New York Stabbing Victim Ignored Death

“On the surveillance video, a woman is followed by a man, who then appears to accost her.

Tale-Yax walks toward them. What can’t be seen is him being stabbed several times in the torso while trying to save the woman.

Within seconds, the camera captures the apparent attacker running away. Authorities say the woman fled from her assailant.

Tale-Yax, who was homeless, starts to chase the attacker but then collapses.

A minute later, a potential good Samaritan walks right by. And so does the next person and the one after that. A procession of more than 20 people seem to notice and fail to help.”

ABC Video and News Story of Stabbing Victim Ignored

Source: abcnews online

In this Roy On Rescue Video Blog, Roy W. Shaw, EMT-Paramedic explores a most disturbing news story about a man who comes to the aid of a woman being mugged, gets stabbed himself and then is left on the sidewalk to die.   The most disturbing part of the whole story is that approximately 20 people walked, drove or rode their bicycle by the dieing man without doing anything to help.

Roy get’s a bit serious in this episode but wants to make sure that if there is a reasonable doubt about getting involved to save another’s life and one is being stopped because of a misconceived fear, that fear must be removed before another person needlessly dies.

Don’t let one of these fears stop you from rescuing:

1.  Lawsuit

2.  Catching a Disease

3.  Unsure of What To Do

4.  Might Hurt or Kill The Person by doing something wrong

5.  Dangerous Environment (Legitimate)

Roy dissolves the misconceptions and misunderstandings of these top fears and hopes that if you know someone that may not rescue due to being afraid to try, you will pass this story on to them!

If you’re reading this or watching video right now, you are probably one of the ten percent of the total population that this story doesn’t apply to.  That’s why we know we are probably “preaching to the choir” but Roy is sure that you probably know someone that wouldn’t get involved in a rescue.  Please pass this on to them.

Snake Bites Part 2 of 2

In Part 1 of Snake Bites we talked about the different kinds of poisonous snakes that pose a risk for serious danger. Remember we were talking about an Emergency Responder who who had emailed me? She helps out with California High Desert Racing and the medical response team and is having some issues with Poisonous snake bites and 35-45 minute response times. This due to being so far away from civilization. In part 1 of this response video blog, we took 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. In this second part, we will get to the bottom of the correct treatment strategy in order to save a snake bite victims life and limb.

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.

What’s A Seizure And How Do I Treat It?

Seizures can be caused by many different things and though they don’t mean that the person has a serious condition, it is important to know what to do during and after a person has one.  A student wrote in asking if I could give  some additional information about how to handle a person who is having a seizure.   Though it seems complicated when you’re watching a seizure in progress, the treatment plan is quite simple.

1. Protect the person while they are having a seizure.

2. If this is the first time this person has ever had a seizure, call 911 or EMS.

3. Treat the patients needs after they stop having a seizure.

4.  Wait for EMS to arrive and takeover.

For a detailed training on seizure first aid, go to www.profirstaid.com and click on the video review tab at the top of the page.  Then search for the topic of seizures, get your favorite beverage and watch the video training.

Until next time…

Roy

http://www.epilepsyfoundation.org/answerplace/medical/seizures/types/

Coaching Sports, Injuries and Liability

BaseballI would like to pass on a quick informational about injuries and liability when it comes to coaching and organized sports.   I found the following outline very helpful when it came to the part about how to put a proactive risk management policy together.  Whether your sports organization is volunteer or paid, a healthy risk management program is always wise.

The following is specifically on how to deal with training, injuries/illnesses and return to play, but the website has a lot of really great advice.  I’ve included the link below or you can click on the hyperlink in this paragraph.

Sport Specific Techniques – Coaches should always follow the accepted practices for teaching sport specific techniques. Certain drills and other methods that are standard for each sport should be followed. Coaches should be involved in continuing education to learn about the advances of teaching techniques. It is especially important that instructions key in on the more hazardous areas of a particular sport such as avoiding a wild pitch, tackling techniques, etc.

Safety Rules and Procedures – Safety rules and procedures should be reviewed before and during every practice and game. They require constant reinforcement with special emphasis on the purpose and intent of the rules and the types of injuries they are meant to prevent. Any rule changes dealing with safety should be reviewed with all coaches during the pre-season with an emphasis on the types of injuries they are meant to prevent.

Sports Injury Care

Sports injury care consists of two basic elements – prevention and recognition/treatment. Youth sports administrators (RMO’s and Coaches) must understand the importance of both elements.

1) Prevention – Consists of pre-participation screening, strength training, conditioning, and awareness of the nature, cause, and mechanism of sport specific injuries.

2) Recognition and Treatment – Once the coach realizes that the injury has occurred, the magnitude must be assessed and appropriate care initiated.

Consent to Treatment – Health care providers can’t lawfully render treatment to a patient without consent. When a minor is involved, consent must be obtained form a parent or legal guardian. In life threatening situations, the law assumes that consent is given. However, once the patient has stabilized, consent must be obtained for further care. Having a “consent form” on file my provide some protection against a parent’s claim that emergency care was not authorized and can help to overcome apprehensions of health care providers about rendering treatment before lawful consent is obtained. Also, such consent forms should list if the athlete is allergic to any medications and should specify who should be notified in the event of an emergency.

First Aid and CPR – All coaches should be certified in basic first aid and in CPR. The coach should not exceed the scope of his training in administering first aid. The purpose of first aid is merely to stabilize the situation by preventing it from worsening. Once the situation has been stabilized, all other treatment should be provided by a doctor.

Emergency Medical Plan – Should be developed with the assistance of local doctors, hospitals, and EMS. The Emergency Medical Plan must be tailored differently for each community because of differing availability, response times, etc. Coaches should be specifically trained how to activate the Emergency Medical Plan.

The plan should be in writing and readily available and should cover the following elements:

  • Who calls EMS?
  • Who stays with injured athlete?
  • Where is nearest phone?
  • What phone number to call?
  • Where is the nearest treatment facility?
  • Where is the ‘consent to treat’ form?
  • Does the athlete have any medicine allergies?
  • How to notify parents?
  • How to initiate crowd control?
  • Who meets EMS and the guides them to the injured athlete?
  • Who accompanies the injured athlete for treatment?
  • Who supervises the team?
  • Who provides proof of insurance?

An alternative Emergency Medical Plan should be formulated when traveling to other facilities.

Return To Play – Once an athlete has suffered an injury, the decision regarding the appropriate time to return to play should be made by a doctor. The coach should not put pressure on an athlete to return too early and the instructions of the doctor should always be honored.

Visit the Sports Insurance and Risk Management Website for Risk Management Outline

Agonal Respirations Kind Of Look Like Sleep Apnea!

As I reflected on yesterdays video blog; “Gasping for Life”, I thought I should expound on what real agonal respirations really are and maybe even find some examples for you to see or hear.   Well, let me tell you this has turned out to be more difficult than I imagined.   As I searched the internet for some medical records of what I have seen during episodes of agonal respirations all I could find was one well intentioned but non realistic version of agonal respirations while everything else was simply informational.   I then began thinking about the times I had seen low blood sugar patients or postictal seizure patients and thought…I bet a good snoring respiration would be close!

After some time, I found an actual serious sleep apnea(OSA) case and thought I would include the link in the video blog for you to see.   Though this is not exactly what agonal respirations look or sound like, it is a far cry closer than other replications I found and will at least get the idea across that any form of agonal or distressed drive to breath is not oxygenating the body well and should be treated with Rescue Breathing or Full CPR depending on the symptoms.

I hope this helps clear up any confusion and please let me know if you would like me to expound on anything else relating to this video blog.

Best Wishes,
Roy Shaw, EMT-P

RoyOnRescue.com

Actual Video Of Sleep Apnea (Warning! This video could be disturbing.  Viewer discretion advised.)

Gasping For Life!

If an unconscious person is gasping but not breathing normally should you call 911 and leave them alone, or should you begin aggressive CPR?  In this Video Blog, Roy Shaw, EMT-P tells a true story about how a child may have died due to not having life saving CPR because she was showing signs of agonal breathing.  This caused the rescuer to stop the life saving CPR and ended tragically.
Watch this Video Blog to learn what agonal breathing is and how to respond to it.

http://www.theheart.org/article/924633.do

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

What is Shock and How Do I Treat It?

In this video blog, Roy Shaw, EMT-P answers a question by a student. The student wanted to know what shock is and how to treat it. Roy explains what shock really is and how you can treat it and possibly save one’s life.