Did You Watch 'Nightwatch' Last Night?

It appears that at least in some EMS circles, the premiere of the new A&E series called ‘Nightwatch’ on Thursday (1/22) was a highly anticipated event. I don’t know if it was just a coincidence that it was also the opening day of the NAEMSP conference held this year in New Orleans, where the EMS-themed reality show was filmed, but I am sure that viewing the first episode at Manning’s restaurant with the NOLA EMS crew must have been quite a party. For me, it was a quiet night of watching the show along with the simultaneous #Nightwatch Twitter stream for live commentary from my fellow medics.

Overall, everyone seemed to be very impressed and pleased with the portrayal of EMTs and Paramedics (with some almost “cameo-like appearances” by NOLA firefighters and police.) I felt the realism was refreshing especially when compared to the stylized public safety shows like the drama of Chicago Fire or the satire of Sirens, in fact, it was much closer to the seminal classic of Emergency! than I would have expected. The incidents were definitely real, clearly they were “cherry-picked” to find interesting moments, but absolutely no doubt that we were witnessing actual history in that town. There were the edited interview commentaries interspersed with the action reminiscent of The Office cast “breaking the fourth wall.” However, there were also a few things missing. Not a single hairy, sweaty chest that needed a 12-lead; no non-emergency transports; no lift assistance; and only a single call for EtOH. It is rare in my rural EMS experience to see a GSW, let alone multiple shots and even multiple victims over the single shift, but we are talking about the “Big Easy” here, not my hometown.

While I was pleased with the general realism as a accurate portrayal of our profession to the public, I did notice the almost non-stop use of lights and sirens. While Code 3 responses make the best television, it also feeds the impression that we are all adrenaline junkies that like to drive fast and “We do everything an emergency room can do,�? as Holly the paramedic tells the camera, “but we do it at 70 miles an hour riding through the streets of New Orleans.�? Hardly the stuff of “community paramedicine.”

I look forward to future episodes, perhaps they will find a creative and exciting way to communicate the value of SSM posting. I’ll be watching for it!

 

How To Perform CPR: The Crucial Steps You Should Know (and Share!)

This important article (and the associated graphics) is reprinted as a guest blog with permission from Monica Gomez, a freelance health and healthcare writer. Originally published at http://carrington.edu/blog/medical/how-to-perform-cpr/.  The animated GIF images alone are worth sharing!

Anybody can and anybody should learn how to perform CPR (Cardiopulmonary resuscitation): According to the American Heart Association, a stunning 70% of Americans don’t know how what to do if somebody is experiencing a cardiac emergency because they don’t know how to administer CPR or they forgot the exact technique. This is especially alarming since almost 90% of cardiac arrests occur at home — where patients depend on the immediate respiratory care response of their family members. In brief, knowing how to perform CPR can save the life of a loved one someday.

While 400,000 cardiac arrests happen outside of hospitals each year in the U.S. alone, hands-on CPR can actually double or triple an adult’s chance of survival. However, you need to act quickly. At four minutes without oxygen, the patient will suffer from permanent brain damage. At eight to ten minutes, the patient can die. Almost 90% of cardiac arrest patients die because no one performed CPR at the scene.

Before You Start CPR

First of all, check if the patient can respond by tapping them on the shoulder and shouting “Are you okay?�? If they don’t respond, call for medical emergency services immediately. If others are around, instruct them to call 911 and if you’re alone, do it yourself. If the patient is an animal, call the closest animal hospital. If you happen to be near an AED (defibrillator), read the instructions and give one shock to the patient (this applies to humans only).

CPR Steps For Adults and Children 9 and Older: Hands-Only CPR

1. Lay the patient on their back and kneel next to their neck and shoulders.
2. Place the heel of one hand on the center of the patient’s chest.
3. Place the heel of your other hand over the first and lace fingers together.
4. Keep your elbows straight and align your shoulders directly over your hands.
5. Begin compression:

• As hard as possible
• At least 100x/minute
• Allow the chest to rise fully between compressions.

TIP: Give compressions to the beat of disco hit “Stayin’ Alive�?!

CPR Steps For Younger Children and Infants

1.  Tilt the head back a bit and lift chin to open the airway and check for breathing.
2. If there’s no breathing, give either of these two rescue breaths:

• Child: Pinch the nose shut and make a complete seal over their mouth
• Infant: Make a complete seal over their mouth and nose.

3. Blow in for one second, so the chest visibly rises and repeat this once.
4. Give 30 chest compressions (100x/minute):

• Child: Push with one or two hands about two inches deep
• Infant: Push with two to three fingers about 1.5 inches deep.

5. Repeat these steps three to four times.

 

Pet CPR – For Dogs and Cats

[Follow these CPR instructions for puppies]

For Animals Under 10kg/22lbs:

1.  Use the one-handed technique, wrapping the hand over sternum and chest.
2. Give 30 chest compressions (100-120x/minute).
3. Allow the chest to fully recoil between compressions.
4. Give two mouth-to-snout rescue breaths after each set of compressions (30:2).

For Medium to Giant Dogs:

• Position the animal on its side.
• Use the two-handed technique, placing your hands over the widest part of the chest.

For Deep, Narrow-Chested Dogs Like Greyhounds:

• Use the two-handed technique, placing your hands directly over the heart.

For Barrel-Chested Dogs Like English Bulldogs:

Place animal on its back and use the same positioning and technique as for adult humans Whether you perform CPR on an adult, child, infant, or pets, DO NOT STOP unless:

• The patient starts breathing
• An EMS or another citizen responder takes over
• An AED is ready to use
• The scene becomes unsafe
• You are physically incapable of continuing

Make sure to practice and/or brush up your CPR abilities today, so you’re ready to potentially save someone’s life in the future! Furthermore, if you’re interested in making it your profession to help people suffering from respiratory conditions like asthma, bronchitis, lung cancer, heart attack, stroke, chronic obstructive pulmonary disease (COPD) or sleep apnea, you should look into Carrington College’s respiratory care program. This two-year program combines classroom lectures, laboratory instruction, and clinical experience in order to prepare you to work in a variety of healthcare settings. If you’d like to assist and educate people regarding respiratory health concerns, our training program is the ideal fit for you!

Trauma Shears Dilemma

I started out with the basic trauma shears that cost only a couple of dollars, but soon realized I wanted something a little more “substantial” and upgraded to the basic titanium shears I currently carry. They do the job adequately, but there are some other interesting options out there and I am looking for some reasoned opinions (or Christmas present suggestions.)

I am impressed by the Leatherman Raptor that can be purchased for around $60 here in the US. They would be like my own little “Transformer” riding it’s very own holster on my belt. However, I have to admit that I kinda fear being seen as a “wacker” with it.

Then there is the RipShears for only about $25 (or a couple extra for the “glow-in-the-dark” version.) These seem very sound with a great track record (and fewer moving parts) but maybe a little bulky.

Both add features like an O2 wench (or window punch or reflex hammer…) but honestly is that necessary? What is your experience or advice?