Follow Up Answer Based On Question Regarding “How To Find The Brachial Pulse”

Hello Everyone,

Great follow up question came in on how to locate the “brachial” artery.

It’s located on the inside of the upper arm between the biceps and triceps muscle along the humerus bone.   Use the flat part of your four fingers to press moderately against the inside of  the arm at this location.  This is a skill that needs practice with a baby who has pulses so as to be confident when looking for a brachial pulse on a child without a pulse.  Remember, when in doubt, if the patient is unconscious, not breathing normally and appears dead…we treat them as they are.  Begin CPR!

Hope it helps.

Roy

Tornadoes and How To Survive.

“I don’t Think We’re In Kansas Anymore Toto!”  This was a famous line from a very good and classic movie, The Wizard Of Oz.  However, many people experience tornados each year and suffer great loss and damage as a result.  In this video blog post, Roy Shaw, EMT-paramedic and host of RoyOnRescue will share video clips of real tornados caught on video and some ideas on how to protect yourself your loved ones and others during the watch and warning phases of a devastating storm like a tornado.  It’s spring and it’s tornado season.  You won’t want to miss this episode.

Here’s a link from OSHA about how to prepare your workplace for a tornado.  Tornado Safety Link

“Why Are There Different Names For Different Pulses?”

Today I had a great question come in through our customer solutions department. Here’s what it said.
“What and why are the pulses of different ages called different things and what are they called?”

Well, I understood this to mean, what are the different locations for the different age groups in cardiac arrest or unconsciousness and so I gave the following answer.

Hello,

Thank you so much for your question. It’s a great question and I think I might be able to shed some light on it.

It can be a little confusing some times as we try and decode the reason why certain things in medicine are named what they are. Basic Life Support is not immune to this same situation. In regards to the names of “pulses” and how they are named according to the age or size of the patient, I’ll try to clarify.

If I understand your question correctly, you’re talking about the three locations of the pulse check.

1. Radial, which is found in the wrist of the patient, usually used for patients who are adult or child size. Older than 1 year of age. This location is used for general pulse rate and quality but not usually for the unconscious patient.
2. Brachial, which is found in the bicep/tricep region of the upper arm on the inside of the arm. This is the location for an unconscious infant, age 1 year or younger.
3. Carotid, which is found in the neck. This would be located between the trachea and the sternocleidomastoid muscle(located on the side of the neck). One can really see this muscle well when one turns their head to one side or the other. This would be the location of choice for the adult and child(older than 1 year) unconscious patient.

There is yet another location used in emergency medicine but not usually pre-hospital and that would be the femoral artery. This is located in the groin of the patient and again is usually used for trauma patients that have C-Spine collar or the carotid is not easily accessed due to intubation etc.

The reason to use the brachial over the carotid for an infant is primarily due to the fact that most baby’s don’t have necks to speak of. They have milk catching folds of skin but other than that, their anatomy is such that an area to evaluate an accurate carotid pulse is not easily obtained. Therefore, the brachial artery is the location of choice and works extremely well for the health care professional to ascertain whether a pulse is present or absent.

In most cases for adults and children over the age of 1 year, the carotid artery is the location of choice to check for pulse presence due to it being the last place to feel a pulse prior to the blood pressure being too low to feel a pulse regardless of whether the heart is beating or not. Secondly, it’s next to the location where we are performing a head tilt and chin lift while giving rescue breaths and is convenient to the rescuer for checking pulse presence(little perk).

So, though the names of the locations can be a little challenging, they do make great scrabble words, or can make you look really intelligent at dinner parties. Remember, it’s not the feeling of a pulse that will determine if we’re going to start cardiac compressions or not, It’s the absence of signs of life that will determine that. This includes, unconscious and unresponsiveness and that the patient is not breathing normally or not breathing at all. If these two signs are present, begin CPR. Pulse checks have often given false readings and postponed cardiac compressions in a patient who needed cardiac compressions desperately.

I hope this helps anyone who may have had the same question.

Best wishes and keep on rescuing!

Roy
RoyOnRescue.com


Roy W. Shaw, EMT-Paramedic
Director of Training and Compliance

ProTrainings.com

Can Anyone Use An AED?

In this mobile vlog, Roy wanted to address the AED question asked by two different people at almost the same time. Though there may be slightly different legal rules in the U.K. Compared to the U.S., both countries follow closely related ILCOR recommendations/guidelines. Always check your local laws to be sure, but in this episode, Roy addresses what the 2010 guidelines changed and why you can probably use an AED without any formal training. Let him know what you think of his more mobile format. He’s trying a new app that would allow him to record and post from almost anywhere and anytime. Not as finished as the in-studio videos but let’s him be more efficient. He will use the other format too but will sneak in some simpler ones when time is crunched. Your comments will be appreciated. Send comments to: royonrescue@gmail.com.

The RoyOnRescue Team


 

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.

 

CPR With A Knife In The Chest?

Hello Everyone!

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

RoyOnRescue End Of Year Wrap Up

In this latest episode of RoyOnRescue, Roy takes a moment to thank everyone for a great year while showing you around the Corporate Office of RoyOnRescue and ProTrainings.com.  Though a few of the professionals may have been caught off guard, you get a chance to see behind the scenes as Roy thanks you and the team for all of the support in 2011.

Enjoy,

RoyOnRescue.com

Did I Do CPR Wrong?

In this episode of RoyOnRescue,  Roy answers an email that was just sent in regarding a person who provided CPR for a cardiac arrest victim but it was different than how the two other certified responders where doing CPR.  Please tell me we don’t give rescue breaths anymore, I hope I did the right thing, “God forbid my way was wrong”.  Roy answers this question in a way that explains how all three of the rescuers did the “Right Thing”.  Be sure to watch this episode to learn how compression only and complete CPR are beneficial for the cardiac arrest victim.

Overcoming Diabetes Part 2 of 2 Interview With Clint Crabtree

This is the concluding episode of the interview between Clint Crabtree, MMA Champion, Brazilian Jiu Jitsu Blackbelt and Owner of Grand Rapids Brazilian Jiu Jitsu.  In this final part of the interview with Clint, he explains in more detail how he manages his diet combined with exercise and how it’s redefining the way we think about living with diabetes type 1 or type 2.  If you have diabetes, want to prevent diabetes or maybe know someone who is diabetic, you won’t want to miss this final part of a very enlightening interview.

 

 

Turkey, Road Rage and Trauma Oh My!

What does Turkey, Trauma, and Road Rage have in common? Black Friday! In this episode of RoyOnRescue, Roy shows how crazy it can be when waiting in line for that “perfect” gift that one could just die for?

Don’t miss this episode of RoyOnRescue where Roy sheds some light on how to stay safe while getting those Black Friday bargains.