial, one way valve, Personal Protection, PPE, prevention, primary assessment, procpr.org, ProFirstAid, respiratory disease, respiratory protection, Roy Shaw, royonrescue

Question: Why Dont We Check ABC’s Anymore?

Posted on January 14th, 2013 by Roy Shaw

In this blog,

I answer a question that came in about why we don’t teach lay rescuers to check for pulses after AED shock. This student thought that we were trying to trick them but in reality, the new standards are what may be tricky. Here’s my answer, I hope it helps.

Hi Shelley,

Thank you for taking the time to comment about the training. I’m writing In regards to your question about AED use and then checking for “signs of life” vs checking for Airway, Breathing and Circulation. Id like to assure you that as wrong as it may seem to do CPR without checking for pulses first, the training you received from ProFirstAid.comis based upon the latest guidelines set forth by the American Heart Association and are correct.

The old standards were to shock with AED Training and then assess for Airway, Breathing and Circulation, if no pulse give CPR. The new standards have eliminated pulse checks for lay rescuers in order to simplify and hopefully reduce pulse check “mistakes”. This is designed to shorten time from arrival of help to first chest compression.

Now, if your feeling a little confused, don’t feel bad… many of us do when there are changes. Be assured that most people who are unconscious, not breathing normally and have received a shock are most probably in cardiac arrest and CPR is called for. Besides, studies show that chest compressions when not needed rarely ever cause severe harm. Better to error on the side if giving CPR.

This however, is the reason for change in training and per the AHA standards it is accurate.

I’d be happy to explain further and in more details if you like.

Best Wishes,

Roy Shaw, paramedic, instructor
ProTrainings.com

Tags: aed, CPR, email, ProCPR, questions, royonrescue, signs of life

Question Answered Regarding Aggresive Chest Compressions and Unconscious Choking Patient

Posted on January 7th, 2013 by Roy Shaw

A really good question came in regarding the choking unconscious protocol.  The question was basically this.

Q:  The way the objective is taught regarding choking patients, you progress to chest compressions once the person loses consciousness with or without a pulse.  I can understand that and have taught that to my staff BUT those with ACLS certification quickly point out that ACLS still stresses that you do not do chest compressions in a patient with a pulse.  I am reviewing my ACLS and I can see the confusion.  As I see it, the key is in what you have available to you and in an unconscious choking vs respiratory arrest but I would like to better explain it and to do that I need to make my peace with it too.

Lastly,  In response to your training question regarding choking unconscious patient.  I know it’s hard to understand some of the changes that take place from time to time with the ILCOR and AHA recommendations.

A:  I’ll try and make sense of this particular skill.  Once we asses for unconsciousness or lower the unconscious choking patient down to the floor, and after calling 911, we’re going to begin 30 chest compressions immediately and then open the airway, check for obstruction or object in mouth and sweep it out if we see it.

If we don’t see it, we will attempt two breaths, if breaths don’t go in, we will reposition the head tilt and chin lift and try two more breaths(ideally with a one way valve mask in place).  If breaths do not go in, we will give 30 more chest compressions and then check mouth for object. Repeat until object is clear, airway is open or help arrives and takes over.  If at some point, we sweep an object  out and the breath goes in, we then check for a carotid pulse for no more than 10 seconds, if no pulse and no normal breathing…begin CPR.   If there is a pulse but patient is not spontaneously breathing, begin rescue breathing at 1 breath every five seconds.

Explanation:  The immediate chest compressions are due to a philosophy that the patient was already choking while conscious and instead of assuming that it came out after unconsciousness, we assume that it’s still blocking the airway.  The only thing we need to do if not already done, is activate the EMS or 911 system.  Then after 30 chest compressions, we check for produced obstruction.

Remember, even in ACLS, we are now less concerned about pulses and more concerned about time from non circulating heart activity or arrest to time of first compression. In other words, if we are not able to detect pulses or are unsure, but the patient is unresponsive and not breathing “normally” (agonal) the science and research is promoting aggressive cardiac compressions and minimization of time between arrest and first compression from CPR.  In this scenario, if the choking patient is in cardiac arrest, then they will benefit from  receiving 30 chest compressions before we check the airway.

Therefore, in theory, we’ve potentially circulated some residual oxygen to the brain and other vascular organs.  If the patient is not in cardiac arrest but simply still choking, the compressions should assist in relieving the obstruction and studies have shown that injury due to non-needed compressions is minimal.  This is why the emphasis on aggressive chest compressions.

I hope this helps anyone else who may have had the same question!

Tags: acls, aha guidelines, bls protocol, check pulses, choking, choking victim, new guidelines, royonrescue, unconscious, why chest compressions

When A Bike Crash Gives More Than A Road Rash!

Posted on October 18th, 2012 by Roy Shaw

Hello Everyone,

It’s been almost three weeks since my last episode was posted!  Just for the record…it’s partly because I’ve filled my Hard Disk and was short by about 4GB of RAM.  Seriously though, after suffering some technical problems I’m back in swing and hope to have several new posts in the next few days.  I’m also working on a new RoyOnRescue format to freshen things up and keep them moving in a direction that you would like to see them go.  In this episode, I cover a topic that was brought to me by a person who saw a road cyclist crash.  They were in bad condition and she wasn’t sure what to do.  I thought I’d take a minute to answer this while I upgrade my hardware on the old MacBook and rest before continuing work on the new style creation for the new upcoming year.  I hope this is helpful.  Keep the questions and comments coming and if you have a story that you’d like to share and get the RoyOnRescue point of view, please email royonrescue@gmail.com.

Thanks and keep on rescuing!

Roy

Tags: bike accidents, bike crash, bike crashes, crash, cycling crashes, first aid, head injury, road rash, royonrescue, royonrescue procpr.org profirstaid.com "first aid" cpr rescue blog "video blog" "how to rescue" heroes