Post accident First Aid/CPR/AED

[JerseyShawn 0]

Watching the news video (granted its a news reporter) of the gentleman that passed away at Perris (12/27/11) he stated CPR was administered when the paramedics arrived. Not debating whether or not is was being done prior to EMT's arriving.

I was wondering how many of you are able to breathe for someone in an emergency situation on the spot?

Are AFFI's or TI's, or anyone at a DZ required to be certified?

I've been trained since I was a kid (father a firefighter) and have been certified every year since, with the refresher course.

In 9th grade I helped a classmate breathe after a seizure when his breathing became really shallow, could hardly find a pulse. Its a valuable tool to have. If anyone is interested http://www.redcross.org/cpr. Some classes are free or a small fee.

[Remster 24]

Yes... But you probably also know that the new CPR method does not include a "mouth to mouth" portion (referring to your "breathe for someone" comment)

Remster

[JerseyShawn 0]

Correct, CCR is what has been taught the past few years, chest compressions. CPR is still the preferred method for drowning, electrical shock ir choking victims. Both have a specific purpose now.

[grimmie 173]

I urge everyone in skydiving to take a basic first aid course.

The Perris FD ( all 3 shifts, the closest 5 stations) plus the Mercy Air helicopter crews are trained on skydive specific injuries and how to treat them every two years. If your Dz would like a training DVD of the course I will mail it to you free of charge.

[Deisel 35]

It truly pains me to say this but - not so fast my friends. The liability associated with having a half assed trained person trying to perform first aid is well beyond any benefit that could come from it. If you have not been trained by a professional and are not current in that discipline do NOT get involved in any emergency medical procedures. You could cause more harm than good and get your ass sued off in the process.

I'm interested to hear if any DZ out there actually has medical procedures or personnel in place. First aid for an up jumper is a very different proposition from treating an injused tandem passenger. Please discuss.

The brave may not live forever, but the timid never live at all.

[Anvilbrother 0]

Thats only for the lay person CPR, I believe the family and friends version. The healthcare provider version still has it all, and is the preferred way. They just diddnt want bystanders with no body substance isolation materials to do nothing at all, when at least compressions is an effort worth doing.

Postes r made from an iPad or iPhone. Spelling and gramhair mistakes guaranteed move along,

[Southern_Man 0]

I'm a health care provider and they teach compressions only at our agency. We have barrier methods available at our office and they provide a barrier that I carry in my car at all times.

"What if there were no hypothetical questions?"

[mutumbo 0]

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It truly pains me to say this but - not so fast my friends. The liability associated with having a half assed trained person trying to perform first aid is well beyond any benefit that could come from it. If you have not been trained by a professional and are not current in that discipline do NOT get involved in any emergency medical procedures. You could cause more harm than good and get your ass sued off in the process..

not quite.

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Good Samaritan laws are laws or acts protecting those who choose to serve and tend to others who are injured, ill, in peril, or otherwise incapacitated. They are intended to reduce bystanders' hesitation to assist, for fear of being sued or prosecuted for unintentional injury or wrongful death. In Canada, a good Samaritan doctrine is a legal principle that prevents a rescuer who has voluntarily helped a victim in distress from being successfully sued for 'wrongdoing'.

and as far as Grimmie's video, hes mailed me a copy a while back, and as far as treating skydiving related events, it is EXCEPTIONAL. id recommed it to any fire dept r EMS service who has a dropzone in their nearby coverage area.

Thanatos340(on landing rounds)--
Landing procedure: Hand all the way up, Feet and Knees Together and PLF soon as you get bitch slapped by a planet.

[Anvilbrother 0]

It may vary from state to state what they require you to have, but here in Louisiana everyone from daycare workers, first responders, dental assistants, emts, and doctors get AHA HCP and it does not include compressions only. We do it for the community at just cost which is the book and card, the department eats the rest.

I'm planning on teaching a HCP or friends and family first aid/CPR at the next safety day, it always sneaks up on me, but I have time to plan ahead for next time
.

Postes r made from an iPad or iPhone. Spelling and gramhair mistakes guaranteed move along,

[NWFlyer 2]

I could do CPR if I needed to, but every time I've been on a DZ during an incident (unfortunately, multiple times at multiple DZs), there have been several trained first responders on site that have been able to add much more value than I can. I have, therefore, kept my assistance to things like calling 911 or bringing in the gear that was left behind when the trained first responders dropped it and ran. But mostly I just stay the hell out of the way and let the pros do what they can do, unless someone asks me to help out.

Still, good reminder to do some refresher training since it's been a while, and there may yet be a time when I'm the only one around.

"There is only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." -P.J. O'Rourke

[theonlyski 3]

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It truly pains me to say this but - not so fast my friends. The liability associated with having a half assed trained person trying to perform first aid is well beyond any benefit that could come from it. If you have not been trained by a professional and are not current in that discipline do NOT get involved in any emergency medical procedures. You could cause more harm than good and get your ass sued off in the process.

http://en.wikipedia.org/wiki/Good_Samaritan_law


http://www.floridamalpractice.com/stat768.13.htm

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768.13 Good Samaritan Act; immunity from civil liability.--

(1) This act shall be known and cited as the "Good Samaritan Act."

(2)(a) Any person, including those licensed to practice medicine, who gratuitously and in good faith renders emergency care or treatment either in direct response to emergency situations related to and arising out of a public health emergency declared pursuant to s. 381.00315, a state of emergency which has been declared pursuant to s. 252.36 or at the scene of an emergency outside of a hospital, doctor’s office, or other place having proper medical equipment, without objection of the injured victim or victims thereof, shall not be held liable for any civil damages as a result of such care or treatment or as a result of any act or failure to act in providing or arranging further medical treatment where the person acts as an ordinary reasonably prudent person would have acted under the same or similar circumstances.

"I may be a dirty pirate hooker...but I'm not about to go stand on the corner." iluvtofly
DPH -7, TDS 578, Muff 5153, SCR 14890
I'm an asshole, and I approve this message

[Deisel 35]

Yep. And I'm not saying that it isnt legal. But you tell me what happens when a whuffo wakes up in a hospital bed, with a six figure medical bill, and the only thing wrong with them are the broken ribs and punctured lung caused by that good samaritan?

There is nothing that will stop any lawsuit that seeks to prove gross negligence or whatever other legal umbrella they wish to file under. Then you have to spend the dough to defend yourself. Regardless of the outcome there is still a cost there.

All I'm saying is that IF there is time, you should consider waiting for EMS. Diving in to help is not simply a forgone conclusion as there can be consequences.

The brave may not live forever, but the timid never live at all.

[theonlyski 3]

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All I'm saying is that IF there is time, you should consider waiting for EMS. Diving in to help is not simply a forgone conclusion as there can be consequences.

And tell them what? Yeah, I saw him having trouble breathing but I didn't bother opening his airway or putting him in a recovery position because I don't wanna get sued.

I let my CPR cert expire almost a decade ago, but I didn't need it in the Army. I've been thru more first aid/TCCC courses than I want to remember and I'll be damned if I let someone die because they MAY sue me.

"I may be a dirty pirate hooker...but I'm not about to go stand on the corner." iluvtofly
DPH -7, TDS 578, Muff 5153, SCR 14890
I'm an asshole, and I approve this message

[PiLFy 0]

I understand your sentiment. This, from Wiki:

"Good Samaritan provisions are not universal in application. The legal principle of imminent peril may also apply.[10] In the absence of imminent peril, the actions of a rescuer may be perceived by the courts to be reckless and not worthy of protection. To illustrate, a motor vehicle collision occurs, but there is no fire, no immediate life threat from injuries and no danger of a second collision. If a 'good Samaritan' elects to 'rescue' the victim from the wreckage, causing paralysis or some other injury, a court may rule that good Samaritan laws do not apply because the victim was not in imminent peril and hold the actions of the rescuer as 'reckless' and unnecessary."

Deisel, if someone isn't breathing? Or, if they are in full arrest? They ARE in imminent danger...

[popsjumper 2]

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There is nothing that will stop any lawsuit that seeks to prove gross negligence or whatever other legal umbrella they wish to file under. Then you have to spend the dough to defend yourself. Regardless of the outcome there is still a cost there.

It's painful to see people arguing this. It's a no-brainer.

You guys...he's not saying don't do anything. Here he's saying that your you would be exposing yourself. If you choose to do that, have a it...with the caveat that you do indeed know what you are doing.

On top of that, if you have no training, stay the hell away. Nothing burns me more than to see all the blood-thirsty rubberneckers go running out to the scene having nothing to contribute except getting in the way....and it happens every time, everywhere.
Bozos.

My reality and yours are quite different.
I think we're all Bozos on this bus.
Falcon5232, SCS8170, SCSA353, POPS9398, DS239

[mutumbo 0]

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All I'm saying is that IF there is time, you should consider waiting for EMS. Diving in to help is not simply a forgone conclusion as there can be consequences.

ok so let me ask you this, since you brought up the big IF. . .
how do you determine how much time you have and what the situation is, without putting your hands on someone? im a paramedic by trade, and even I cant tell how serious someone is from 20 feet away. kinda hard to tell if someone has a pulse and is breathing from across the DZ. so with out assessing them physically, you dont know.

and if you do go up and assess them and determine that they are in cardiac arrest/respiratory arrest/distress/whatever, after doing that you are just going to stand around and do nothing?

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I could do CPR if I needed to, but every time I've been on a DZ during an incident (unfortunately, multiple times at multiple DZs), there have been several trained first responders on site that have been able to add much more value than I can. I have, therefore, kept my assistance to things like calling 911 or bringing in the gear that was left behind when the trained first responders dropped it and ran. But mostly I just stay the hell out of the way and let the pros do what they can do, unless someone asks me to help out.

Still, good reminder to do some refresher training since it's been a while, and there may yet be a time when I'm the only one around.

this is probably the best thing you can do for EMS people EVER. do what you can till we get there, , give me a QUICK summary of what happened, answer questions the best you can, and then stay out of the way, unless we ask you to do something, (which happens often) that is the greatest help you could possibly be.

Thanatos340(on landing rounds)--
Landing procedure: Hand all the way up, Feet and Knees Together and PLF soon as you get bitch slapped by a planet.

[Deisel 35]

I completly agree. If a victim is unresponsive yes, they must me assesed through physical contact.

My comments here are based on seeing shit go sideways when someone was just trying to help but didnt know what they were doing. There is liability involved that must be considered when establishing any kind of aid response program.

The brave may not live forever, but the timid never live at all.

[billvon 2,380]

>All I'm saying is that IF there is time, you should consider waiting for EMS. Diving in to
>help is not simply a forgone conclusion as there can be consequences.

That may well be true if you have no training; you might just make it worse. Which is why a good part of a CPR training course is devoted to when to leave someone alone. If someone has a pulse, and they're breathing (and have an airway) and they're not going to lose most of their blood by the time EMS gets there, generally it's better to monitor them (and protect them from the elements etc) unless you have significant medical training. However, if any of those three things are present, then you have a choice between doing something (and thus maybe saving the guy's life if he's lucky) or doing nothing and watching him die.

Also keep in mind that the reason CPR is taught is because if you don't do it the guy is dead, and if you do do it he's still probably dead - CPR only helps in 5 to 10% of the cases out there. So it's a "might as well give it a shot, you're probably not going to make anything worse" thing.

[MartinOlsson 0]

Just to ad some insight. The percentage that would be saved by CPR is highly depending on how fast it is started and how fast defibrilation can be done. Furthermore the cause of pulselessnes is also a major factor. To bad for us, traumatic injury is the one cause with the worst odds. This doesn't mean you shouldn't do anything. I'm just saying that the type of simple CPR that are taught to the general public will do very little help on the DZ except if someone collapses in the hangar.

On the other hand. With a little more thorough first aid training, i.e. how to keep an open airway, how to stabilize a pelvis and/or stop a major bleeding. You can make a big difference.

One last note, it's not wrong to give chest compressions to someone if you are not sure there is a pulse or not. It is probably even helpfull. A heart with a weak own activity can be helped by supporting compressions.

Martin (Trauma trained nurse and med student)

[mutumbo 0]

On the subject of cpr with a pulse....the latest american heart assoc guidelines state that IMMEDIATELYfollowing a shock you are to do 2 mins of CPR and THEN check a pulse. So in theory the person could have a pulse while yor doing compressions....

Long story short, if someone collapses, and have been trained in CPR, and feel confident in Your abilities, and you cant palpate a pulse....start compressions.

Thanatos340(on landing rounds)--
Landing procedure: Hand all the way up, Feet and Knees Together and PLF soon as you get bitch slapped by a planet.

[bigorangemd 0]

Hate to throw cold water on the subject but; while there is a place for basic first aid for an injured skydiver, cardiac arrest from blunt trauma (hitting the ground) is not a recoverable injury. There is no chance of survival. I have recommended against CPR for injured skydivers at our DZ. Sounds harsh but it is what it is.

[mutumbo 0]

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Hate to throw cold water on the subject but; while there is a place for basic first aid for an injured skydiver, cardiac arrest from blunt trauma (hitting the ground) is not a recoverable injury. There is no chance of survival. I have recommended against CPR for injured skydivers at our DZ. Sounds harsh but it is what it is.

In a traumatic arrest, yes, but im sure people have died by other reasons than going splat at a DZ. But someone can have a pulse and the people first responding may not be experienced enough to find it, or it may be so soft that its not noticible. So i dont think swearing off all CPR efforts pre-EMS arrival is a good idea. You lack a radial pulse around 90 systolic, carotid at around 60 systolic, and femoral around 30(if you can find that damn one in the first place). just last night i ran a guy who after majorly losing a fight, being hit in the head with a bat causing a MAJOR avulsion, and a ton of other injuries, had a BP OF 60/20. Initially, and was all but unresponsive, barely had a carotid....to the layperson hes dead....but after some fluids and positioning we got his bp up around 90 systolic. Hes doing "ok" last i heard tonight.

Long story short...without a blood pressure cuff and a cardiac monitor not many people are too dead for me to not attempt CPR at least untill EMS arrives.
Caveat to above: if they have brains hanging out or his head is 30 feet from his body then yes, id withhold CPR.

Thanatos340(on landing rounds)--
Landing procedure: Hand all the way up, Feet and Knees Together and PLF soon as you get bitch slapped by a planet.

[skydiver30960 0]

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In a traumatic arrest, yes, but im sure people have died by other reasons than going splat at a DZ. But someone can have a pulse and the people first responding may not be experienced enough to find it, or it may be so soft that its not noticible...

I would tend to agree with this. Paramedics have a protocol (written by their Medical Director aka Da Boss) for deciding when to withhold resuscitation, and while it does include simple stuff like decapitation or exposed gray matter it also includes a pretty full assessment including a neuro assessment and checking the EKG for electrical activity, things a layperson cannot do.

SO, while I don't want to wade into the argument of "is it appropriate or not to start CPR on someone who hits at terminal" I do feel comfortable saying that for lay providers (or those trained in CCR or First Aid only) that CCR is like your reserve canopy: when in doubt, whip it out. If nothing else, you'll feel better knowing you did everything you could, even if the medics call it quits as soon as they get there.


Elvisio "there's always the precordial thump" Rodriguez

[bigorangemd 0]

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Hate to throw cold water on the subject but; while there is a place for basic first aid for an injured skydiver, cardiac arrest from blunt trauma (hitting the ground) is not a recoverable injury. There is no chance of survival. I have recommended against CPR for injured skydivers at our DZ. Sounds harsh but it is what it is.

In a traumatic arrest, yes, but im sure people have died by other reasons than going splat at a DZ. But someone can have a pulse and the people first responding may not be experienced enough to find it, or it may be so soft that its not noticible. So i dont think swearing off all CPR efforts pre-EMS arrival is a good idea. You lack a radial pulse around 90 systolic, carotid at around 60 systolic, and femoral around 30(if you can find that damn one in the first place). just last night i ran a guy who after majorly losing a fight, being hit in the head with a bat causing a MAJOR avulsion, and a ton of other injuries, had a BP OF 60/20. Initially, and was all but unresponsive, barely had a carotid....to the layperson hes dead....but after some fluids and positioning we got his bp up around 90 systolic. Hes doing "ok" last i heard tonight.

Long story short...without a blood pressure cuff and a cardiac monitor not many people are too dead for me to not attempt CPR at least untill EMS arrives.
Caveat to above: if they have brains hanging out or his head is 30 feet from his body then yes, id withhold CPR.

You've got the pressures at which you can palpate various points a little turned around, but that's neither here nor there. Your point about having laypeople start CPR because the injured person may have a pulse but the BP is low and they are too inexperienced to find a pulse is illogical. They should do CPR because the person may have a heart beat but they can't find it? I do agree there is little harm in doing CPR in the field with one caveat. With a lay person there is a significant risk of body fluid contact with a traumatic arrest and I doubt if there are many protective devices readily handy at most DZ's. If bystanders feel better starting CPR, by all means do so. Even if you are unsure of how, you can't hurt dead.

[mutumbo 0]

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You've got the pressures at which you can palpate various points a little turned around, but that's neither here nor there. Your point about having laypeople start CPR because the injured person may have a pulse but the BP is low and they are too inexperienced to find a pulse is illogical. They should do CPR because the person may have a heart beat but they can't find it? I do agree there is little harm in doing CPR in the field with one caveat. With a lay person there is a significant risk of body fluid contact with a traumatic arrest and I doubt if there are many protective devices readily handy at most DZ's. If bystanders feel better starting CPR, by all means do so. Even if you are unsure of how, you can't hurt dead.

You state that my saying that bystanders should start cpr because the person may have such a low BP that a pulse is not palpable is illogical, yes basically confirm what i said, saying that "it cant hurt".

if a person has such a low pulse that its not palpable, the major organs. are not being perfused, so pulse or no pulse, they are still in need of chest compressions to supplement what their heart is not doing/attempting to do.

the issue to contamination of bodily fluids, to some extent i could see that a justifible reason not to attempt resuscitation, in some situations, DZs SHOULD have at least gloves on site if they dont, theyre useful for more things other than scraping up squished people. i know some have more things available, but thats a different debate in itself

Thanatos340(on landing rounds)--
Landing procedure: Hand all the way up, Feet and Knees Together and PLF soon as you get bitch slapped by a planet.