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Posted: 7/22/2010 9:14:42 AM EDT
[#1]
Everything happens for a reason...
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Posted: 7/22/2010 9:14:46 AM EDT
[#2]
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I was on my way to clinicals when I get a text saying that clinicals are canceled so I turn around and head for school. While on the 10 freeway I see a car stopped on the side of the freeway with the guard rail smashed, being that I was a couple hours too early to go to school, I stopped to see if anyone needed help. As soon as I get out of my truck the lady starts screaming that a car went over the guard rail and in to a irrigation cannel, flipping end over end twice. I start running and (not so gracefuly  ) went down the embankment with the daughter of the lady that was screaming (she said she was an RT) as I got to the car I find a male in his late fortys in a very smashed Lexus, with no pulse and no spontaneous breathing. I sent a spectator to go grab a fire extinguisher from my truck (it wasn't needed).
All the windows where smashed and the drivers door had popped open, I cut his seatbelt and, while the girl held C-spine, lowered his seat (which still worked even though they where electric) and begain CPR. It felt like an hour until fire got on scene (it was only 10 minutes) by the time fire got on scene the victim had a weak pulse and some limited spontaneous breathing, me and the girl stepped back and let the paid professionals do there stuff, they got him out of the car, on a back board and got some large bore IV's in place and then got the guy to the waiting ambulance. Last i saw he had sinus tachycardia and was intubated and on his way to a local trama center code three. Lessions learned: Always have your emergency equipment easly assesable, not locked in a truck tool box. Remember to GRAB your emergency equipment, even though there was nothing in my emergency equipment except for a CPR mask that would of helped in this case. a Kershaw blur cuts through seatbelts like butter. Somethings happen for a reason, if my clinicals weren't canceled this man may have had an even lower chance of survival. http://i6.photobucket.com/albums/y203/paraframe/crash.jpg Correlation and causation, learn the difference. What do you mean? |
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Posted: 7/22/2010 9:18:13 AM EDT
[#3]
Quoted: Well done, sir! Technical question: <Always have your emergency equipment easly assesable, not locked in a truck tool box. Remember to GRAB your emergency equipment, even though there was nothing in my emergency equipment except for a CPR mask that would of helped in this case.> Do people still need/use CPR masks any more? I thought the current drill was compressions only, no breathing. No? I was just certified two months ago in my police academy, we were taught ventilations & compressions. |
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Posted: 7/22/2010 9:22:22 AM EDT
[#4]
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Well done, sir! Technical question: <Always have your emergency equipment easly assesable, not locked in a truck tool box. Remember to GRAB your emergency equipment, even though there was nothing in my emergency equipment except for a CPR mask that would of helped in this case.> Do people still need/use CPR masks any more? I thought the current drill was compressions only, no breathing. No? It is for lay persons/single rescuer but I feel that 2 person CPR with breathing never hurt. There now pushing for no drugs or advanced airway or even shock until 2 mins of CPR is done. They say statistically patients do better. The theroy is by keeping the heart clear of the free radicals produced by shock allows for or healthier heart when defiberlated. For the OP- good on you for a trauma arrest. They usually don't come back. Our protocols call for opening airway- if no spontainious breaths or pulse, then no start to procedures. Wonder if the guy lived. Just speculation, the times we haved had successfull trauma saves usually from a medical condition causing the accident in the first place. Where are you at nursing school? really? That is what I am guessing happened, his car was pretty smashed up but I have seen people walk away from much worst. I really wish I got his name at least, nothing in the news paper today. I am going to concorde in SB to become an LVN/LPN, I am in my last term and graduate Sep. 14. Right on born and Raised in SB. Concord is over off of De La Guerra right? Did you work as a basic at AMR? And yes, we call it if they are not breathing...studies studies studies  . Most of our protocols are study based. You would be surprised at how closed minded the EMS in Cali is. The nurses have to much control. One of the reasons I moved. Here you tell people that when you called for orders the nurses, working off YOUR protocols, ALLOWED you to give 2nd and 3rd line meds ONLY if they felt comfortable and they go . Here when only call if we have a special question or want to do an off protocol treatment, which we usually can. Where did they go over, on 101 between Ventura?
Chris |
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Posted: 7/22/2010 9:23:33 AM EDT
[#5]
Quoted: Quoted: Quoted: I was on my way to clinicals when I get a text saying that clinicals are canceled so I turn around and head for school. While on the 10 freeway I see a car stopped on the side of the freeway with the guard rail smashed, being that I was a couple hours too early to go to school, I stopped to see if anyone needed help. As soon as I get out of my truck the lady starts screaming that a car went over the guard rail and in to a irrigation cannel, flipping end over end twice. I start running and (not so gracefuly ) went down the embankment with the daughter of the lady that was screaming (she said she was an RT) as I got to the car I find a male in his late fortys in a very smashed Lexus, with no pulse and no spontaneous breathing. I sent a spectator to go grab a fire extinguisher from my truck (it wasn't needed).All the windows where smashed and the drivers door had popped open, I cut his seatbelt and, while the girl held C-spine, lowered his seat (which still worked even though they where electric) and begain CPR. It felt like an hour until fire got on scene (it was only 10 minutes) by the time fire got on scene the victim had a weak pulse and some limited spontaneous breathing, me and the girl stepped back and let the paid professionals do there stuff, they got him out of the car, on a back board and got some large bore IV's in place and then got the guy to the waiting ambulance. Last i saw he had sinus tachycardia and was intubated and on his way to a local trama center code three. Lessions learned: Always have your emergency equipment easly assesable, not locked in a truck tool box. Remember to GRAB your emergency equipment, even though there was nothing in my emergency equipment except for a CPR mask that would of helped in this case. a Kershaw blur cuts through seatbelts like butter. Somethings happen for a reason, if my clinicals weren't canceled this man may have had an even lower chance of survival. http://i6.photobucket.com/albums/y203/paraframe/crash.jpg Correlation and causation, learn the difference. What do you mean? The only evidence for them being alive is that you were there and saved their lives. (Causation) Don't sell yourself short. It was your effort and your skill. The coincidence of you being there is just that, a coincidence. (Correlation) |
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Posted: 7/22/2010 9:23:48 AM EDT
[#6]
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Good job! I tell all my students to keep a CPR mask or barrier on or close at all times for situations like this. Did you use hands only CPR? compression only CPR, the newest way the red cross says to do it. Yeah, why did they change that? I'd like to know. It doesn't seem like the compressions would work the diaphram enough for decent oxygen flow. AHA says that more laypeople are willing to do hands only than CPR with rescue breathing and if that will get more to engage in CPR it is worth teaching. I still think standard 30:2 is best but do what you have to do. Actually that is only part of it. They also found out that Healthcare professionals will not do mouth to mouth with out a barrier. They also found Negligible difference in save rates of Mouth-mouth w/ comp. and comp. only CPR. Comp. only works just as well. The way I understand it is Healthcare Provider will stay the way it is and layperson will be hands only, but I don't know this for sure yet. I don't believe that hands only is just as good crap, where did they do the studies? Where ALS intercept was 5-10 min or out in a rural area where it was 10-30? Also with rescue breathing you are pushing air in the lungs even if you are not doing adequate compressions. That said I am not doing mouth to mouth with out some kind of barrier. |
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Posted: 7/22/2010 9:27:16 AM EDT
[#7]
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Good job! I tell all my students to keep a CPR mask or barrier on or close at all times for situations like this. Did you use hands only CPR? compression only CPR, the newest way the red cross says to do it. Yeah, why did they change that? I'd like to know. It doesn't seem like the compressions would work the diaphram enough for decent oxygen flow. AHA says that more laypeople are willing to do hands only than CPR with rescue breathing and if that will get more to engage in CPR it is worth teaching. I still think standard 30:2 is best but do what you have to do. Actually that is only part of it. They also found out that Healthcare professionals will not do mouth to mouth with out a barrier. They also found Negligible difference in save rates of Mouth-mouth w/ comp. and comp. only CPR. Comp. only works just as well. The way I understand it is Healthcare Provider will stay the way it is and layperson will be hands only, but I don't know this for sure yet. I don't believe that hands only is just as good crap, where did they do the studies? Where ALS intercept was 5-10 min or out in a rural area where it was 10-30? Also with rescue breathing you are pushing air in the lungs even if you are not doing adequate compressions. That said I am not doing mouth to mouth with out some kind of barrier. I know that many of the studies were performed in Arizona and Seatle. There are actually counties in AZ that are going to compression only in cardiac arrest per my Medical Director. I will look up the studies and post them. Trust me, as a Medic for 10 yrs and Basic for 4yrs before that, much of this was hard for me to swallow. Chris |
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Posted: 7/22/2010 9:30:01 AM EDT
[#8]
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thank you for properly using your training as it's worth repeating!
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Posted: 7/22/2010 9:30:48 AM EDT
[#9]
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(she said she was an RT) you met a Raccoon Trainer also ? Damn, what a day. |
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Posted: 7/22/2010 9:32:17 AM EDT
[#10]
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Good job! I tell all my students to keep a CPR mask or barrier on or close at all times for situations like this. Did you use hands only CPR? compression only CPR, the newest way the red cross says to do it. Yeah, why did they change that? I'd like to know. It doesn't seem like the compressions would work the diaphram enough for decent oxygen flow. AHA says that more laypeople are willing to do hands only than CPR with rescue breathing and if that will get more to engage in CPR it is worth teaching. I still think standard 30:2 is best but do what you have to do. Actually that is only part of it. They also found out that Healthcare professionals will not do mouth to mouth with out a barrier. They also found Negligible difference in save rates of Mouth-mouth w/ comp. and comp. only CPR. Comp. only works just as well. The way I understand it is Healthcare Provider will stay the way it is and layperson will be hands only, but I don't know this for sure yet. I don't believe that hands only is just as good crap, where did they do the studies? Where ALS intercept was 5-10 min or out in a rural area where it was 10-30? Also with rescue breathing you are pushing air in the lungs even if you are not doing adequate compressions. That said I am not doing mouth to mouth with out some kind of barrier. I know that many of the studies were performed in Arizona and Seatle. There are actually counties in AZ that are going to compression only in cardiac arrest per my Medical Director. I will look up the studies and post them. Trust me, as a Medic for 10 yrs and Basic for 4yrs before that, much of this was hard for me to swallow. Chris Here is one study I quick Googled: https://www.instructorscorner.org/ViewLink.aspx?lnk=4. I'll try and fid more. |
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Posted: 7/22/2010 9:39:06 AM EDT
[#11]
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Well done, sir! Technical question: <Always have your emergency equipment easly assesable, not locked in a truck tool box. Remember to GRAB your emergency equipment, even though there was nothing in my emergency equipment except for a CPR mask that would of helped in this case.> Do people still need/use CPR masks any more? I thought the current drill was compressions only, no breathing. No? It is for lay persons/single rescuer but I feel that 2 person CPR with breathing never hurt. There now pushing for no drugs or advanced airway or even shock until 2 mins of CPR is done. They say statistically patients do better. The theroy is by keeping the heart clear of the free radicals produced by shock allows for or healthier heart when defiberlated. For the OP- good on you for a trauma arrest. They usually don't come back. Our protocols call for opening airway- if no spontainious breaths or pulse, then no start to procedures. Wonder if the guy lived. Just speculation, the times we haved had successfull trauma saves usually from a medical condition causing the accident in the first place. Where are you at nursing school? really? That is what I am guessing happened, his car was pretty smashed up but I have seen people walk away from much worst. I really wish I got his name at least, nothing in the news paper today. I am going to concorde in SB to become an LVN/LPN, I am in my last term and graduate Sep. 14. Right on born and Raised in SB. Concord is over off of De La Guerra right? Did you work as a basic at AMR? And yes, we call it if they are not breathing...studies studies studies . Most of our protocols are study based. You would be surprised at how closed minded the EMS in Cali is. The nurses have to much control. One of the reasons I moved. Here you tell people that when you called for orders the nurses, working off YOUR protocols, ALLOWED you to give 2nd and 3rd line meds ONLY if they felt comfortable and they go. Here when only call if we have a special question or want to do an off protocol treatment, which we usually can. Where did they go over, on 101 between Ventura?
Chris It is off Hospitality by the El Torto, I don't really remember street names (which sucks when you are driving an ambulance ) . Yes I worked Redlands devision AMR for a litle over 18 months. He went over right after countyline Road on the 10 freeway.
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Posted: 7/22/2010 9:49:32 AM EDT
[#12]
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Well done, sir! Technical question: <Always have your emergency equipment easly assesable, not locked in a truck tool box. Remember to GRAB your emergency equipment, even though there was nothing in my emergency equipment except for a CPR mask that would of helped in this case.> Do people still need/use CPR masks any more? I thought the current drill was compressions only, no breathing. No? It is for lay persons/single rescuer but I feel that 2 person CPR with breathing never hurt. There now pushing for no drugs or advanced airway or even shock until 2 mins of CPR is done. They say statistically patients do better. The theroy is by keeping the heart clear of the free radicals produced by shock allows for or healthier heart when defiberlated. For the OP- good on you for a trauma arrest. They usually don't come back. Our protocols call for opening airway- if no spontainious breaths or pulse, then no start to procedures. Wonder if the guy lived. Just speculation, the times we haved had successfull trauma saves usually from a medical condition causing the accident in the first place. Where are you at nursing school? really? That is what I am guessing happened, his car was pretty smashed up but I have seen people walk away from much worst. I really wish I got his name at least, nothing in the news paper today. I am going to concorde in SB to become an LVN/LPN, I am in my last term and graduate Sep. 14. Right on born and Raised in SB. Concord is over off of De La Guerra right? Did you work as a basic at AMR? And yes, we call it if they are not breathing...studies studies studies . Most of our protocols are study based. You would be surprised at how closed minded the EMS in Cali is. The nurses have to much control. One of the reasons I moved. Here you tell people that when you called for orders the nurses, working off YOUR protocols, ALLOWED you to give 2nd and 3rd line meds ONLY if they felt comfortable and they go. Here when only call if we have a special question or want to do an off protocol treatment, which we usually can. Where did they go over, on 101 between Ventura?
Chris It is off Hospitality by the El Torto, I don't really remember street names (which sucks when you are driving an ambulance ) . Yes I worked Redlands devision AMR for a litle over 18 months. He went over right after countyline Road on the 10 freeway.Gotcha  Wrong SB. We called SB Santa Barbara (thats were I'm from), San Bernadino is SB. I should be more intuitive. We had a few guys from over there come to work for us, good medics.
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Posted: 7/22/2010 9:53:24 AM EDT
[#13]
my experience on scenes with lay people giving cpr is breathing is almost 100% ineffective anyway. they forget to check the airway or properly position the head which leads to little if any air actually getting into the lungs.
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Posted: 7/22/2010 10:11:19 AM EDT
[#14]
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my experience on scenes with lay people giving cpr is breathing is almost 100% ineffective anyway. they forget to check the airway or properly position the head which leads to little if any air actually getting into the lungs. 1st time I saw mouth -mouth, other than TV, while at work running cardiac arrests was about 3 years ago. My partner and I were working a 5K run, got a call for a seizure, as we were about 50 ft away I told my partner, "that dude is dead", he was gray not breathing, there were 3 people around him as everyone else kept on running, before we had even touched him my partener called for more units (since we were only on a John Deer Gator with minimal equipment) and stated cardiac arrest, I started CPR and #1 bystander yelled at us" I am an ICU nurse and this guy ONLY had a seizure" but he finally figured it out and took over CPR for me so I could tube the Pt (partner placing monitor and IV), while I pulled out BVM and began to set up bystander #2 (HOT blond) sts " I just took a class on CPR, do you want me to do mouth-mouth", split second decision  I had never seen it and it was going to take 30 seconds to set up...so...."Sure"(I said). and she did, 2 breaths. I subsequently entubated, we admin 1 Epi, 1 atro. within 5 mins of collapse we had pulses and BP just as Fire and transport unit arrived. Patient servived and is doing awsome, almost no CNS issues (some forgetfullness). Patient had LAD occlusion, VFIB, sent to cath lab upon arrival.
Personally I think he servived do to the sweet blondies lips But that is just me.
Chris |
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Posted: 7/22/2010 11:37:28 AM EDT
[#15]
Outstanding! BTW I am 1 for 2. Lost my first patient just after nationals when we rolled up on a motorcycle accident. Lost the driver saved the passenger. I learned the very same way you did about having your gear. Now I have a bag with basic BLS gear. Never going to let that happen again. Again Good on you.
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Posted: 7/22/2010 11:41:26 AM EDT
[#16]
I bet you feel like a million bucks.
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Posted: 7/22/2010 11:54:41 AM EDT
[#17]
good for you. question did you rememebr your BSI?? i kicked my self in the head after I had to help a choker at work one day and realized that my move advanced kit stuff was upstairs.
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Posted: 7/22/2010 11:58:10 AM EDT
[#18]
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I start running and (not so gracefuly ) went down the embankment with the daughter of the lady that was screaming 
I've been told I walked on water to pull a guy out of a river. I guess what I'm saying is bystanders will remember how the aid-giver runs to the victim. So, when people recall the time so-and-so almost died, the second thing they'll always remember is how dumb you looked getting there.
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Posted: 7/22/2010 11:58:29 AM EDT
[#19]
Sleep well tonight, you done good.
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Posted: 7/22/2010 12:03:11 PM EDT
[#20]
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good for you. question did you rememebr your BSI?? i kicked my self in the head after I had to help a choker at work one day and realized that my move advanced kit stuff was upstairs. I did have gloves stuffed in my pockets because i thought i was going to clinicals. |
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Posted: 7/22/2010 12:23:17 PM EDT
[#21]
My last save was at a K-Mart. Ten people standing around a guy on floor in full arrest. No one was doing a thing other then talking about how blue he was getting. Started CPR and fire got there with AED and shocked guy 2 times. More CPR then got pulses back. Coded 5 more times but went to cath lab and walked out of hospital.
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Posted: 7/22/2010 12:24:38 PM EDT
[#22]
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My last save was at a K-Mart. Ten people standing around a guy on floor in full arrest. No one was doing a thing other then talking about how blue he was getting. Started CPR and fire got there with AED and shocked guy 2 times. More CPR then got pulses back. Coded 5 more times but went to cath lab and walked out of hospital. Nice.
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Posted: 7/22/2010 12:27:18 PM EDT
[#23]
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Sounds like youre someone's guardian angel. Good for you! This............................. |
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Posted: 7/22/2010 4:04:57 PM EDT
[#24]
Quoted: Quoted: What's your profession? Don't you carry one of those combo tools that will break a window and cut the belt? No criticism, just curious. I am currently in nursing school and was/am an emt-basic.I don't carry one of those combo tools because it is just one more thing to carry and why carry it when a pocket knife (you do carry a pocket knife, right?) does the same job. as far as breaking windows, its a crap shoot even if you have the "right tools", I have yet to come to an accident that was bad enough to make the doors jam, but didn't break the windows, in the event that I needed to break out the window I could of smashed it with my fire exstingisher. I have. Car off an embankment earlier this year, driver's door was jammed by a sapling, engine compartment on fire. Another ARFCOM'er and I tried to break out the windows with no success, he'd already tried to pull her out the back seat but her foot was caught, I looked around and realized I could get the sapling out of the way while the other guy opened the door, within seconds of pulling her out the smoke in the passenger compartment was too thick to see anything and it was fully engulfed by the time the first sheriff's deputy arrived, much less a fire crew. |
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Posted: 7/22/2010 8:46:55 PM EDT
[#25]
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I start running and (not so gracefuly ) went down the embankment with the daughter of the lady that was screaming
I've been told I walked on water to pull a guy out of a river. I guess what I'm saying is bystanders will remember how the aid-giver runs to the victim. So, when people recall the time so-and-so almost died, the second thing they'll always remember is how dumb you looked getting there. Well the guy was technically dead and the RT chick was infront of me so I think I am safe. 
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