“I take care of a child who has a trach and is on a ventilator when he sleeps. Do you have a course for cpr involving a patient with a trach if we were out and did not have access to a vent?”
Though we don’t offer any specific ventilator training, I thought this would be a good time to do a royonrescue episode covering this topic.
I didn’t want to delay this reply any longer than necessary so as Jody Marvin and I were on the road discussing training issues for ProCPR.org, I thought we would take advantage of the drive time and answer this very good question.
It’s hard enough initiating CPR or rescue breathing for a person who doesn’t have any special needs, but then when it’s complicated with something like a tracheostomy, it can really become confusing. I hope this video blog helps clear things up. Keep the training questions coming I think it really helps everyone who’s concerned about rescue and saving lives.
A student emailed a question regarding the Head to Toe exam. Though this is normally performed as a secondary survey in a more advanced setting, I do think there are times where knowing how to check a person for other injuries is a good idea. Take a look at the video blog and I hope this helps.
Best Wishes,
Roy
Knitting Needles can be the source of warm mittens, cozy scarves and comforting winter sweaters. They can also become sharp pointed weapons or injury causing spikes when fallen upon or when they are thrust into the face, neck, chest or abdomen due to a car accident or accidentally falling onto them. In this RoyOnRescue episode, we take a look at the hidden danger of sharp pointed objects that usually remain harmless but when not respected and carried safely, they could cause great harm. Learn about the dangers of pointed objects and how to keep knitting needles a source of pleasure not pain.
I received an email that I think we can all benefit from.
It read…
“Since most of the first aid measures for a no pulse, no breathing situation is immediate CPR, is it alright to do CPR if the victim has a wound on the chest that is bleeding profusely? This is not that I have seen this situation, but I like to think that if it happens I would know what to do!”
C. H.
That’s a great question C. Sometimes it’s easy to get distracted by a serious traumatic injury and forget the basics and what needs to be done first in order to try and save the person’s life. Or, we can look at a complicating injury such as a chest wound and think, How am I going to do CPR on this person, there chest has a serious bleeding wound right where I’m going to give my compressions?
In this episode of RoyOnRescue we are going to look a proper treatment plan if we ever came across a person who had a serious chest injury and needed CPR.
This response was written after receiving an email from a person, who has a cousin that is a trained CPR provider and attempted to save their own father’s life with CPR but their father remained dead despite their efforts. This person felt badly and didn’t know what to say to their cousin to help them not feel guilty or that their father’s death was in some way the rescuer’s fault. I responded to them, and afterward, felt that my response may be helpful to others who have suffered or are suffering or asking themselves the question, “Was there more I could have done?”. I hope that this response will be of help to anyone who may have feelings of failure or guilt as a result of their cpr efforts not ending in the survival of the patient.
Student’s Email Question:
(Paraphrased to protect students identity)
“My cousin has recently lost his dad and he is a trained CPR provider. He tried CPR on him but it didn’t work. I was wondering if you had a way you deal with death if you could not save them. I just don’t know what to say to him or how to help him. I’m the only one he is talking to and trusts. So not knowing how to help him bothers me. If you would email me back that would be great.”
-Thanks
Dear Student,
One of the most important things to remember when providing CPR to anyone let alone a loved one, is that people who need CPR are already in a state of death. When the person is not breathing and they don’t have a pulse strong enough to detect with obvious signs of life, they are clinically dead. From the point of clinical death, they are only a short distance from biological death, which is permanent.
One way of looking at the success of CPR, regardless of the outcome, helps me and I believe helps my students to be much more at peace with themselves. The fact that your cousin’s Dad did not survive cardiac arrest has very little to do with the CPR given to him. It’s important to remember that CPR, in and of itself does not save anyone’s life directly. CPR is designed to “Buy Time”. CPR only provides about 25% of the oxygen circulation that is required for someone to stay alive biologically. CPR was never designed to be life support viewed as a way to keep people alive indefinitely, but rather to slow down the process of clinical death to biological death. This is to provide a chance to intercept the patient with electrical therapy, advanced therapy and medications combined with CPR and time to fix the underlying problem which caused the person to die in the first place.
In my opinion what your cousin did, is give his Dad the best chance of survival possible if he was indeed going to survive. Let’s look at clinical death as a heavy iron gate that is slowly dropping to the ground, and once closed the person is biologically or permanently dead. CPR is like arms holding the heavy gate of possible survival open a bit longer. Again, not stopping the progression of clinical death to biological death, but slowing it down so that if there is a chance of survival, they would have the greatest opportunity of slipping back through the gate available. Eventually, the gate is going to close even if CPR is perfect. As I said earlier, CPR in and of itself is not enough to keep the human body alive. But if the person is going to survive and the person needs more time, CPR buys the precious time required to make this a reality.
Now, it’s important to remember a simple but powerful truth. Everyone dies. I have had patients that had everything go right in order for them to survive a cardiac arrest and they still remained dead despite our rescue efforts. That day was their day to die and nothing that the cpr providers, paramedics, nurses or doctors did changed the outcome. The CPR helped keep them viable long enough for the rescue and medical team to try and fix the underlying problem but the person remained dead. I had to realize that as a professional rescuer and paramedic, everyone has a day to die. It’s not my job to save everyone but it is my job to give everyone the best chance of survival possible. When I provided care to cardiac arrest patients, I provided care to them as if they were suppose to survive and didn’t give up hope unless they proved to me otherwise by not surviving. It may be frustrating but we just cannot know what day is the day a person is going to live or die until the outcome is evident.
I’m quite sure that no matter what I say, your cousin is really missing his Dad. I don’t think there is any amount of explanation of science, death, dying and CPR that’s going to change that. One thing I do know about what your cousin did the day he provided CPR for his Dad though, he showed others and his Dad how much he loved him. How much he really cared. Your cousin gave his Dad his own strength when his Dad didn’t have any of his own. In my opionion, that’s one of the most loving and unselfish ways to tell a daddy goodbye.
May God bless your cousin and all hurting friends and family during these difficult times.
In Part 1 of Snake Bites we talked about the different kinds of poisonous snakes that pose a risk for serious danger. Remember we were talking about an Emergency Responder who who had emailed me? She helps out with California High Desert Racing and the medical response team and is having some issues with Poisonous snake bites and 35-45 minute response times. This due to being so far away from civilization. In part 1 of this response video blog, we took a look at the different types of rattlesnakes that are causing problems, how they might kill a person and how we as rescuers could make the difference between life and death. In this second part, we will get to the bottom of the correct treatment strategy in order to save a snake bite victims life and limb.
An Emergency Responder who helps out with California High Desert Races is having some issues with Poisonous Snake Bites and slow response times due to being so far away from civilization. In this response video blog, we take a look at the different types of rattlesnakes that are causing problems, how they might kill a person and how we as rescuers could make the difference between life and death.
As I reflected on yesterdays video blog; “Gasping for Life”, I thought I should expound on what real agonal respirations really are and maybe even find some examples for you to see or hear. Well, let me tell you this has turned out to be more difficult than I imagined. As I searched the internet for some medical records of what I have seen during episodes of agonal respirations all I could find was one well intentioned but non realistic version of agonal respirations while everything else was simply informational. I then began thinking about the times I had seen low blood sugar patients or postictal seizure patients and thought…I bet a good snoring respiration would be close!
After some time, I found an actual serious sleep apnea(OSA) case and thought I would include the link in the video blog for you to see. Though this is not exactly what agonal respirations look or sound like, it is a far cry closer than other replications I found and will at least get the idea across that any form of agonal or distressed drive to breath is not oxygenating the body well and should be treated with Rescue Breathing or Full CPR depending on the symptoms.
I hope this helps clear up any confusion and please let me know if you would like me to expound on anything else relating to this video blog.
If an unconscious person is gasping but not breathing normally should you call 911 and leave them alone, or should you begin aggressive CPR? In this Video Blog, Roy Shaw, EMT-P tells a true story about how a child may have died due to not having life saving CPR because she was showing signs of agonal breathing. This caused the rescuer to stop the life saving CPR and ended tragically.
Watch this Video Blog to learn what agonal breathing is and how to respond to it.
Ever wonder why someone passes out unexpectedly? More importantly, ever wonder what to do if someone passes out? Today, Roy Shaw, EMT-Paramedic answers a question that was sent to him where someone who really cares about rescue asks, “How do I handle a situation where someone has passed out?” Roy explains what is happening when someone passes out and how to apply basic first aid in order to help. So, the next time someone goes unconscious for any reason, you may know what to do.
