Category Archives: First Aid

Posted in Preparedness • Roy on Rescue • RoyOnRescue Personal Responses • CPR for Instructors • CPR for Providers • Personal Protective Equipment • Scene Safety • Self Defense Preparedness

Why Put On Personal Protective Equipment(PPE) Before Checking For Consciousness?

Comments:2 Comments

Hello Rescuers!

I just received a question via our ProCPR customer feedback that read: PPE

Dear ProCPR, “Question 16 says you have on PPE (personal protective equipment)  already, then you check for
responsiveness. Why would you put on your PPE before you check consciousness?

– Anthony

In case anyone else may have asked the same question I though I’d address it.  First, Question 16 is the number this person was on while taking the ProCPR.org test.  This is the online portion of the Health Care Provider level BLS certification training in case anyone was wondering.

Okay,  now for the answer.  As professional health care providers, we should always be thinking about cross contamination.  We don’t want to catch what the patient may have and we don’t want to give the patient anything that we may have!  Remember, PPE works both ways.  Can anyone say, nosocomial infection?  Even if the patient isn’t in obvious distress or obviously infectious, we should be thinking about the fact that the person seems to be in need and may require medical treatment.  This means that we may need gloves, CPR shield with one way barrier, goggles, face mask, respiratory protection etc.   This is why it’s so important to think about PPE  whenever we encounter a situation that may call us into action.  Not just when the person is unconscious or not breathing.

Forever, I’ve battled the problem with health care professionals short cutting PPE while giving care or even thinking about care.  We really do need to consider the two way protective properties related to infection control as it relates to appropriate personal protective equipment.

When it comes to layperson rescue, one of the top five reasons that laypeople will not intervene when a person is in distress is the fear of disease!  If the rescuer is approaching a victim and dons their gloves early as well as ensures that they have a CPR shield available, the fear of catching a disease is greatly diminished.  This will  increase the chances that the Good Samaritan may actually get physically involved in the rescue.

Now I know what you may be thinking…”Roy!  Do you really think that I’ll have one of those rescue kits on by belt all the time?  You may be a “Rescue Hero” type but the feasibility of me having PPE on my person when I’m at the beach, shopping, walking, vacationing, or even at a business meeting is slim to none.”  Well, I have to agree!  Unless you are a professional rescuer on duty, you probably won’t have your jump kit, glove pouch or a one way valve mask bag swinging from your belt loop.  So how will you have the PPE you need at the time you need it?  The best way I’ve found is to have a key ring rescue kit.  The catch is having it be small enough to not get in the way and large enough to carry your gloves and a one way CPR shield.  The reason I say a Key Ring style, is that I think that keys are the one item that most people have with them most of the time.  If they don’t have them with them, then they are usually close at hand.  And if we have our keys, we’ll at least have gloves and a CPR shield.   So make sure you get one and then the PPE problem is out of the way.  Still don’t think that PPE is needed?   Well, that’s why the AHA endorses “hands only” CPR!  It’s really not that compression only CPR is better than full Cardio PULMONARY resuscitation, it’s that there are so many non PPE toting people afraid that they may catch a disease if they do mouth to mouth rescue breaths that we had to design a new form of  bystander CPR.  Since implementing  “Hands only” CPR, there has been an increase in rescuer involvement.  And when people get involved and provide CPR, lives are saved!

PPE should be on every rescuer’s mind…and key chain, lay or professional and when we begin to think about PPE as the first step in rescue, lives are saved and infection is prevented more often!

Hope this helps.

Posted in Roy on Rescue • Sports Related • Cold Related • Environmental • Trauma

Lindsey Vonn Super G Skiing Accident Medical Breakdown

Comments:

 

newskicrashthumb

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.

Posted in Roy on Rescue • Head Injuries

What Is Cerebral Venous Sinus Thrombosis?

Comments:

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:

http://en.wikipedia.org/wiki/Cerebral_venous_sinus_thrombosis

http://neurology.jwatch.org/cgi/content/full/2007/515/2

http://www.medscape.com/viewarticle/705510_3

 

 

Posted in Roy on Rescue • Weather Related • Cold Related • Environmental • Dehydration • Outdoor Emergencies

Could You Survive Stranded In A Snow Storm?

Comments:

After hearing about a couple getting stranded in a mountain pass off-roading and the driver dying while seeking help, I thought I should talk about key elements around surviving out in the cold.  People are often overcome by the cold simply due to lack of pre-planning, proper equipment and an adequate plan for survival until rescue help arrives.  If you’ve ever wondered what you would do if you were lost, stranded or overcome by the winter elements, be sure to watch this episode of RoyOnRescue.
In the meantime, remember at least these important points:

1.   Let people know where you are going and what route you’ll be taking…then stick to it!
2.   Dress with layers of clothing or have extra clothing available
3.   Bring warming agents like hand and pocket warmers along with extra blankets
4.   Bring extra food that can handle getting cold or even freezing like granola, nuts etc.
5.   Eat snow for hydration
6.   Bring GPS
7.   Bring Flare Gun
8.   Never drive with low gas tank
9.   If the roads are dangerous, maybe stay home or extend your vacation
10. Repeat steps 1 thru 9

Peace,

Roy, RoyOnRescue.com

Posted in Roy on Rescue • Trauma

Punch To The Face And A Visit To The Doctor

Comments:3 Comments

Hello Rescuers!
I wanted to respond to this question sent in via email from what I think is a Martial Artist. Being active in martial arts myself (TKD and BJJ) I completely understand the question sent in from Michael about eye injuries, face injuries and teeth problems.

Like any trauma, there can be several things to think about right away.  Is there a more serious injury that is being missed because of the blood coming from the face(distracting injury)? Maybe a head injury, brain swelling, breathing problems, neck injury, broken bone, etc. If no life threatening situation, then we may have some more time to think about how bad the injury really is.

If ever there is a loss of sight, loss of limb or loss of life, the answer is simple. Activate your medical emergency services RIGHT AWAY and support the patient with CPR and First Aid. If no life threatening emergency, glove up, clean up the patient and see what’s going on. If the person has an eye injury that makes them unable to see or may be the result of a poking injury, get them to the ER for examination. If the person has a hematoma(blood under skin) that is making their eye swell and unable to open, it may be a good idea to get a cold pack on it right away and then get to doctor or ER for reduction of hematoma, stitches, tetanus shot etc.

Loose, broken or missing teeth? Dentist right away.  Anything less then these may buy you some time to see if it gets better or worse. We have all been hurt while sparring but it’s the possible tears, broken bones, eyes and teeth that we don’t want to let go too far without treatment.  Remember,  if in doubt, call your 911 (EMS) or doctor and run the situation by them. Get a second opinion and see if they want you to come in or treat with first aid.

Now a reminder on prevention. Head gear, mouth-guards, face shields and proper guards are all essential to the prevention and reduction of needless injuries during contact sports. Yeah I know, they’re clumsy and usually not needed but if you’ve ever been kicked, hit or struck in the wrong place you can appreciate their protective abilities. Remind new people that sparring means practice with control not out and out fighting. Warn your sparring partners of injured areas and communicate when things are not going right. Whenever your in doubt about an injury…see a doctor.
I hope this helps. Be Well.

Roy, RoyOnRescue

Posted in Roy on Rescue • Safety • Scene Safety • Personal Protective Equipment

Dangers Of The Rescue Scene

Comments:

In this episode, I take a moment to talk about the recent traumatic death of an EMT who was struck by a vehicle while working with a patient on the scene of an accident. No matter if you’re a professional or a good samaritan, scene safety is the utmost important factor to keep in mind. It’s terrible that this EMT was killed in the line of duty trying to save lives and help people. I hope this RoyOnRescue helps to sharpen everyone’s level of awareness regarding safe scenes and how to rescue without becoming a patient yourself.

Posted in First Aid • Impaled Objects • Sprains • Trauma • Roy on Rescue

Ankles, Impaled Objects and CPR

Comments:

In this episode of RoyOnRescue, I answer two different emailed questions. The first from Michael who asked: “I was taught you remove the object only if it interferes with CPR.” Great question Mike. As a general rule of EMS, we only remove an impaled object if it’s obstructing the airway and preventing the ability to secure an airway. Removing an impaled object will often times “un-plug: the hole that was created by the injury and may cause excessive internal bleeding that can only be controlled in a surgical environment. As a lay rescuer, the Good Samaritan will follow the directions of the 911 dispatcher. In a worse case scenario, hands only CPR can still be performed. If the object is in the chest, try and work around the object as best as possible and provide what care you can without causing more harm. A second question came in just this afternoon from Sara who asks about an “ankle popping out” and what to do if this were to happen while on vacation. It sounds as though Sara may have a chronic problem with her knee or ankle but because of a recent injury is especially concerned that it could happen while on an exciting vacation this Friday. In both cases I hope that the advice I give helps and a little tidbit about the first aid acronym, RICES could be the solution while on vacation. Watch this episode to learn more about what to do in case either of these situations arise.

Happy Thanksgiving!

Roy, RoyOnRescue

Posted in First Aid • Concussions • Roy on Rescue • Bicycle Accidents • CPR for Providers

When A Bike Crash Gives More Than A Road Rash!

Comments:

Hello Everyone,

It’s been almost three weeks since my last episode was posted!  Just for the record…it’s partly because I’ve filled my Hard Disk and was short by about 4GB of RAM.  Seriously though, after suffering some technical problems I’m back in swing and hope to have several new posts in the next few days.  I’m also working on a new RoyOnRescue format to freshen things up and keep them moving in a direction that you would like to see them go.  In this episode, I cover a topic that was brought to me by a person who saw a road cyclist crash.  They were in bad condition and she wasn’t sure what to do.  I thought I’d take a minute to answer this while I upgrade my hardware on the old MacBook and rest before continuing work on the new style creation for the new upcoming year.  I hope this is helpful.  Keep the questions and comments coming and if you have a story that you’d like to share and get the RoyOnRescue point of view, please email royonrescue@gmail.com.

Thanks and keep on rescuing!

Roy

Posted in Roy on Rescue • Sports Related • Concussions

Football Helmet Removal During Emergencies

Comments:2 Comments

In this episode, Roy answers a question that came in regarding how to remove a football helmet if a person may have a neck injury.  Roy explains that only when the person’s life depends on it, should a helmet be removed before professional rescue personnel arrive.  If the person’s life depends on a rescuer being able to remove the helmet, then it should be removed following a few guidelines.  Be sure to watch this episode of RoyOnRescue to learn when and how a helmet should be removed during an emergency.

Posted in Roy on Rescue • Shock

What Do I Do If I Find Someone In Anemic Shock?

Comments:

Hello Everyone,

In this Vlog, Roy replies to an emailed question regarding someone’s friend who apparently has anemic complications. Due to this, she goes into shock, most likely due to the lack of Red Blood Cells which are required to carry oxygenated blood to the body’s tissues. Roy wanted to make sure and reply to this before the weekend. Hope it helps.

Keep On Rescuing,

RoyOnRescue Team

P.S. The following is the explanation of anemia per MedScape Reference(http://emedicine.medscape.com/article/780334-overview)
Anemia is characterized by a reduction in the number of circulating red blood cells (RBCs), the amount of hemoglobin, or the volume of packed red blood cells (hematocrit). Anemia is classified as acute or chronic. Acute anemia denotes a precipitous drop in the RBC population due to hemolysis or acute hemorrhage. In the emergency department (ED), acute hemorrhage is by far the most common etiology. This article also discusses other causes of acute anemia.