Can I Do The Heimlich On A Person Who Just Had Back Surgery?

Heimlich procedure and if it’s okay to do it on a person who may have recently had a surgery on their back.  The quick answer is YES! If you think about it, what’s more dangerous, the Heimlich on a sore back or letting the person die from a blocked airway?  I wanted to take a couple minutes and answer this question directly and I hope it helps.

Are Hot Dogs Dangerous?

I received an email a couple of weeks ago by a well known television news show.  They asked if I could help them with the topic of choking and specifically on hot dogs.  I liked the idea and though they didn’t need the training I put together, I thought you all might benefit from it.  In producing this training, I found that kids choke 60% of the time on food!  Did you also know that of that 60%, 17% of the time it’s a hot dog?  I thought it would be helpful for you rescue fans so I thought I’d share it with you.  In this episode we discuss why kids choke on hot dogs, how kids choke on hot dogs, how to help prevent kids from choking and what to do if it happens.  Get summer safe by catching up on this latest episode of RoyonRescue right now!

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

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.
asthmaHi 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

When A Person’s Choking, How Do I Know When It Comes Out?

In this episode of RoyOnRescue, Roy answers a question that came in via email regarding a situation where the person did the abdominal thrusts but the object did not come out to the best of their knowledge. Should they keep doing chest compressions or is there something else that can be done to get the foreign body out of the victim’s airway. Be sure to watch this episode to get the answer.

 

Isn’t “Not Breathing Normally” Still Breathing? Maybe Not.

ConfusedHello Everyone,

I had a great comment come through the student comment section this week and thought it might help others if I shared my response.

So, the student asked,
” Some questions on your test seemed to give incomplete or misleading information, in my opinion. Such as the one referring to a man who is unresponsive and not breathing normally. The answer to pass was to give them 30 chest compressions yet if someone is not breathing NORMALLY it leads me to believe that they are breathing and the first thing I would want to do is try and figure out why the breathing is not normal. Not give them chest compressions. Have I checked for a heartbeat? I wouldn’t give chest compressions unless I couldn’t detect a pulse.”
-ProFirstAid.com Student

Here was my response. I hope it helps.

Dear “Student”,

There were a couple of changes in this 2010 ECC/ILCOR and American Heart Association release from the guidelines of 2005. One was that if the person is unresponsive and not breathing “normally” we begin chest compressions. Pretty aggressive I know but this is what the guidelines suggest as best practice. Secondly, basic first aid providers no longer check for pulses in the unresponsive victim. Now, when a lay-rescuer comes upon a person who is unconscious, not breathing or not breathing “normally”, they are to activate EMS(call 911) and begin chest compressions at a rate of at least 100 per minute and at least 2 inches deep. This is to continue for 30 compressions only interrupted long enough to give two full breaths after the head tilt chin lift and then back to the chest compressions. The rescuer is not to stop this process unless the patient begins to respond and become conscious, begins breathing normally again, an AED is available, or if EMS arrives and takes over. CPR is to be provided fast and hard with as few interruptions as possible. So there you have it as stated by the new and latest ECC/ILCOR guidelines.

Now, for my subjective slant on the whole deal. I say, don’t feel bad if you’re a little frustrated. As a licensed paramedic, instructor trainer for CPR, First Aid, ACLS and PALS, it still a bit hard for me to watch the latest recommendations and guidelines put forth by the International Liaison Committee On Resuscitation”. It was hard to watch them throw the proverbial “baby out with the bath water” if you will. I for one believe that people can learn how to perform effective and more advanced assessment if given the correct learning mechanisms by which to learn and retain the information in order to use it well during a real rescue situation. I believe that people are more than capable of providing optimal CPR and First Aid which would include pulse checks. I think that there can be times, though maybe rare, where checking for pulses would be helpful in determining the correct next steps especially when dealing with patients suffering from low blood sugar, or a hard hit to the head which temporarily knocks them unconscious and they stop breathing for some time. I also wonder about the person who has been in cardiac arrest for some time. The person is certainly permanently dead and any resuscitation efforts will not change the patients status because they’ve been dead for more than half an hour or longer. Does the rescuer still perform CPR and Rescue Breathing because the person is not moving, not breathing or not breathing normally? Very difficult for me to believe that a rescuer would have to perform CPR on a person with rigor mortis while waiting for the EMS providers to arrive and confirm time of death.

But, the ECC/ILCOR recommendations were based on some evidence, though from my findings I admit not much, that more people would benefit from these simplified procedures than would suffer any ill consequence. So they made the change.

What helps me to deal with the changes when I don’t agree with them, is that the changes were made by the ILCOR group to “simplify” the procedures of CPR and to hopefully encourage more people trained or not, to get involved and hopefully make a difference in saving more lives. If this is indeed the case and we’ll know in a few years, than I guess it’s worth the bit of frustration that some of us must suffer.

I hope this helped. Please let me know if you have any further questions.

Best Wishes,

Roy
royonrescue@gmail.com

Asthma Attack and No Medication!

One of the scariest feelings is not being able to breath.  This is exactly what is happening during a severe asthma attack.  I received an email from a person who stated that they have been trained in CPR and First Aid multiple times and though it covers the basics of asthma it never really talks about what to do in depth.  They gave me a scenario where a person may be having an asthma attack and EMS is quite some ways away.  What’s worse, there isn’t any medication for the asthma attack!  Now what?

In this episode we take a look at what asthma is, and how we can confidently handle it even if there isn’t any medications and EMS/911 is delayed.

Asthma Guide
Asthma Symptoms
ProFirstAid.com Training (Allergic Reactions)

Agonal Respirations Kind Of Look Like Sleep Apnea!

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.

Best Wishes,
Roy Shaw, EMT-P

RoyOnRescue.com

Actual Video Of Sleep Apnea (Warning! This video could be disturbing.  Viewer discretion advised.)

Gasping For Life!

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.

http://www.theheart.org/article/924633.do

Should I Use Abdominal Thrusts or Chest Compressions?

Ever wonder what to do if someone chokes near you?   Should you give them the Heimlich Maneuver or Chest Compressions?   In this video Blog, Roy Shaw, EMT-Paramedic answers a students question about what to do if someone chokes and if Abdominal Thrusts or Chest Compressions are better.  Roy takes a look at when to use abdominal thrusts as in the Heimlich Maneuver and when to use Chest Compressions for a person who is definitely choking.