Riding and Push Lawnmower Safety!

Have you ever been surprised by how fast a child can be in one place and the next time you turn around they are in another?  Have you ever been shocked by how fast an accident can happen?  In this episode, I address lawn mower safety as a result of a terrible tragedy where a 5 year old girl was hit and then run over by a riding lawn mower. It is unknown as to the exact details leading up to this horrific accident or what the abnormal conditions may have been that caused this to happen.  The little girl was pronounced dead on scene. There was nothing related to first aid that would have helped her but I have to think that being more sensitive to prevention may be able to save future lives.   I pray for a miraculous Grace and healing to be given to the surviving family members of this little girl and I hope to remind us all of some ways to ensure this doesn’t happen.

May God bless and heal this family.

Roy, RoyOnRescue.com

Link To News Story:

RoyOnRescue.com

 

My Baby Is Having A Seizure, What Do I Do?

Hello Everyone!

I received a question regarding infants having seizures and the proper treatment for them.  

The person asked if  it’s proper to handle the patient the same as an adult?  This is a great question and one I wanted to address a little more in depth than a simple reply by email.

First, it’s important to understand what a seizure is.  The following is a quote by  physician, Dr. Fawn Leigh from Duke Health who did a great job describing the two different categories of seizures and how they manifest themselves.

Click here to see the complete article located at:  http://www.dukehealth.org/health_library/advice_from_doctors/your_childs_health/childhoodseizures

“Seizures are divided into two major categories (based on 1981 international classification):

  • Generalized seizures affect the whole brain or both hemispheres of the brain
  • Partial seizures, also known as focal seizures, affect one part or one side of the brain

Generalized Seizures

Generalized seizures are divided into convulsive and nonconvulsive. Convulsive means that there is muscle movement such as stiffening (also known as tonic) or jerking (clonic) activity. When these movements are combined it may be called “grand mal.”

Other types of convulsive seizure activity include myoclonic and atonic seizure activity. Myoclonus is usually characterized by sudden, single jerks. Atonic seizure activity is typically characterized by dropping quickly to the floor as if suddenly asleep or paralyzed. The child then quickly recovers.

These two latter convulsive seizure types can both be difficult to diagnose and treat because often they are the manifestation of a mixed seizure disorder. In infants these seizures may be called infantile spasms.

Nonconvulsive means that there is alteration of consciousness without muscle movement. This form of seizure activity was formerly called “petit mal,” and is now commonly referred to as “absence.”

Absence seizures are unique in that typically they are characterized by an abrupt onset of staring and end just as abruptly with no confused state following the events. Parents usually report that the child looks like they are “spacing out.” (Teenagers who look like this often are not having seizures — they are simply bored.)

Partial Seizures

Partial seizures can be simple or complex. Simple partial seizures are focal seizures that involve movement or sensation on one side of the body without altered consciousness. Simple partial seizures are commonly localized to areas in the brain called the motor or sensory strip.

Partial seizures may be with or without aura, which involves associated states such as fear, or changes in heart rate, flushing, or abdominal discomfort.

Complex partial seizures commonly originate from the frontal and temporal lobes of the brain where there are many complex interconnections, resulting in alteration of conscious. Typical complex partial seizures manifest as sudden change in level of alertness with or without aura, blank stare, confusional state, or aimless movements such as wandering around or repetitive behavior.”

DukeHealth.org (http://www.dukehealth.org/health_library/advice_from_doctors/your_childs_health/childhoodseizures)

 

Second, it’s important to understand what the main cuases of seizures are:

  • Fever
  • Infection such as meningitis
  • Trauma
  • Hemorrhage
  • Brain malformations
  • Brain dysmaturity
  • Genetic disorder

Thirdly, when it comes to treating an infant compared to an adult, it’s a bit easier, though not any less intense especially if it’s your child.  It’s physically easier because baby is smaller and easier to manage.

If this seizure is with a child who has never had a seizure before, 911 or Emergency Medical Services should be activated.  The rescuer is going to  follow National and International guidelines for treating a seizure patient.  Protect the baby from hurting itself while seizing.  If it’s in a bath tub, drain the bath tub of water so as to reduce the risk of drowning and then protect the child from hurting itself while seizing.  Nothing should be put into it’s mouth which is old school for seizure management in trying to prevent “swallowing the tongue” or biting the tongue off.  It is also important that we not try and prevent the baby’s body from convulsing by holding it still or wrapping them tightly.  Simply protect it’s head and other parts of it’s body from hitting anything during the convulsive stage of the seizure.  After the seizure is over, the baby will usually go into a post seizure phase called the “postictal” phase, and there may be some frothy sputum(spit) around the baby’s mouth or in its nose. A bulb syringe normally used for suctioning mucous or sinus congestion could be used to suction or clear the baby’s nasal passage but it is probably not as necessary as we’d like to think.  As a general rule, baby’s have a great gag reflex and if they have any mucous or sputum in their upper airway, it will probably be coughed clear.  If the baby begins to breath after the seizure, it could be irregular with some grunting for a short time and then increasingly get more normal.  Skin color if it has changed during the seizure to a dusky, purple or blue color should improve as the baby begins breathing more normal and it is perfectly acceptable to comfort the baby in a natural position while maintaining a neutral airway in order for it to recover from the seizure.

If it does not begin breathing, begin basic cardiac life support according to the latest ECC/ILCOR and American Heart Association guidelines. Courtesy of ProFirstAid.com, a Free Online infant CPR training video is available by clicking here!

As many as 2-5% of all children will experience at least one seizure related to a fever over 102 degrees Fahrenheit.  The seizure itself is usually harmless and does not cause brain damage nor lead to epilepsy.

Seizures in any age patient can be very scary, and the causes of a seizure are many.  Therefore, if it’s the first seizure the person has ever had, we should plan for the worst and hope for the best.  This can be done by calling the emergency medical services or 911 depending on your area.  Support the patient with basic first aid procedures while waiting for rescuers to arrive and then follow up with your pediatrician after the baby is stable.

If your baby is having a high fever and your afraid that it may cause a febrile seizure, there are some basic steps to help lower your baby’s temperature.  Click here to read an article about how to lower a body temperature from a fever.

 

Well,  I hope this helps and I appreciate the great questions so many of you have been asking.  Keep them coming and while your waiting for a response, keep on saving lives!

 

Best Wishes,

Roy

RoyOnRescue.com

royonrescue@gmail.com

 

What’s Been Going On With RoyOnRescue?

Hello Everyone,

Well, it’s been crazy in the ProTrainings.com camp, but it’s all been great!   Updating all of the 2010 CPR and First Aid manuals and workbooks, creating the new ProTrainings Instructor program and expanding further into the UK market.  All very exciting.  I’m hoping to bring some new subject matter into the RoyOnRescue.com program and maybe even implement a USTREAM.com RoyOnRescue live program.  All to be seen but I can tell you, your comments regarding it would be really helpful. Let me know if a live show where you could call in, chat live, email questions and interact while I’m hosting the show would be helpful, fun or just a waste of time.  Let me know what time of day and on what day would work best too.  Tuesdays -Thursdays or Fridays between 8am and 3pm EST.  Let me know what kind of topics you’d like me to cover too.  Would you like to see more interviews with victims, rescuers or both?  And regarding the video shoot today, sorry to record while cruising down the highway to my next meeting but I wanted to let everyone know where I’ve been and what’s been going on.  Time is a very expensive commodity but I didn’t want to miss another week.  P.S.  When ever you get a video capture while I’m driving, please note that safety measures are in place to ensure there is no danger while recording to me or to anyone else.

Best Wishes,

Roy

RoyOnRescue.com

Roy On Location at the 2010 Video Training Updates

I wanted to update everyone on the progress of the ProTrainings update video shoot.

I had come in early one morning and thought I’d have a cup of good coffee and let you see the on-site video location where the production team and I were shooting the new updated video trainings for the ProTraining websites. It’s important for ProTrainings to be a leader in the area of this type of training and though the video trainings are not required to be updated for a long time, we thought we’d get them out to you as soon as possible. If there’s enough benefit to change the guidelines then there’s enough benefit to get them to the ProCPR.org and ProFirstAid.com students as fast as possible.
On a side note, the production team and I have been having a lot of fun while working really hard on the set. I hope you’ll like some changes we’ve made for the new guidelines and I know that the team and I are very excited to get these updates edited and uploaded to our website in the next month or so.

Feel free to email me any questions you may have about what goes into our video production of these trainings or what it’s like behind the scenes at ProCPR.org and ProFirstAid.com.

Until next time,

Be A Rescue Hero For Someone’s Loved One,

Best wishes,

Roy

2010 CPR Guidelines Update – Activation of EMS or Calling a Code

In this episode of RoyOnRescue, Roy Shaw visits the new 2010 CPR guideline update regarding activation of Emergency Medical Services and calling a code. Be sure to watch this episode to get the latest guideline release covering this subject.

But The Family Said…DO NOT RESUSCITATE!

A student emailed in a great question and one in which can be a very tough one to answer!      It’s challenging enough to get bystanders to begin CPR.  But when we complicate the scenario with a person yelling; “They have a DNR, don’t do CPR or you’ll get sued!”   This can really complicate matters.  What do you do?   Stop CPR and hope that the withholding of potentially life saving CPR is legitimate?  Don’t stop CPR and continue to upset the people that are yelling stop in the first place?   Whoa! Tough spot to be in.

In this episode I’m going to do my best to explain the very complicated issue surrounding Do Not Resuscitate orders(DNR) when CPR is already in progress or about to begin.

Sample of Proposed DNR Guidelines From BENO-Ethics

How to Give CPR to A Ventilator Patient

This week a student asked:

“I take care of a child who has a trach and is on a ventilator when he sleeps.  Do you have a course for cpr involving a patient with a trach if we were out and did not have access to a vent?”

Though we don’t offer any specific ventilator training, I thought this would be a good time to do a royonrescue episode covering this topic.

I didn’t want to delay this reply any longer than necessary so as Jody Marvin and I were on the road discussing training issues for ProCPR.org, I thought we would take advantage of the drive time and answer this very good question.

It’s hard enough initiating CPR or rescue breathing for a person who doesn’t have any special needs, but then when it’s complicated with something like a tracheostomy, it can really become confusing.  I hope this video blog helps clear things up.  Keep the training questions coming I think it really helps everyone who’s concerned about rescue and saving lives.

Best Wishes,

Roy

How to Hit Your Head on Pavement at 17MPH and Survive!

Imagine riding your road bike and as you near a curve in the bike trail hitting speeds of around 17 miles per hour your front tire instantly goes flat.  Now you’re trying to corner on a metal rim sliding across the pavement which has as much traction as an ice skating rink.   This is exactly what happened to Tom Monett, cycling enthusiast, big mountain skier, hiker and mountain climber.  As Tom’s bike slid out from underneath him, he didn’t have enough time to catch himself let alone think about what was about to happen.  As his head hit the pavement, and his ribs began to break, his wisdom to ride with personal protective equipment most likely made the difference between life and death.  Watch this episode of royonrescue to see the full interview and hear his story about surviving a high speed cycling crash.

Concussion

Warning!  Video contains graphic pictures of injuries and accidents.

Video Gallery of Actual Bike Accidents

“Head and Shoulders, Knees and Toes…”

A student emailed a question regarding the Head to Toe exam.  Though this is normally performed as a secondary survey in a more advanced setting, I do think there are times where knowing how to check a person for other injuries is a good idea.  Take a look at the video blog and I hope this helps.
Best Wishes,
Roy

Staying Safe In The Heat

QUESTION:

“It’s so hot where we live and it seems that we have elderly people who suffer most when it gets hot and humid.  Is there anything I can do to stay cool myself and maybe even help someone who is having a heat related health problem?”

Signed,

Melting in Florida

Dear Melting,

Benjamin Franklin once said “An ounce of prevention is worth a pound of cure.” This saying applies to many different health care related scenarios, heat related emergencies certainly not the least of them.

When staying safe and healthy in hot and humid weather it is important to understand what types of environments will put one at risk.

To get started, let’s take a look at how a heat index works.

A heat index combines air temperature with relative humidity as a way of determining how hot a person feels.  A person feels hotter in more humid climates because the moisture in the air does not allow one’s perspiration to carry the heat generated by the body away and evaporate as easily.  When the body cannot cool itself by perspiration and evaporation, the body’s temperature rises and one may feel less comfortable or may even lead to more serious heat related problem.

An example of what could take place in certain heat indexes are as follows:

  1. 80–90 °F  Caution — fatigue is possible with prolonged exposure and activity. Prolonged activity could result in heat cramps.
  2. 90-105 °F  Extreme Caution — heat cramps, and heat exhaustion are possible.  Prolonged exposure and activity could result in heat stroke.
  3. 105-130 °F  Danger — heat cramps, and heat exhaustion are likely; heat stroke is probable with continued activity.
  4. Over 130 °F Extreme danger — heat stroke is imminent.                                                                                                                                                                                               (Please note that these are shade values.  Exposure to direct full sunshine could increase these heat values by more than 10 degrees.) Closely paraphrased from the public domain article Heat Index on the website of the Pueblo, CO United States National Weather Service.

Most individuals can indeed acclimatize to heat which will help the body tolerate hotter conditions with less stress to the body.  This process for normal healthy individuals usually takes about 5 -7 days.  This should be done gradually and with a person maintaining good hydration.  A person is capable of sweating up to 2-3 gallons of water per day in hot conditions and cannot rely on the thirst drive in order to know when to drink.  During heavy sweating, a person should be drinking approximately 5-7 ounces every 15 minutes 20-30 ounces per hour in order to replenish lost fluids.  Valuable electrolytes such as sodium, calcium and potassium may be lost during heavy perspiration and should be replaced with proper nutrition and diet. http://www.cdc.gov/niosh/hotenvt.html

Those who are most vulnerable to these heat indexes include:

  • infants,
  • the elderly (often with associated heart diseases, lung diseases, kidney diseases, or who are taking medications that make them vulnerable to heat strokes),
  • athletes, and
  • outdoor workers physically exerting themselves under the sun.

or

Those who do not have means for escaping the heat.  Some examples of how to escape the heat include:

  1. Circulation of air by fan or ventilation,
  2. Accessing lakes, ponds or pools
  3. Air conditioning or subterranean cooling like a vegetable cellar or cool basement.
  4. In certain cases, placing ice bags under arm pits or around the neck or over other arteries like the wrists, ankles, top of head which may help in cooling core body temperatures.
  5. Cool or tepid bath water or a cool shower

If an individual does not have means of cooling and succumbs to the heat they may be suffering from heat fatigue, heat exhaustion or heat stroke.  Let’s take a look at each of these and how to treat each problem.

Definition Heat Fatigue: The signs and symptoms of heat fatigue may include heavy sweating, muscle weakness, tiredness, and impaired performance of skilled sensorimotor jobs.

Treatment:  Remove from heat, encourage water intake and good healthy nutrition and allow person to rest.  Allow person to acclimatize longer to increased heat environment.

Definition Heat Exhaustion: The signs and symptoms of heat exhaustion may include all of the above with the addition of heat cramps in legs, abdomen, back, calves and arms, headache, nausea, vomiting, dizziness, confusion and lethargy.

Treatment:  Remove from heat, encourage fluid intake, loosen clothing, poor water over persons body to soak clothing and begin cooling persons body. Monitor person for unresponsiveness, difficulty breathing or cardiac arrest.  If person is not improving with treatment or symptoms worsen, activate EMS or 911.  Heat exhaustion can become heat stroke if body temperature is not reduced.

Definition of Heat Stroke:   All of the above for heat exhaustion but usually progress to the following:

  • high body temperature
  • the absence of sweating, with hot red or flushed dry skin
  • rapid pulse
  • difficulty breathing
  • strange behavior
  • hallucinations
  • confusion
  • agitation
  • disorientation
  • seizure
  • coma

Treatment: Remove person from source of heat, loosen clothing, begin cooling the person’s body safely as soon as possible in order to lower body temperature.  Nothing should be given by mouth once the person cannot drink safely on their own.  Activate EMS/911 and support with CPR and First Aid for life saving measures. http://www.medicinenet.com/heat_stroke/article.htm

So, next time you’re planning a trip out into hot conditions, take a moment to check the heat index and formulate a plan for protecting, preventing and treating yourself and others who might fall to heat related emergencies.  Oh, and if you know someone who may be vulnerable to hot weather, see if you have an extra fan, or maybe even give them some tips on how to cool down right in their own home.  You could just find that you have some rescue hero in you too.