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!

Why Wouldn’t Someone Bleed Much After A Traumatic Amputation?

Whoa!  I can hardly believe that anyone would dare to question the utter possibility of real people suffering after being affected by an explosion, but they are!  I received a comment from a Rescue Fan and they had seen posts and videos put out by someone who claims that the bombing injuries could actually be “mocked” or “fake”.  Now, regardless of whether they are or are not, I would like to answer this question regarding the claims that minimize this type of event.bloodclotfactor

Regardless, it appears that those who are questioning authenticity of the recent bombings and injuries/amputations related to these bombings are due to pictures that show people right after the bombing with little or no visible blood.

Most professionally trained people understand the properties of blood and how amazing our body is.  We understand that the body was created in such a way that it reacts to emergency situations in ways that help to slow down the process of shock and death in time to get help and try to recover from the injury or illness.  The following is a technical breakdown of how the body reacts to injuries, cuts and amputations and why minimal blood is not a good theory to use when it comes to deciding if a person really suffered an amputation or not.

In short, we must remember that when a vessel is cut and the body sends  the signal that an accident has occurred, the body takes action to lose as little blood as possible and conserve it’s life as efficiently as possible.  The following is a very good breakdown as to how and why it does.  I hope it helps and in the mean time.  Let’s be careful about calling every event a hoax even if it is possible.  Especially when innocent lives are part of the equation.

The 3 main functions of platelets are:
1. The release of chemicals important to the clotting process.
2. The formation of a temporary patch in the walls of damaged blood vessels.
3. Active tissue contraction after clot formation has occurred.
(the cessation of bleeding) consists of 3 phases:
1.the vascular phase
2. the platelet phase
3.the coagulation phase
The Vascular Phase
*Cutting the wall of a blood vessel triggers a vascular spasm which contracts the diameter of the blood vessel at the site of the injury for about 30 minutes (the vascular phase).
 During the vascular phase:
1. The endothelial cells contract and expose the underlying basal lamina to the bloodstream.
2. The endothelial cells begin releasing chemical factors (ADP, tissue factor and prostacyclin) and
local hormones (endothelins) that stimulate smooth muscle contraction and cell division.
3. The endothelial cell membranes become “sticky,” sealing off blood flow.
The Platelet Phase:
In the platelet phase (within 15 seconds after injury) platelets attach to sticky endothelial surfaces, basal laminae and exposed collagen fibers (platelet adhesion). Many platelets stick together (platelet aggregation) to form a platelet plug that closes small breaks.
Platelets arriving at an injury site become activated, releasing several compounds including:
 which stimulates platelet aggregation
-thromboxane A2 and serotonin which stimulate vascular spasms
-clotting factors
-derived growth factor (PDGF) which promotes vessel repair
-calcium ions required for clotting
The size of a platelet plug is limited to the immediate site of the injury by:
1. prostacyclin, which inhibits platelet aggregation
2. inhibitory compounds released by other white blood cells in the area
3.circulating enzymes that break down ADP
4. negative (inhibitory) feedback from high concentrations of serotonin
5. development of a blood clot which isolates the area
The Coagulation Phase
The coagulation phase does not begin until 30 seconds or more after the injury. Blood clotting(coagulation) involves a series of steps leading to the conversion of circulating fibrinogen into the insoluble protein fibrin. The fibrin network covers the platelet plug and traps blood cells, forming a blood clot that seals off the area.
Normal blood clotting depends on the presence of clotting factors(procoagulants) in the plasma. During the coagulation phase, enzymes and proenzymes react in chains or
cascades that form 3 pathways:
1. the extrinsic pathway, which begins in the vessel wall, outside the blood stream
2. the intrinsic pathway, which begins with a circulating proenzyme within the bloodstream
3. the common pathway, where intrinsic and extrinsic pathways converge
The extrinsic pathway begins with the release of Factor III or Tissue Factor(TF) by damaged cells. TF combines with a series of other compounds which activate Factor X, the first
 step in the common pathway. The intrinsic pathway begins with the activation of enzymes exposed to collagen at the injury site. All factors leading to the activation of Factor X are found within the blood.
The common pathway begins with the activation of Factor X, forming the enzyme prothrombinase which converts the protein
prothrombin to the enzyme thrombin. Thrombin converts soluble fibrinogen to insoluble fibrin.
 Thrombin stimulates blood clotting by:
(1)stimulating the formation of tissue factor, and
the release of PF.
(3) which forms a positive feedback loop with the intrinsic and extrinsic pathways,
accelerating clotting.

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!

Why Is Smog So Dangerous In Los Angeles In the Summer?

A rescue fan wrote in and asked, “Why is smog worse in the summer in Los Angeles?”Smog in Los Angeles

I did a little research and found the following.  I hope it helps.

SMOG, nicknamed in the 19th century for the “smoke” and “Fog” found in London due to coal burning fireplaces and furnaces and low hanging fog can be a real problem with increased pollution.  One of the reasons smog is so dangerous is due to the fact that many times higher than the safe level of pollution particles hangs in the air like a nebulizer mist.  when inhaled, this polution can get into our blood stream and effect our whole body and vital organs.  There has been a lot of concern about this especially in China.  Over 8000 deaths have been attributed to SMOG in China and I’m sure that long term affects are even worse.
In an article by the “The Daily Green”, it stated that, “ozone needs heat and sunlight to form from its precursor chemicals. That’s why you hear warnings about air pollution most often on hot sunny summer days. But be aware: Ozone persists for hours after forming, so unhealthy conditions often last well into the evening, after the sun has gone down. Also be aware that ozone isn’t the only pollutant out there. Another major cause for concern are fine particulates — dust and soot, but also tiny chemical droplets. Particulates can cause air pollution problems year round, especially since furnaces and wood-burning stoves can produce unhealthy levels in the winter.”(http://www.thedailygreen.com/environmental-news/latest/ozone-air-pollution-smog-0706)china smog

China too has hit an all time high in air pollution and a complication with Smog.(http://www.cnbc.com/id/100456949)  It is said that High levels of air pollution in China’s cities leads to 350,000-400,000 premature deaths.(http://news.bbc.co.uk/2/hi/asia-pacific/6265098.stm)

So what can be done if you find yourself “socked in” by a cloud of toxic particulate?  Well, depending on the chemicals in the air, we could walk around with particulate filtering masks designed with the appropriate micron filter.  But this is not sustainable.  It is helpful however, if you find yourself in such a slichenituation.  It would be wise to view it like any hazardous environment and try to escape as soon as possible.  One should be aware that some of these chemicals can enter our bodies via  eyes, nose, mouth, food, water and in some cases the skin or breaks in the skin.  So, the next time you go outside and can take a deep breath of fresh air and view the nice minty green lichen growing on the north side of your trees, be sure to thank God that you don’t have to deal with terrible conditions of these very polluted locations.  Oh, but remember, air moves smogmaskeverywhere and it eventually affects us all.  So, don’t forget to call your government reps and let them know you’re thinking about them and the anti pollution policies their voting on.  Here, and everywhere else too!

Here’s a News Video About The China Smog.

Tourniquet Use Deemed A Lifesaver During Boston Bombing Incident

In this episode, I take a closer look at the reasons that tourniquets were so important during the Boston Marathon bombing aftermath. Injuries were similar to those seen on the battle field and the battle field has trauma that requires immediate hemorrhage treatment and usually includes a long transport time. In the case of the bombing, we saw a very similar landscape. Though we don’t use tourniquets often in peaceful situations, there can and may be times where a tourniquet could mean the difference between life and death. Watch this episode to sharpen your skills on how to apply an effective tourniquet.

Fellow Workers Credited For Saving Co-Workers Life With CPR

This video covers a story of how a person’s life is saved because others cared enough to try CPR. Watch this video and be encouraged that you never know when you may need to use CPR skills. If you want to learn CPR today, go to www.profirstaid.com and click on the training tab at the top of the site. Then watch the videos for free, and learn what to do in case of an emergency. It really can make a difference! It did in this person’s life.

Keep On Rescuing,

Watch A Real Cardiac Arrest and Survival! Plus Patient Interview Post Resuscitation.

I wanted to share this video with you.  We know sudden cardiac arrest happens almost every 2 minutes to someone in the U.S. but we rarely get a chance to watch a real cardiac arrest occur, see the rescue caught on a security camera and then hear the patient talk about his experience so that everyone can learn from it.  If you or someone you know does not know how to provide CPR, please go to www.profirstaid.com and watch the free CPR training by clicking on the training video tab.  Or simply click here after  you watch the video below.

Lindsey Vonn Super G Skiing Accident Medical Breakdown



In this episode of RoyOnRescue, I take a look at the details of the recent Lindsey Vonn skiing accident and what mechanism of injury caused the serious knee injury she suffered. Watch actual footage of the accident while I comment on how the crash caused her injuries. Then, discuss what steps you might take to minimize further damage and what you would do as the rescuer on scene prior to air evacuation.

When Abdominal Pain Calls For 911!


hitinthestomachIs abdominal pain a reason to call 911?
“Abdominal pain is pretty common, how do I know when to call the doctor or when to call 911?” -email sent by rescue fan.


I noticed that some Rescue Fans were wondering about when to call 911 or know when they should seek help after they get hit in the stomach. Great question! Abdominal pain can be everything from simple gas to a life threatening bleed. In my opinion, one should call 911 whenever the pain is causing decreased level of consciousness, is unbearable, rigid abdomen, pale skin, blood in urine or feces or anytime that voice inside is saying, “something isn’t right”. Then, if its nothing, great! But if it is serious, time is short and fast action to the hospital is vital. I hope this helps!

Stay well!

Question: Why Dont We Check ABC’s Anymore?

In this blog,

I answer a question that came in about why we don’t teach lay rescuers to check for pulses after AED shock. This student thought that we were trying to trick them but in reality, the new standards are what may be tricky. Here’s my answer, I hope it helps.

Hi Shelley,

Thank you for taking the time to comment about the training. I’m writing In regards to your question about AED use and then checking for “signs of life” vs checking for Airway, Breathing and Circulation. Id like to assure you that as wrong as it may seem to do CPR without checking for pulses first, the training you received from ProFirstAid.comis based upon the latest guidelines set forth by the American Heart Association and are correct.

The old standards were to shock with AED Training and then assess for Airway, Breathing and Circulation, if no pulse give CPR. The new standards have eliminated pulse checks for lay rescuers in order to simplify and hopefully reduce pulse check “mistakes”. This is designed to shorten time from arrival of help to first chest compression.

Now, if your feeling a little confused, don’t feel bad… many of us do when there are changes. Be assured that most people who are unconscious, not breathing normally and have received a shock are most probably in cardiac arrest and CPR is called for. Besides, studies show that chest compressions when not needed rarely ever cause severe harm. Better to error on the side if giving CPR.

This however, is the reason for change in training and per the AHA standards it is accurate.

I’d be happy to explain further and in more details if you like.

Best Wishes,

Roy Shaw, paramedic, instructor