Monday, November 27, 2017

When YOU Are the First Responder

Emergency medical care--having EMTs and paramedics show up at your door when you call 911--is a fairly recent invention.  Prior to 1970 someone (usually untrained) would show up at your door and toss your loved one into the back of an ambulance and haul them to the hospital and maybe they would make it, often they would not.

Around 1970, staffing ambulances with trained medical providers (EMTs and paramedics) started to show greater promise for patient survival rates.  Then came better protocols for when someone called 911 (ie: the dispatcher would get EMS rolling but then offer instructions on how to help the patient until EMS arrived such as giving instructions on how to perform CPR).

Due to the many recent mass murder events including 9/11, the Oklahoma City bombing, and numerous mass shootings, emergency medical care is changing yet again.  In these mass casualty incidents a few problems have been noted.  #1--dispatchers can't give life saving instructions to one caller when they have hundreds and hundreds of calls coming in, #2--patients may have to wait longer for EMS to show up because they are busy helping other wounded people and #3--mass casualty events are taking place in both urban and rural areas.  In urban areas, mass casualty response is pretty good.  All of the responding agencies practice together, plans and protocols for response have been developed, and you are much more likely to survive a mass casualty event today than you were a decade or so ago.  Rural areas are still problematic as there are usually few responders who show up immediately and they usually have to wait for mutual aid from larger cities that are further away.  Patients also usually wait longer to be transported to level one trauma centers (rural hospitals are usually designated a level 4 or 5 trauma center).  Obviously this is not good when it comes to survival rates.

More and more it is being recognized that immediate medical care for victims of trauma and severe injury means that it's more likely the patient will survive.  And by immediate I don't mean when EMS arrives but seconds after the patient drops.  This is where you come in.  The difference between life and death in a trauma injury situation is literally minutes.  If a patient is in cardiac arrest or bleeding out, waiting five minutes means the patient will be dead when EMS shows up.  But, with appropriate bystander care, these lost-cause patients can often survive even the worst wounds.  As an untrained bystander, these are the things you can do now to help out in the event that someone (like in the case of a heart attack at the family Christmas dinner) or many someones (like in the case of a mass shooter at a concert venue) need immediate medical care.

  • Learn CPR.  There are classes for this in almost all towns and it is a simple skill to learn that can save lives.
  • Learn basic first aid.  Again, these are easy skills to learn that can come in handy for the simplest household injury to something bigger.
  • Learn how to use an AED and pay attention when you are out and about so you know where AEDs are located in your community.  Most AEDs will talk you through the steps to use the device and a shock or two can mean the difference between life and death when a patient is in cardiac arrest.
  • Learn how to do the Heimlich Maneuver.  There are dozens of YouTube videos on this topic and preventing someone from chocking to death is a very important skill to have.
  • Stop the Bleed is a relatively new civilian training class in Washington State that is aimed at providing immediate patient care to prevent someone from bleeding out before help arrives.  Learning this skill (and learning how to improvise if necessary) can be a real lifesaver in an emergency situation.
  • Donate blood regularly if you can.  Obviously this isn't an emergency response skill but having blood during a mass casualty event is crucial for blood banks/hospitals in order to save lives.  Usually after a mass casualty incident the community comes out in droves to donate blood but the problem with this is that blood is needed now not in five hours when people can get to the blood center to donate.  Also, blood has a limited shelf life so hundreds of people donating blood after an event doesn't mean enough blood will be available in two weeks if needed.
  • Always carry first aid supplies with you.  This can be as simple as a handful of tampons or feminine hygiene pads (great for stopping bleeding), some condoms (can be used as a tourniquet), aspirin (not NSAIDs or acetaminophen although these belong in a first aid kit too) for when someone is having a heart attack, an EpiPen (these days this item is insanely expensive but can be a lifesaver when someone is having an allergic reaction), plus other basic first aid supplies are better than nothing and can tide you over until emergency help arrives.
  • Communities are always looking for volunteer first responders.  Organizations like fire departments, ambulance companies, and hospitals will often pay for your training course if you agree to volunteer a certain number of field hours after you successfully complete the certification process (as an EMR, EMT, ILS, or paramedic).
  • There are also a number of tactical EMS/first aid courses offered to both certified first responders as well as the general public.  Examples here, here, and here.
  • If nothing else, there are numerous YouTube videos and books you can take advantage of to learn the basics of first responder care to help out others during an emergency.
  • In a Wisdom of the Crowd-esque means of giving and seeking emergency medical help, you can check out the PulsePoint app.

1 comment:

  1. Thank you for all your wise counsel!
    I don’t say it often enough, but You freaking RULE