Life and Death With Dignity…and Privacy

just received a question from a student who asked:

Dear RoyOnRescue,

“In thinking about the use of an AED, what if the person is a woman and we have to “bare the chest”.   Should we place the AED pads under the shirt, or do we have to actually bare the chest for proper use of an AED?”

-CH

This is a good question and one that is uncomfortable for some to think about.  Whenever a rescuer is working on a patient, male or female,  a rule of ethics applies.  We as rescuers should be thinking about the dignity and respect of the patients privacy and confidentiality at all times.  This includes times where we may have to “Bare” the chest of the victim in order for us to defibrillate or treat them.  We should seek to be discrete as long as we are able to get the job of rescue accomplished without delay.   If the person is able to be defibrillated without full removal of the clothing that’s great.  If the person needs to have shirt or underclothing cut or removed in order to defibrillate properly than that will need to be done.  If there are bystanders, those bystanders could turn their backs to the patient and try to make a human curtain around the patient in order to protect the patients privacy and dignity.  Think about if this is in a public workplace or location where the person is known.  They may survive if everything goes the way it should and if they do, they will probably return to this workplace.  We must make sure that as far as we can control, we protected their dignity and helped them as much as possible without complicating or slowing down the rescue process.

I hope this helps.

Best Wishes,

Roy

www.royonrescue.com
royonresccue@gmail.com

2010 AHA Updates From Chicago

Hi Everyone,

I’m here at the 2010 American Heart Association instructor conference hosted at the McCormick Place. It was a wonderful weekend in the “Windy City” and worked out well for Jody Marvi(ProTrainings.com Compliance and Accreditation Manager) and I to attend the new guideline roll-out for BLS, ACLS, PALS and NeoNatal Resuscitation. I’m glad to announce that in the end, I don’t see any serious issues to any of the latest guidelines for resuscitation. I was afraid there was going to be some changes that were going to cause ethical issues for end of life issues but thankfully to the best of my knowledge, this didn’t materialize for 2010. So take a peek and let me know what you think of the latest ECC/ILCOR recommendations for resuscitation.

AVPU for Deciding to Start CPR?

In this episode of RoyOnRescue, Roy offers an answer to an email question about using the assessment of Awake, Verbal, Painful Response, Unconscious(AVPU) method for deciding to begin CPR.   He sheds some light on what AVPU is and how it can be blended with the guidelines to decide to start CPR.

Roy On Location at the 2010 Video Training Updates

I wanted to update everyone on the progress of the ProTrainings update video shoot.

I had come in early one morning and thought I’d have a cup of good coffee and let you see the on-site video location where the production team and I were shooting the new updated video trainings for the ProTraining websites. It’s important for ProTrainings to be a leader in the area of this type of training and though the video trainings are not required to be updated for a long time, we thought we’d get them out to you as soon as possible. If there’s enough benefit to change the guidelines then there’s enough benefit to get them to the ProCPR.org and ProFirstAid.com students as fast as possible.
On a side note, the production team and I have been having a lot of fun while working really hard on the set. I hope you’ll like some changes we’ve made for the new guidelines and I know that the team and I are very excited to get these updates edited and uploaded to our website in the next month or so.

Feel free to email me any questions you may have about what goes into our video production of these trainings or what it’s like behind the scenes at ProCPR.org and ProFirstAid.com.

Until next time,

Be A Rescue Hero For Someone’s Loved One,

Best wishes,

Roy

2010 CPR Guidelines Update – Activation of EMS or Calling a Code

In this episode of RoyOnRescue, Roy Shaw visits the new 2010 CPR guideline update regarding activation of Emergency Medical Services and calling a code. Be sure to watch this episode to get the latest guideline release covering this subject.

2010 CPR Updates -Compression Only CPR

Hello Everyone,

I’ve been debating on trying to post this before the weekend and now I’m sure I should. It’s not going to be short but I will try and get too the point.
There is a lot of talk going on about Compression Only CPR and how it rivals traditional CPR. I’m going to shed some light on the technique and try to sneak in a bit of synthesized science to help understand what it is and what it’s not. Hold on to your seat…hear we go!

2010 CPR Update Series – 911 and Dispatcher Changes

This 2010 CPR update training, I take a look at the 911 and Dispatch Changes.  The biggest takeaway from this change is a simplification for the rescuer who is calling 911.  The dispatcher is going to ask a series of questions to determine if the victim is breathing or “Not”.  Not, can mean not breathing at all, or could mean not breathing normally(Agonal or gasping).  Upon this finding as well as deciding if this victim is in cardiac arrest due to asphyxia or medical condition like cardiac disease will change the directives the dispatcher will give to the rescuer.

Watch this RoyOnRescue video to help understand the difference between 2005 and 2010 and why the change was made.

2010 Latest CPR Guidelines Released!

Roy Shaw, EMT-Paramedic and Instructor Trainer for ProTrainings.com has embarked on a quest to cover all of the important updates and topics related to the new 2010 ECC/ILCOR and American Heart Association updates which are in the process of being released and communicated via email, news, TV, blogs, twitter, Facebook and any other means of communication you can think of. Only one problem, many CPR instructors haven’t been told how to handle them yet! So after many emails, phone calls and questions, Roy Shaw has decided to work through the updates topic by topic and give the old and new standards, his take on them and then open them up for converstaion. So if you’re looking for some insight on how to handle the 2010 CPR changes, look no further.

But The Family Said…DO NOT RESUSCITATE!

A student emailed in a great question and one in which can be a very tough one to answer!      It’s challenging enough to get bystanders to begin CPR.  But when we complicate the scenario with a person yelling; “They have a DNR, don’t do CPR or you’ll get sued!”   This can really complicate matters.  What do you do?   Stop CPR and hope that the withholding of potentially life saving CPR is legitimate?  Don’t stop CPR and continue to upset the people that are yelling stop in the first place?   Whoa! Tough spot to be in.

In this episode I’m going to do my best to explain the very complicated issue surrounding Do Not Resuscitate orders(DNR) when CPR is already in progress or about to begin.

Sample of Proposed DNR Guidelines From BENO-Ethics

How to Give CPR to A Ventilator Patient

This week a student asked:

“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.

Best Wishes,

Roy