In this RoyOnRescue Video Blog, a student had emailed Roy a question about explaining the Capillary Refill Test and how it may relate to determining if someone is suffering from shock.
Be sure to watch this episode of RoyOnRescue and learn a new trick that could either tell you if someone is going into shock, or that their hands are simply cold.
There are three main reasons why a person may have more than a 2 second capillary refill time:
1. Shock
2. Peripheral Vascular Disease
3. Hypothermia or cold hands
This slow capillary refill time of more than 2 seconds should only be an indication that we should check for other problems. Please don’t assume simply because someone has a slow cap. refill that they are going into shock. It is simply a quick and easy test to help point a first aider in the right direction and to tell us we should check for other issues.
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Asthma Attack and No Medication!
One of the scariest feelings is not being able to breath. This is exactly what is happening during a severe asthma attack. I received an email from a person who stated that they have been trained in CPR and First Aid multiple times and though it covers the basics of asthma it never really talks about what to do in depth. They gave me a scenario where a person may be having an asthma attack and EMS is quite some ways away. What’s worse, there isn’t any medication for the asthma attack! Now what?
In this episode we take a look at what asthma is, and how we can confidently handle it even if there isn’t any medications and EMS/911 is delayed.
Asthma Guide
Asthma Symptoms
ProFirstAid.com Training (Allergic Reactions)
How to Deal With Death When CPR Doesn’t “Work”
This response was written after receiving an email from a person, who has a cousin that is a trained CPR provider and attempted to save their own father’s life with CPR but their father remained dead despite their efforts. This person felt badly and didn’t know what to say to their cousin to help them not feel guilty or that their father’s death was in some way the rescuer’s fault. I responded to them, and afterward, felt that my response may be helpful to others who have suffered or are suffering or asking themselves the question, “Was there more I could have done?”. I hope that this response will be of help to anyone who may have feelings of failure or guilt as a result of their cpr efforts not ending in the survival of the patient.
Student’s Email Question:
(Paraphrased to protect students identity)
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Dear Student,
One of the most important things to remember when providing CPR to anyone let alone a loved one, is that people who need CPR are already in a state of death. When the person is not breathing and they don’t have a pulse strong enough to detect with obvious signs of life, they are clinically dead. From the point of clinical death, they are only a short distance from biological death, which is permanent.
One way of looking at the success of CPR, regardless of the outcome, helps me and I believe helps my students to be much more at peace with themselves. The fact that your cousin’s Dad did not survive cardiac arrest has very little to do with the CPR given to him. It’s important to remember that CPR, in and of itself does not save anyone’s life directly. CPR is designed to “Buy Time”. CPR only provides about 25% of the oxygen circulation that is required for someone to stay alive biologically. CPR was never designed to be life support viewed as a way to keep people alive indefinitely, but rather to slow down the process of clinical death to biological death. This is to provide a chance to intercept the patient with electrical therapy, advanced therapy and medications combined with CPR and time to fix the underlying problem which caused the person to die in the first place.
In my opinion what your cousin did, is give his Dad the best chance of survival possible if he was indeed going to survive. Let’s look at clinical death as a heavy iron gate that is slowly dropping to the ground, and once closed the person is biologically or permanently dead. CPR is like arms holding the heavy gate of possible survival open a bit longer. Again, not stopping the progression of clinical death to biological death, but slowing it down so that if there is a chance of survival, they would have the greatest opportunity of slipping back through the gate available. Eventually, the gate is going to close even if CPR is perfect. As I said earlier, CPR in and of itself is not enough to keep the human body alive. But if the person is going to survive and the person needs more time, CPR buys the precious time required to make this a reality.
Now, it’s important to remember a simple but powerful truth. Everyone dies. I have had patients that had everything go right in order for them to survive a cardiac arrest and they still remained dead despite our rescue efforts. That day was their day to die and nothing that the cpr providers, paramedics, nurses or doctors did changed the outcome. The CPR helped keep them viable long enough for the rescue and medical team to try and fix the underlying problem but the person remained dead. I had to realize that as a professional rescuer and paramedic, everyone has a day to die. It’s not my job to save everyone but it is my job to give everyone the best chance of survival possible. When I provided care to cardiac arrest patients, I provided care to them as if they were suppose to survive and didn’t give up hope unless they proved to me otherwise by not surviving. It may be frustrating but we just cannot know what day is the day a person is going to live or die until the outcome is evident.
I’m quite sure that no matter what I say, your cousin is really missing his Dad. I don’t think there is any amount of explanation of science, death, dying and CPR that’s going to change that. One thing I do know about what your cousin did the day he provided CPR for his Dad though, he showed others and his Dad how much he loved him. How much he really cared. Your cousin gave his Dad his own strength when his Dad didn’t have any of his own. In my opionion, that’s one of the most loving and unselfish ways to tell a daddy goodbye.
May God bless your cousin and all hurting friends and family during these difficult times.
Sincerely,
Roy Shaw, ProCPR, LLC
RoyOnRescue.com
Roy Shaw
