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Disaster Preparedness, Part 1: The New CPR

By: John Hedtke & Maurice Ramirez, Clifton Castleman

When cardiopulmonary resuscitation (CPR) was invented in the 1970s, the goal was to train as many potential bystanders as possible to help if someone had a heart attack or choked in public. In an effort to educate everyone about the importance of learning basic chest compression and the Heimlich maneuver, even Hollywood got in on the act, incorporating the practices into movie and TV storylines. As a result of great marketing, virtually everyone knows what CPR is, and hundreds of thousands of people are trained to do it. (more…)

Deep in the Woods, Out on the River

Wilderness first aid required when medical technology is unavailable
By Michael Darzi

When calling 911 is not an immediate option and help in the form of a hospital or trauma center is more than an hour (or days) away, time becomes the essential element between wilderness first aid (WFA) and standard first aid. In such situations, the task of managing the injured and the ill will challenge one beyond basic first-aid knowledge, and require skills that make you think “outside the box.”

Wilderness medicine is required whenever medical technology is unavailable, whether due to a lack of adequate equipment or too distant medical facilities. WFA’s value makes it a requirement for many groups such as search-and-rescue and the Boy Scouts of America for its highadventure bases, and highly recommended for outdoor leaders and guides. WFA is an intensive 16-hour course that teaches students how to properly assess, treat, and manage common illnesses and injuries.

Long hikes, extended lengths of rivers, large expanses of ocean, and miles of asphalt may separate the patient from a medical facility. You may have to endure heat or cold, rain, wind, or darkness.

The equipment needed for treatment and evacuation may have to be improvised, and communication with the “outside world” may be limited or nonexistent. Remote locations and harsh environments may require creative treatments. All these things can be a part of the world of Wilderness First Aid.

The Sierra Club’s Potomac Region Outings (PRO) is teaming with The Center for Wilderness Safety to hold two Wilderness First Aid courses this summer. The courses, taught by The Center for Wilderness Safety at the Turkey Run Education Center in Prince William Forest Park, are sponsored by PRO.

Courses are open to all. Sierra Club outings leaders are eligible for reimbursement. CPR/AED certification is a prerequisite—if you do not have that, you may register for a CPR/AED course at TrinityPresbyterian Church, Herndon, VA. See the complete schedule at www.wildsafe.org/courses.

This WFA course covers more than the basic first-aid requirement for Sierra Club outings leaders. If you are interested only in a CPR/AED course, CWS also teaches American Red Cross CPR/AED and will gladly schedule a class to accommodate your schedule. See www.wildsafe.org/courses/cpr.htm for more information. Outings leaders are also eligible for reimbursement of basic first-aid training.

Michael Darzi is chair of Potomac Region Outings.

Hands-Only CPR: The How, Why, and Does it Work?

By Clif Castleman, WEMT & American Red Cross Instructor

My thoughts as a medical professional (and by the way, these protocols have already become effective in Loudoun County, Virginia), are that overall, it makes sense, however you’re only supposed to provide chest compressions for the first two minutes after arriving on the scene where somebody has collapsed and you witnessed them collapse then switch over to providing “traditional” CPR. The order of things is a bit of a lie; because first things first, you still have to check the scene for safety, then check the victim to see if they’re responsive; if so, call 9-1-1 or your local emergency response number. Only then should you begin to do chest compressions.

After two minutes of chest-compressions-only have been done, both the American Heart Association and American Red Cross state that you then need to go into “traditional” CPR with 30 chest compressions and two breaths. This is because there is enough residual oxygen in your bloodstream and vital organs, however after roughly two minutes, that residual oxygen is used up, and must be replaced with new fresh oxygen. Remember, the air we breathe contains roughly 21% oxygen and when we breathe it in, our body uses only about 5% of that, exhaling 16% oxygen – which is way more than enough for another human being to utilize.

The real key to all of this is the Automated External Defibrillator, or AED. The AED is designed to shock the heart back into an effective rhythm. The sooner an AED is brought to the aide of a person who has collapsed and is completely unresponsive – even to painful stimuli such as a sternal “noogie” or a hard pinch on the back of their arm – the better chance that person has of being successfully revived. If you find yourself in a situation where you just saw the individual collapse, have checked for scene safety, checked them for responsiveness, and have called 9-1-1 – and there’s an AED in the building but no one else to go get it, GO GET THE AED FIRST and don’t worry about the two minutes of compressions, because literally speaking, the chest compressions are only pumping somewhat oxygenated blood to the vital organs long enough for an AED to restart the heart on its own.


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