On this episode of RoyOnRescue, Roy answers a question that came in some time ago about how to do CPR if the person has an object imbedded in their chest.  Roy sheds some light on the simple yet affective way to rescue without causing harm to yourself and to the patient.  If you’ve ever wondered what to do if a person had a knife in the chest and was in cardiac arrest, you’ll want to watch this video blog.

RoyOnRescue Team

So, don’t stop having fun and living life to the fullest, but if you’re going to go out into the wild, make sure you’ve got a game plan for surviving unexpected events.

This “mini stroke” can last from a couple of minutes to around a half hour and looks and acts like a full blown stroke.  Take a look at this RoyOnRescue post to learn the difference and what you should do if you come across someone who shows these signs and symptoms.

Best Wishes,

Roy, RoyOnRescue.com

The post read as follows:

Roy,

My wife has a heart condition called ARVD. This involves the RIGHT VENTRICAL and the things you are asserting(about CPR) will injure or kill the person.  Please see the website at Johns Hopkins on ARVD. This is a congenital heart disease that WILL NOT RESPOND TO STANDARD RESCUE PROTOCOLS. Because it involves the right ventricle the symptoms and treatments are all different. Lynn wears a Medic Alert bracelet and part of the information is to NOT perform standard CPR protocols, but to contact her doctors for information on how to proceed. She has a pacemaker and ICD, and cannot be given lidocaine or any of the standard cardiac resusitation drugs that ACLS requires. We will add that oxygen, lying on the left side and transporting to a facility familiar with heart electrophysiology, and ARVD treatment. This disease is found in athletes (runners, football and basketball players,
tennis and extreme sports) who seem on the outside to be fit, but have a heart that is not functioning as it should. This disease runs in families and it traceable through genetic testing at Johns Hopkins.

-A

It must be difficult having a loved one struggle with a cardiovascular disease as mysterious as arrhythmogenic right ventricular dysplasia(ARVD), but I want to reiterate that CPR performed by bystanders will still give more benefit than doing nothing at all.

The fact that the right ventrical is dysplastic should not have anything to do with CPR performed as an emergency intervention in order to try and circulate any increased amount of oxygenated blood to the brain and vital organs.   As with everyone who goes into sudden cardiac arrest, there is no study showing that any amount of CPR would make a cardiac arrest victims biological condition worse.  If left alone, and no automatic circulation and oxygenation is present,  the body would continue to go without gas exchange circulation.  This is why most emergency protocols, and 911 systems will encourage CPR regardless of the underlying pathology related to the cause of death.  Out in the field, the goal is to keep the victim biologically alive enough to make it to the hospital or advanced care where when applicable, reversible conditions can be made right.  I did contact John Hopkins and after a short discussion with an ER nurse, it was confirmed that ARVD has different protocols for cardiac arrest.  Most victims of ARVD do not know they have it and therefore would present as a spontaneous sudden cardiac arrest event.  If this occurs, most EMS 911 dispatch systems are going to encourage CPR. I hope this helps and I’ll let you know what I find out from the American Heart Association when they respond to my question for clarity regarding this special case. I hope this helps.

Best Wishes,

Roy, RoyOnRescue.com

Happy Memorial Day Weekend!

Roy

May God bless and heal this family.

Roy, RoyOnRescue.com

Link To News Story:

RoyOnRescue.com

I received a question regarding infants having seizures and the proper treatment for them.  

The person asked if  it’s proper to handle the patient the same as an adult?  This is a great question and one I wanted to address a little more in depth than a simple reply by email.

First, it’s important to understand what a seizure is.  The following is a quote by  physician, Dr. Fawn Leigh from Duke Health who did a great job describing the two different categories of seizures and how they manifest themselves.

Click here to see the complete article located at:  http://www.dukehealth.org/health_library/advice_from_doctors/your_childs_health/childhoodseizures

“Seizures are divided into two major categories (based on 1981 international classification):

• Generalized seizures affect the whole brain or both hemispheres of the brain
• Partial seizures, also known as focal seizures, affect one part or one side of the brain

Generalized Seizures

Generalized seizures are divided into convulsive and nonconvulsive. Convulsive means that there is muscle movement such as stiffening (also known as tonic) or jerking (clonic) activity. When these movements are combined it may be called “grand mal.”

Other types of convulsive seizure activity include myoclonic and atonic seizure activity. Myoclonus is usually characterized by sudden, single jerks. Atonic seizure activity is typically characterized by dropping quickly to the floor as if suddenly asleep or paralyzed. The child then quickly recovers.

These two latter convulsive seizure types can both be difficult to diagnose and treat because often they are the manifestation of a mixed seizure disorder. In infants these seizures may be called infantile spasms.

Nonconvulsive means that there is alteration of consciousness without muscle movement. This form of seizure activity was formerly called “petit mal,” and is now commonly referred to as “absence.”

Absence seizures are unique in that typically they are characterized by an abrupt onset of staring and end just as abruptly with no confused state following the events. Parents usually report that the child looks like they are “spacing out.” (Teenagers who look like this often are not having seizures — they are simply bored.)

Partial Seizures

Partial seizures can be simple or complex. Simple partial seizures are focal seizures that involve movement or sensation on one side of the body without altered consciousness. Simple partial seizures are commonly localized to areas in the brain called the motor or sensory strip.

Partial seizures may be with or without aura, which involves associated states such as fear, or changes in heart rate, flushing, or abdominal discomfort.

Complex partial seizures commonly originate from the frontal and temporal lobes of the brain where there are many complex interconnections, resulting in alteration of conscious. Typical complex partial seizures manifest as sudden change in level of alertness with or without aura, blank stare, confusional state, or aimless movements such as wandering around or repetitive behavior.”

DukeHealth.org (http://www.dukehealth.org/health_library/advice_from_doctors/your_childs_health/childhoodseizures)

Second, it’s important to understand what the main cuases of seizures are:

• Fever
• Infection such as meningitis
• Trauma
• Hemorrhage
• Brain malformations
• Brain dysmaturity
• Genetic disorder

Thirdly, when it comes to treating an infant compared to an adult, it’s a bit easier, though not any less intense especially if it’s your child.  It’s physically easier because baby is smaller and easier to manage.

If this seizure is with a child who has never had a seizure before, 911 or Emergency Medical Services should be activated.  The rescuer is going to  follow National and International guidelines for treating a seizure patient.  Protect the baby from hurting itself while seizing.  If it’s in a bath tub, drain the bath tub of water so as to reduce the risk of drowning and then protect the child from hurting itself while seizing.  Nothing should be put into it’s mouth which is old school for seizure management in trying to prevent “swallowing the tongue” or biting the tongue off.  It is also important that we not try and prevent the baby’s body from convulsing by holding it still or wrapping them tightly.  Simply protect it’s head and other parts of it’s body from hitting anything during the convulsive stage of the seizure.  After the seizure is over, the baby will usually go into a post seizure phase called the “postictal” phase, and there may be some frothy sputum(spit) around the baby’s mouth or in its nose. A bulb syringe normally used for suctioning mucous or sinus congestion could be used to suction or clear the baby’s nasal passage but it is probably not as necessary as we’d like to think.  As a general rule, baby’s have a great gag reflex and if they have any mucous or sputum in their upper airway, it will probably be coughed clear.  If the baby begins to breath after the seizure, it could be irregular with some grunting for a short time and then increasingly get more normal.  Skin color if it has changed during the seizure to a dusky, purple or blue color should improve as the baby begins breathing more normal and it is perfectly acceptable to comfort the baby in a natural position while maintaining a neutral airway in order for it to recover from the seizure.

If it does not begin breathing, begin basic cardiac life support according to the latest ECC/ILCOR and American Heart Association guidelines. Courtesy of ProFirstAid.com, a Free Online infant CPR training video is available by clicking here!

As many as 2-5% of all children will experience at least one seizure related to a fever over 102 degrees Fahrenheit.  The seizure itself is usually harmless and does not cause brain damage nor lead to epilepsy.

Seizures in any age patient can be very scary, and the causes of a seizure are many.  Therefore, if it’s the first seizure the person has ever had, we should plan for the worst and hope for the best.  This can be done by calling the emergency medical services or 911 depending on your area.  Support the patient with basic first aid procedures while waiting for rescuers to arrive and then follow up with your pediatrician after the baby is stable.

If your baby is having a high fever and your afraid that it may cause a febrile seizure, there are some basic steps to help lower your baby’s temperature.  Click here to read an article about how to lower a body temperature from a fever.

Well,  I hope this helps and I appreciate the great questions so many of you have been asking.  Keep them coming and while your waiting for a response, keep on saving lives!

Best Wishes,

Roy

RoyOnRescue.com

royonrescue@gmail.com