Posted on 12/22/2006 6:43:29 PM PST by sig226
Preparation does not always mean preparing so that you can preserve your own life. Many of us know that preparation means we have food, supplies, and money to maintain our families in the event of disaster. Some of us take it to mean that we must always scan the area around us to ensure that there are no threats. Sometimes even though we think we are ready, somebody drops a school bus out of the UFO and it smacks us in the head.
No one was delivering on Saturday, so the guys at the shop asked me if I would go get us pizza for lunch. Sure, why not . . .
It wasn't ready, so I paid for it and told the cashier that I was going to go outside and smoke a cigarette while I was waiting. This happened at Bob and Eddie's in DelRay Beach, at Congress and Atlantic, if you're wondering.
The door closed and I noticed a Nissan Sentra in the middle of the parking lot, halfway pulled out of a parking space. I lit my smoke and thought of pompous drivers who stop in the middle of a parking lot to yap on their cell phones. An elderly woman tried to back out of a space opposite this guy, but he wasn't moving. I could see that she was waiting. I thought he was a jerk.
She got out of her car and said, "He's not moving." I said, "He's probably blabbing on the phone."
She said, "I think he's not conscious."
I wasn't really listening, so she said it again. I dropped the cigarette and went to the Sentra. The driver was the sole occupant, an overweight, old man. He was indeed unconscious. I opened the door and shouted, "Are you okay?"
This is a stupid thing to shout, but if the person is unconscious, anything is a stupid thing to shout. "Would you like oral sex?" will get as much response from an unconscious person as, "What is your name?"
He drew a labored breath. I stuck my finger on his carotid artery, there was something, thready, faint, irregular. He drew another breath and it was a long time between them. I didn't have gloves or a mask on me, I used to carry those things. I used them, too. I've become complacent.
He drew another labored breath, a rate of about 6. They were agonal respirations. Some guy stopped at the side of the car and I called 911. I told them there was an elderly man with a heart attack and gave the address. They were asking questions and I was losing his pulse. He hadn't taken a breath for about twenty seconds. The dispatcher asked me if I found him in the car. Stupid question, what difference did it make? She should have opened the flip book and started reading the CPR instructions. I said, "I think he's dead. I have to go."
I hung up. He had no pulse. He had drawn one labored breath while I talked to 911, but there was nothing going on in his arteries. The guy asked if I needed help. I got him to help me pull the old man out of the car. He drew another breath. Agonal respirations are more like snores. He still had no pulse. I told the other guy I was going to start CPR.
I F***ing hate CPR. I especially hate it because I have no idea if the guy had a heart attack, Hepatitis, phunemonia, or somebody just filled his air conditioner vents with sodium cyanide and it's still on his lips. I gave him two breaths and compressed his chest fifteen times, counting one one thousand, etc. I ran four cycles and checked for a pulse. Nothing.
Someone asked if she should call 911. I said, "Yes, they respond faster to multiple calls."
The other guy did compressions and I gave breaths for another minute or so. He stopped, I checked for a pulse. A woman said that 911 wanted to know something. I shouted, "Tell them to move their f***ing ass." I think they heard me.
I had ripped the guys shirt to get a lnadmark, but it was sloppy. I took out my knife and cut the shirt and his undershirt wide open. I kept doing compressions and giving him breaths. I heard sirens. You can't imagine how long it takes to hear sirens until you've waited for them.
I thanked God. Oxygen. Airway. Bag Valve mask. Defibrillator. Thank God every day that you live in a world that has these things. It used to take Jesus to do what these things can do.
The EMTs took over and I stepped off. They shocked him twice. I saw mostly artifact on the three lead, an occasional bump that could pass for a QRS. I gave my name to the police and told what happened. The guy that helped me had run off.
I spoke to the officer who took the report Thursday. He said the man was pronounced in the emergency room. Sad, I feel like if I had been a little quicker, I could have made this man's Christmas, and his family's, a lot brighter.
Lessons learned: I had my gun. You can see how much good it did me. I also had my switchblade, which was handy when I had to cut the guy's shirt open. I did not have a CPR mask, I did not have gloves. I used to carry these things at all times. I f***ed up. Pay attention. I won't tell myself that the guy would have lived if I had reacted a few seconds faster, but it is possible. There was a time when I would have walked up to the car and checked the driver without being prompted.
You'll never know when your world will go from green to red, you'll never know why it did.
Gun. Sharp knife. CPR mask. Large trauma dressing. First aid tape. Ace bandage. Fire extinguisher. Know CPR. Learn first aid.
With these things, you can shoot an attacker and render aid to anyone he shot. You can control arterial bleeding, close and ventilate a pnuemothorax, control poison flow from a snakebite, give life to whoever you find.
Gun. Sharp knife. CPR mask. Large trauma dressing. First aid tape. Ace bandage. Fire extinguisher. Have one set in your car and one set in your house. Know CPR. Learn first aid.
Condition One means anything. It could be a pervert trying to kidnap your child, or it could be your neighbor with his femoral artery opened up when he slipped with a hedge trimmer. You don't know. Condition one means seeing what is in front of you and accepting what is happening. "It can't happen to me," is bullshit. It happens to somebody every day.
Merry Christmas, my wish is that in the coming year you will heed these words and one of you will give the greatest gift there is.
God bless.
God bless you for trying to save him. And thanks for your well-considered words of advice.
Good words. You did what you did. Make peace with it and know that time only goes forward.
Even if you never use CPR to save a stranger, every married person should probably reflect: The odds are perhaps better than even that you could use CPR someday to save your spouse.
Right now, my wife could save me but I couldn't save her. Kind of selfish of me. Thanks for the reminder.
At least he didn't die alone, I think it helps a whole lot in the big scheme of things, that this man had a fellow human being so involved in his life at the end.
And your advice for all of us is incredibly well done.
I will try to update my skills and preparations.
You said it better.
You said it better.
Sig226--thanks for the good advice, and for helping a fellow human being in trouble.
Happened to me in 1981. Just finished a course in CPR at work, got the Red Cross card on Friday. Sunday morning at church, a man gets a heart attack. A friend and I did two man CPR, kept the man alive until the ambulance came, but he died at the hospital.
It didn't hit me un til the ambulance went away and we started for home. Couldn't stop shaking.
Like you said, you never know when Condition one hits.
BTW, any advice on defibrillators for the home?
Bless you.
CPR 15 seconds sooner probably wouldn't have made any difference.
But you always wonder.
I haven't recertified in fifteen years. I am told that the current protocol is no breaths. This actually makes sense. The effect of chest compression will expand and contract the lungs. In fact, the other guy removed the patient's dentures, which is something you aren't supposed to do because it compromises the seal for the breaths. I was having trouble getting a seal, and I couldn't see a chest rise. The other guy told me that his chest rose as I breathed, but I didn't see it.
The guy's face turned blue, but returned to pink after a few cycles of compressions. So there is something to this new idea.
Amen.
And, sig, thanks for the advice. I was once well-trained, as a teen, and actually saved a choking man at a restaurant once, and a drowning friend. But I've failed to refresh.
Merry Christmas, y'all.
Thanks to everyone who expressed concern over my own feelings about this. I am a little bit sad because the man and his family have experienced a death and it was at an especially bad time. I was also a professional EMT and I have done CPR lots of times, I was a volunteer EMT for many years, too. I posted this as much to remind myself to carry a few important things and maintain my training as for the benefit of others.
"Had a call this am....the wife heard something fall on the floor in the next room....runs in and finds her hubby unconcious and she calls 911.....on our arrival, pt. is pulsless and apneic. Check airway and grab forceps and extract a piece of orange outta the guys throat...CPR intitiated and defib`d pt. twice.....on arrival to ER, pt. is breathing on his own but still unconcious.....possibly brain damaged from hypoxia but time will tell... . . same as the moral of your story, if only wife knew how to clear an obstructed airway from an unconcious person, this pt. may not have any deficits in the outcome.... . . Merry Christmas and be careful when eating oranges!"
A blanket is an infinitely useful item. If you think that you will not encounter someone with hypothermia because you live in Florida or southern California, you're wrong. Hypothermia is a concern when a person suffers traumatic injury, and people come up with all kinds of creative ways to hurt themselves. Fold the blanket up tight and wrap it in a heavy garbage bag so it stays clean. You can use it to elevate a bleeding limb, or to elevate the legs of a person with severe blood loss.
Sterile water is good for burns, good for someone who is dehydrating, if you find someone who is hyperthermic, pour it on his head and fan it to cool the body. EMT shears were suggested, but a sharp folding knife is better. It will cut anything. It should have metal bolsters so it can be used to break a car window. It is a weapon. Eye shield can be simple plastic shop glasses. Burn sheet is a large, sterile dressing. It is intended to cover a severe burn, but it can also be used a a trauma dressing.
Sharp knife
Gloves
Eye shield
CPR mask
Large trauma dressing
Burn sheet
Sterile water
Blanket
First aid tape
Ace bandage
Fire extinguisher
Paper
Pen
Know CPR
Learn first aid
Paper and pen are used to write down what you saw. Emergency room teams don't care so much about the patient's pulse rate now, they want to know how it is changing.
7:10 - pulse 80
7:15 - pulse 90
This indicates serious blood loss, among other things.
How to estimate systolic blood pressure based on pulse:
Where you can feel a pulse is a good indicator of the person's systolic blood pressure (the first number.)
dorsal pulse (top of foot) systolic pressure > 100
radial pulse (wrist) > 90
brachial pulse (inside bicep) > 80
carotid pulse (neck) > 60
femoral pulse (thigh) you do not need to check here because patients who have no carotid pulse are already dead, or else you are trying to make them get horny.
ping
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