What Does An Actual Drowning Look Like And How Do We Help?

As in all accidental deaths, the more we know about how to prevent them, the better off we will all be. In this episode, I answer an email that asked if I could combine training with some more realistic visuals about how a person may actually look when they’re drowning vs. the hollywood melodramatic look. The rescue fan was concerned that many people may not even realize that a drowning victim could be very quiet and not really even yell for help.

I hope this training helps us all have a much safer summer of fun!

What Is Cerebral Venous Sinus Thrombosis?

Hello Rescuers!

I received an email from a RoyOnRescue friend who had suffered a head injury while playing a sport.  After being seen by the doctor he was diagnosed with Cerebral Venous Sinus Thrombosis or (CVST).  He had asked me if I would give my explanation of what it is and if it was something he should be worried about.  His doctor had exCSVTplained it but he was still a bit foggy regarding the diagnosis.  Well, after looking into it from the clinical perspective, I realized that it was a pretty big deal and in some cases may be fatal.  I researched multiple sources to gather credible information and when it all came down to brass tacks, I found that the Wikipedia explanation had done a pretty dog-gone good job of summarizing CSVT.  So, with all credit given to them for most of this article and a link back to their website, here it is.

I have personally responded and treated many different types of head injuries as a paramedic but had not researched this problem to this level.  Then, shortly after receiving this question, I read that  Secretary of State, Hillary Clinton was diagnosed and hospitalized with the very same problem secondary to her head injury!  Ironic.   So, I thought to myself, if two people experienced this problem secondary to a common traumatic head injury(concussion), there may be more with the same question.

Here’s my trimmed-down version of what it is, what it’s symptoms are, how to determine if it is truly CSVT and then what a person may want to do if they think they may be suffering from such a complication.  So let’s dig into some of the questions you may have!  P.S.  You’ll notice there are more links then usual in this article.  The topic is so complex and has so many different facets I thought it wise to allow you to do some of your own information mining and hope the links make it easier.

Q:  What is a cerebral venous sinus thrombosis anyway?

A:  A CVST is the presence of thrombosis (a blood clot) in the dural venous sinuses, which drain blood from the brain. 

Q:  What causes a CVST?

A:  There can be many causes of CVST.  Here is a few I included:

Q:  How might I know if I have a CVST?

A: Headache that may worsen over the period of several days, but may also develop suddenly.  Strangely the headache may be the only symptom of cerebral venous sinus thrombosis.  Stroke, 40% of all patients have seizures, Common symptoms in the elderly with this condition are otherwise unexplained changes in mental status and a depressed level of consciousness.  The pressure around the brain may rise, causing papilledema (swelling of the optic disc) which may be experienced as visual problems.  In severely raised intracranial pressure, the level of consciousness is decreased, the blood pressure rises, the heart rate falls.  This is a common symptom found in closed head injuries which makes sense as the mechanism is very similar.

Q:  How will the doctor know if this is what I have?

A:  The most commonly used tests are computed tomography (CT) and magnetic resonance imaging (MRI), both using various types of radiocontrast to perform a venogram and  visualise the veins around the brain

Q:  How is a CVST treated and cured?

A: Treatment is with anticoagulants (medication that suppresses blood clotting), and rarely thrombolysis (enzymatic destruction of the blood clot). Given that there is usually an underlying cause for the disease, tests may be performed to look for these. The disease may be complicated by raised intracranial pressure, which may warrant surgical intervention such as the placement of a shunt.

AmbulanceQ:  Can this be serious?

A:  Yes.  Like any illness or injury that causes a problem with the circulation of oxygenated blood to our tissues, this type of problem can be very dangerous if left untreated.  It also runs a risk of complication in that it raises the intracranial pressures which can act similar to a closed head injury and this too can cause severe injury or death.  If a person has any of the symptoms listed above, they should be seen as soon as possible to rule out this potentially life threatening disorder.  If a person is reacting with decreased level of consciousness, or any type of life threatening complications, activation of Emergency Medical Services or 911 should be immediate with life saving or time buying intervention given.


I hope this helps and keep well!

See Source:






When I Was Doing CPR The Patient Began To Revive…But I Heard They Didn’t Make It. What Gives?

I received a really good email from a rescuer who provided CPR to a person and before the emergency services arrived, the patient was exhibiting signs of revival.  Later, the rescuer discovered that the patient did not survive after all.  This person had a valid question about how or why this would happen and I wanted to include my reply so that it may help others who may in the future or  have already had the same experience.

Dear “Rescuer”,

There are so many reasons why a person may start to revive or does revive from initial cardiac arrest only to arrest again later and die. This fact that he later died should in no way be connected to your heroic actions you performed. By getting involved you increased his chance of survival by attempting to circulate some percentage of oxygenated blood to his vital organs in order to slow down the clinical to biological death process.

Of course, we never want to think that our rescue efforts will not change the end result. But in expressing compassion, you gave this individual one of the greatest gifts one can give, your care, compassion and your love for a fellow human.

Whomever that gentleman was, for a certain amount of time, you were able to give him the care he needed in order to have a chance to survive. Statistics and data show us this to be true. This does not mean however, that his condition would allow him to survive for the long term. The cardiac related disease that he may have suffered from chronically, the pulmonary embolism that may have occluded a vital vessel in the circulatory system or any other serious medical problem could have still determined that he was not going to survive his cardiac event.

Your efforts were completely successful because they did exactly what CPR is suppose to do… buy time! Be at peace knowing that you were successful in that you did buy him time and your efforts were not in vain. His last hours of life were spent knowing that someone he didn’t even know intimately cared enough to try and save his life. That’s an incredible gift to give someone.

I hope that this in some way can help bring you comfort.



Hurricane Sandy Is In Full Force and Now I Need An Ambulance!

Okay Rescuers,

When natural or unnatural disasters strike, the chance of getting emergency help to your doorstep fast while the EMS services are exhausted is very slim.  I wanted to take this opportunity to talk about a situation that doesn’t get discussed much.  What effect does a hurricane or natural disaster have on the rest of the community?  We sometimes forget the fact that though the rest of the world is distracted by a storm or other disaster related buzz, people still get sick, heart attacks still happen, car accidents still happen but we don’t often think about from where the next ambulance, fire truck or police car is going to be responding.  This episode of RoyOnRescue addresses this issue and urges people who may be in high risk of needing an ambulance or other EMS service to think proactively and make arrangements before the emergency happens.  Think about moving loved ones with fragile health to temporary locations that may not be effected by the hurricane.  Can the person stay with a relative until the community has recovered?  What is the back up plan if one can be found?  I hope this RoyOnRescue episode get’s everyone thinking and will hopefully help prevent a needless death due to not having the appropriate plans in place.  Stay safe, our prayers are with everyone who has been and is effected by hurricane Sandy and other storms.


Emailed Message from A RoyOnRescue Viewer From The UK

Hayley from the UK sent me a very nice email response and I thought I’d share it with everyone.
It reads:
My name is Hayley and I’m from the UK. I just want to say how fantastic your videos are and has made me want to follow the career I want to pursue even more, being a paramedic. Thank you.
Hayley H., age 16

Hello Hayley,

Thank you for taking the time to write. It’s great to hear that you are enjoying the RoyOnRescue series of video blog entries. I hope that you will continue to find them helpful, interesting and educational. Best wishes on your pursuit of an EMS career. There’s nothing like being a paramedic and being able to help others in their time of crisis. EMS is filled with everything from comedy to tragedy and the successful EMS provider is one that can cope well with each situation and know that they did their best regardless of the outcome. Let me know if I can be of further assistance and congratulations on Queen Elizabeth’s Diamond Jubilee celebration! 60 years…Wow!


Roy, RoyOnRescue.com

Does CPR Save Lives?

Roy Shaw, Paramedic and Trainer explains how CPR works in detail and how it can help save lives. Many people think that CPR saves lives by keeping people alive artificially. Roy helps to clarify what is really happening when you begin CPR.

Many people think that if I keep doing cpr the person will stay alive. The fact is, the person is already dead if they need CPR and even cpr done less than by the book will give the person a better chance at survival. In this video Blog, Roy explains that people don’t die from poorly done cpr, people die because CPR is never started. If you don’t want to be another one of those people who misunderstands how CPR works and how you can make a difference by trying to help, you may want to watch the video now!