Heat Exhaustion vs. Heat Stroke

In this RoyOnRescue, I reply to a question a student emailed me about how to recognize heat exhaustion and heat stroke and how to treat both.   If you ever wondered if a person was just “over heated” or if they might be in danger of suffering a life threatening heat stroke, you will want to watch this video blog reply.

In some parts of the country it doesn’t feel very hot but don’t be fooled…Summer is just around the corner.  Be ready and don’t allow you or someone you love to become a victim of Heat Stroke!

Surviving A Flood

Flooding causes many problems with people who experience them.  From drowning to hypothermia and fractures to contaminated drinking water.  In this episode, Roy talks about the massive flooding that has affected the Tennessee region and what types of injuries and illness floods can bring.

ABC News and Video of Tennessee Flood

Snake Bites Part 1 of 2

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.

Can a Ball Hitting My Childs Chest Kill Him?

In some cases it has!  The velocity of an object striking one’s chest can cause a phenomenon that could disrupt the normal beating heart.  If this happens, everyone standing by should hope they can recognize it, and treat it.  Here’s how I got on this subject.

An email came in to our offices asking about more information regarding what happens when a child is struck in the chest or abdomen ,ith a ball, puck, bat or other hard object.

Sports can be fun but not when someone gets seriously hurt or dies.  One type of injury that is a real concern to everyone is cardiac arrest secondary to  chest trauma from a blunt object.  This can happen when a baseball, soccer ball, basketball, hockey puck, bat or person hits another persons chest with a great deal of velocity or force.(http://pediatrics.aappublications.org/cgi/content/full/122/2/437)   In some cases, it is suspected that if a ball or other object hits a person chest over the top of the location of the heart, the strike works somewhat like a technique that was once used to mechanically cardiovert a heart called a precordial thump(http://www.heartrhythmjournal.com/article/S1547-5271%2809%2900687-0/abstract).  This technique used force vs. electricity to create some form of rhythm or Arrhythmia/ Ventricular Fibrillation in order for the heart to be corrected so as to regain a purposeful and organized heart rhythm.  This technique though used rarely today, may be the effect that is causing sudden cardiac arrest in children and adults who are involved in a chest trauma from sports.   If this does happen, the person may collapse immediately and stop breathing with no palpable(you can’t feel it) pulse. If the person is in cardiac arrest or is not showing signs of life,  911/Activation of EMS and CPR should be started immediately and an AED may be very useful if the person is in a shockable condition.  If an AED is not present, CPR will be done continuously without interruption unless the person becomes conscious and begins to move or attempts to speak(signs of life).   Be on guard, bruising, punctured lung or other underlying conditions could cause the person to return to a state of cardiac arrest so frequent reassessments will be required until the person is turned fully over to the care of emergency medical services.   The best cure for this injury is prevention.  Many companies are designing and selling chest guards and protective devices to help prevent this condition from happening.(http://www.allsportsarmour.com/CHEST_ARMOUR_SHIRT_p/asa100%20dual.htm A well trained professional or volunteer coaching team in CPR and First Aid (http://www.profirstaid.com)would be highly suggested and an AED can be purchased for less than a laptop today.(ProFirstAid.com)

In comparison another condition related to a blunt trauma to the abdomen is a condition nick named, “getting the wind knocked out”.  This condition usually occurs when a person receives a blow to the upper center abdomen which is approximately where we provide inward and upward abdominal thrusts for a choking victim.  This area is physiologically perfect for compressing the diaphragm and compressing the lower lobes of the lungs.  This forces residual air out of the lungs and feels scary.  Normally, after a few minutes of one trying to breath deeply, fighting hard for that first real deep breath, the spasm releases in the diaphragm and air is gradually brought back into a normal state.  Complications related to this fairly common condition could include ruptured or torn internal organs.  If a person is hit hard enough, as in situations where a bat or object was used, or the lower half of a steering wheel which is common in unrestrained, non airbag vehicular accidents, the trauma could rupture/tear internal organs and even the descending aorta.  If the Aorta is torn or ruptured, it is well know to be a usually fatal injury as time to surgery is quite a few minutes away and one can loose enough blood internally to die from hypovolemia.  A condition where there is not enough blood to circulate oxygenated blood or maintain an adequate blood pressure  which leads to death if not corrected.  Treatment for this more serious condition is activation of emergency medical services while providing CPR, Shock Therapy(http://www.profirstaid.com) and minimization of movement.  A way to prevent this injury is to avoid the types of conditions that could present it.  Another way is to incorporate an aggressive core strength training program which will build strength in the abdominal muscles so as to help protect against sport related injuries.

It is important to consult with your health care professional or physician before beginning any intense workout program and if you are at all concerned that you or someone you know may have internal injuries, call 911/EMS and seek medical help.

Most of the signs and symptoms related to an internal injury in the chest or abdomen are severe pain that disables a person from performing normal behaviors.  Tender abdomen to touch, distending(bulging) belly, rigid or hard belly) bruising or marks over the abdomen or chest, shortness of breath or difficulty breathing, pale, cool, sweaty, increased anxiety, increased respiratory rate, dizziness, fear of dying and unconsciousness.  If any of these signs or symptoms are present or appear after an injury, activate the Emergency Medical Services immediately and/or seek medical help right away.

I hope this answers the question and I hope the next time you are by someone who is struck in the chest or simply gets the wind knocked out of them, you’ll better know what it is, what to do, and how to help.

Best Wishes,

Roy Shaw, EMT-P, RoyOnRescue

www.royonrescue.com

Tweet:  @royonrescue

P.S.  Here’s a link to  a real life scenario.  It’s worth the read Mom and Dad.
http://www.huffingtonpost.com/2008/05/19/family-of-boy-hit-by-base_n_102439.html

Infant Choking, Back Slaps or Chest Thrusts?

Ever wonder what to do if an infant began choking next to you?   Ever wonder if one procedure was more effective than another?  Well, one of our students did and emailed me a question about his topic.  In this video blog entry I open up the discussion about back slaps and chest thrusts, what they do, and how they work to help a choking victim.  Then at the end, I give you the secret about which one is more effective.  Enjoy!

Clinical Pediatrics

The Choking Child—A Life-Threatening Emergency

Evaluation of Current Recommendations

Susan B. Torrey, MD

http://cpj.sagepub.com/cgi/content/abstract/22/11/751

Volume 44, Issue 2, Pages 105-108 (April 2000)

Airway pressure with chest compressions versus Heimlich

manoeuvre in recently dead adults with complete airway

obstruction

A. Langhelleab, K. Sundeab, L. Wikc, P.A. Steend

Accepted 22 November 1999. published online 17 August 2004.

Abstract

In a previous case report a standard chest compression successfully removed a foreign body from the airway after the Heimlich manoeuvre had failed. Based on this case, standard chest compressions and Heimlich manoeuvres were performed by emergency physicians on 12 unselected cadavers with a simulated complete airway obstruction in a randomised crossover design. The mean peak airway pressure was significantly lower with abdominal thrusts compared to chest compressions, 26.4±19.8 cmH2O versus 40.8±16.4 cmH2O, respectively (P=0.005, 95% confidence interval for the mean difference 5.3–23.4 cmH2O). Standard chest compressions therefore have the potential of being more effective than the Heimlich manoeuvre for the management of complete airway obstruction by a foreign body in an unconscious patient. Removal of the Heimlich manoeuvre from the resuscitation algorithm for unconscious patients with suspected airway obstruction will also simplify training.

http://www.resuscitationjournal.com/article/S0300-9572%2800%2900161-1/abstract

Heimlich vs Back Blows/Chest Thrusts

http://medfraud.info/Koop.html

Consensus Guidelines Not Followed in 1985 Release Encouraging Heimlich Maneuver

How To Recognize and Treat Diabetic Emergencies

I received an email today from a concerned rescuer who wondered how she could determine if a person is suffering from low blood sugar or high blood sugar and what to do for each.  I thought it would be better if I simply video blogged my answer to her and to the rest of you who might benefit from it.  It can be very scary to see someone with a decreased level of consciousness and not know why it’s happening.  If one thinks that it may be due to low blood sugar, watching this video blog may empower you to know what to do and become a rescuer today.

If you would like to see a five minute training video on what diabetic emergencies are, please go to www.profirstaid.com and click on the video training tab at the top.  Then scroll down to diabetic emergencies. Keep Rescuing!

Concussion vs. Closed Head Injury

Ever see someone hit their head very hard?   Wonder if it’s just a minor “Knock on the Noggin” or could it be a serious head injury?  In this Roy On Rescue Video Blog entry, Roy Shaw, EMT-Paramedic answers those questions with directives on how to assess, stabilize and treat a person for a serious head injury or minor. There’s nothing worse than sitting with a crying child or an injured adult and wonder if we are over reacting by calling 911, or under reacting by not doing more. Watch this video blog for some interesting insights straight from the Paramedics mouth on what to do.

Don’t miss this entry where Roy puts a common sense spin on how to handle the next event where someone hits their head and no one knows if they should go in to the hospital or just sleep off the headache.

Watch the video below if you would like to see a video animation of what happens in the skull when a person hits their head.

A website that shows a video explaining a traumatic closed head injury is located at: http://www.youtube.com/watch?v=AmAML1-F2LE

When Is Cell Phone A Weapon?

Viewer Discretion Is Advised Due to Graphic Nature!

In this episode of Roy on Rescue, Roy Shaw had received an article on his desk from AutoWeek.com.  It was an article that talked about the growing danger of drivers who are using not only there cell phones to talk, but to text message while driving.  After Roy interviewed a full time professional dispatcher from  a leading ambulance provider, and heard the same message, he decided to write this article and include this most disturbing yet realistic video.

Viewer discretion is advised! Graphic reproductions of actual car crash injuries are included in this video.  The desire of showing this video is not to create anxiety for anxiety sake, but to create a disturbing awareness that will change behaviors while driving vehicles.  We all have loved ones that drive everyday.  Even if we as drivers don’t use the phone while driving, that doesn’t stop the driver in front of you, beside you or in back of you!

Let’s create a new and safer environment and prevent needless accidents…Now.

If after you view this video you decide to show it to your teenage drivers, please educate them to the graphic nature and then talk about the public service announcement after you view it together.

Please spread the word.  Everyone’s life may depend on it.

Roy Shaw would like to specially thank the United Kingdom for producing such a realistic and educational Public Service Announcement in this fight against accidents and cell phone misuse.


Texting Kills: Cell Phone Use Impairs Drivers More than Alcohol
Jul 27, 2009 … Texting Kills: Cell Phone Use Impairs Drivers More than Alcohol, Charles Moore, Miscellaneous Ramblings, 2009.07.27.
lowendmac.com/misc/09mr/texting-kills.html

Driven to Distraction – Britain Sets Tough New Laws for Texting …
Nov 2, 2009 … When Texting Kills, Britain Offers Path to Prison …. DRIVEN TO DISTRACTION; When Driver Starts Texting, Back Seat Delivers a Message …
www.nytimes.com/2009/11/02/technology/02texting.html

Woman killed by teenage driver who was sending text messages at …
Jul 21, 2007 … A young bank worker who caused a fatal accident by sending a text message on her mobile phone while driving at 70mph on a rainy night was …
www.timesonline.co.uk/tol/news/uk/crime/article2112869.ece

FDI Voice | Driving While Texting Kills – What will it Take to Get …
Dec 29, 2009 … FDI Voice | Driving While Texting Kills – What will it Take to Get … found that truck drivers who were texting were 23 times more at risk …

www.prlog.org/10468710-fdi-voice-driving-while-texting-kills-what-will-it- take-to-get-this-message-out-fdivoice.html

Crap Cycling & Walking in Waltham Forest: Texting kills
Jan 17, 2010 … Texting kills. A girl of ten was killed by a passenger airbag after her mother … Driver who killed cyclist: “it was just one of tho. …
crapwalthamforest.blogspot.com/2010/01/texting-kills.html

What To Do If A Person Falls and Hits Their Head

A concerned Good Samaritan(G.S.) wrote me a question and I thought it would be good to share it with you on RoyOnRescue(ROR).

G.S.: “In my scenario, the person fell down hit their head twice and then fell onto the floor face down. I am now wondering if we did the right thing. We picked the person up and carried her outside for fresh air where she revived immediately. We  then monitored the person but nothing else seemed to be wrong with her.”

ROR:  It sounds like the story ends well regardless of the treatment given which is always great!  There may be a few things that we cold improve upon for the future. Let’s analyze what happened and what we might be able to do differently next time to protect and help the fall victim even more.

Whenever a person falls, there is a risk for head and neck injury. As stated in your scenario, this particular person did  hit their head… twice.  This would be enough mechanism of injury that instead of moving the person right away, we would want to minimize movement while assessing the person for any signs or symptoms of other injuries.  We can minimize movement by softly but confidently speaking to the patient who is either conscious or unconscious and place one hand carefully on the victims forehead to help remind them and us not to move their head and neck.   Try to find out  if the person is breathing on their own and if their skin color is somewhat normal while they are lying in the position found. If they are breathing and skin color is good, we do not have to move the person before Emergency Medical Services arrive.

If assessing the person’s airway is impossible in this position,(face down) we may need to carefully roll the person over onto their back even if we suspect that there may be a serious neck or back injury.  We do not move spinal chord injury patients unless they need cpr, their airway is compromised or they are in danger due to the environment.

If we determine that we must roll, or move a person with a suspected spinal chord injury, utilize several people if available,  in order to minimization spinal movement.  If you are the only person, then do the job the best way you can and follow the “Life Over Limb” philosophy.  If the person wakes and is not complaining of any pain or numbness and they don’t allow you to minimize movement because they want to get up, they should be allowed to do so.  It is not wise to hold the person down as this can complicate injuries the patient already sustained trying to wrestle.  Keep encouraging the person to stay still until help arrives by the ambulance service. Keep the person in a position of comfort with confident words of encouragement like, you are in good hands, I’m going to take good care of you and help is on the way.  If they still refuse treatment, there is little you can do at that point other than inform  911 of what has happened.

It sounds as though you did the best you could for this person at the time.  Remember,  most people don’t even get involved when someone needs help.  The fact that you did get involved and tried to help makes you a natural rescuer!

I thought a video clip of all different fainting episodes would not only get my point across that falls can cause injuries to the person even if the fainting spell or the reason they fell wasn’t serious. I hope you don’t feel faint watching others faint but if you want to see what happens to people when they fall from standing up, take a look at the clip below.

P.S. One of the most effective rescue moves for a person who is starting to faint, is to simply help them to the floor before they fall!

Best Wishes,

Roy On Rescue