In this episode, I wanted to take a moment to focus on the success of rescue attempts. Though it’s no guarantee that anyone will survive no matter how hard we try to save their lives, from time to time…they do.
And this is a video that celebrates survival. Don’t forget to celebrate the caring enough to try, no matter what the outcome too.
Cheers,
Roy
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
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.
Knitting Needles can be the source of warm mittens, cozy scarves and comforting winter sweaters. They can also become sharp pointed weapons or injury causing spikes when fallen upon or when they are thrust into the face, neck, chest or abdomen due to a car accident or accidentally falling onto them. In this RoyOnRescue episode, we take a look at the hidden danger of sharp pointed objects that usually remain harmless but when not respected and carried safely, they could cause great harm. Learn about the dangers of pointed objects and how to keep knitting needles a source of pleasure not pain.
I received an email that I think we can all benefit from.
It read…
“Since most of the first aid measures for a no pulse, no breathing situation is immediate CPR, is it alright to do CPR if the victim has a wound on the chest that is bleeding profusely? This is not that I have seen this situation, but I like to think that if it happens I would know what to do!”
C. H.
That’s a great question C. Sometimes it’s easy to get distracted by a serious traumatic injury and forget the basics and what needs to be done first in order to try and save the person’s life. Or, we can look at a complicating injury such as a chest wound and think, How am I going to do CPR on this person, there chest has a serious bleeding wound right where I’m going to give my compressions?
In this episode of RoyOnRescue we are going to look a proper treatment plan if we ever came across a person who had a serious chest injury and needed CPR.
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.)
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.
