(Not I, however - these posts are awesome. Every time I read one I feel the strange urge to go to EMT school.)

Paramedics tend to be more graphic about educating folks in first aid, as well as more practical. "Secure the site" was the second thing we were supposed to do, after calling 911.

Nice thing, our school is right behind the fire department...

We pause to remember Ajay's comment #85 in the metacomments thread.

One thing:

> Kneeling above the patient’s head, holding his head stable with the heels of your hands, push up with your fingers moving the chin up. This will lift the patient’s tongue out of his airway.

Do you know of any youtube or similar videos showing how this is done? I don't think I'm visualising it well.

So, got any advice for the layman, besides trying to remember 'A-B-C'?

Teresa, you forgot the haiku at the beginning of the last open thread.

I'm sure I don't really want to know the answer.

If you're at the scene of an accident and you don't know what to do, the single most important thing to bear in mind is that EMTs would lots rather get called out to an accident where the injuries prove to be fairly minor, than have you wait twenty or forty minutes before calling 911 because you're not sure you're doing the right thing.

1. Call 911. Stay on the line.

2. Make that whatever caused the injury doesn't get anybody else, especially you.

3. Everything else.

I've done it now about 4 times. It's interesting. Some people forget to yell. The fire department stresses the yell part. You must yell first, before you try to put the fire out, so that while you are spraying the fire, someone else is calling 911. Some people can't bring themselves to approach the fire. If that happens to you, hand off the extinguisher and get out, you won't do any good standing around. If one extinguisher doesn't put the fire out, drop it and get out, don't look for another extinguisher. Don't throw water on the fire: it's too late for that. Don't stand next to the fire while you wait for the fire department. They'll find it, and they'll know what to do when they do. They won't need your advice.

Help! Fire! Call 911! Kind of like ABC...

Stay inside your own comfort zone.

Get help rolling then make the scene safe. If you can't think of anything else to do, call 9-1-1. Then go stop traffic.

Or, just keep other bystanders, all the looky-loos, from running over and getting munched. Accident scenes are dangerous.

Taking a first-aid course now, before you need it, is never a bad idea. American Heart Association and American Red Cross both have first aid courses they teach the public. SOLO has a wonderful wilderness first aid course; many of the things they teach you are applicable in urban areas too (a broken leg doesn't know if it's in a cow pasture or a shopping mall).

Call for help and stay safe. Be ready to direct the responders to the right place.

> Lizzy, I would add that, if you have the time, you tell a specific person to call 911. Saves some confusion on the scene and with 911. Of course, it has to be better that ten people call 911 than none.

Also I'd imagine that avoids the unfortunate group of crowd dynamic where a group of people stand around waiting for someone elseto act. The larger the crowd, the worse this can be.

I've always heard that as "Treat trauma with diesel."

It's easy, really.

While the patient's chest is fully expanded, take off the occlusive dressing. Let the patient breathe out. Air should come out of the wound. When the patient has breathed all the way out, put the occlusive dressing (taped down on three sides, or with a corner untaped, to form a flutter valve) back over the wound.

You can buy commercial devices that are occlusive dressings with built in one-way valves. One such is the Asherman Chest Seal. You probably won't see enough sucking chest wounds in your life to make it worth your while to buy one and put it in your supplies, then throw it out when it expires (the adhesive gets old, the plastic gets stiff and cracks) and buy a new one.

#5 Do you know of any youtube or similar videos showing how this is done? I don't think I'm visualising it well.

Your wish is my command: Jaw Thrust Maneuver

I call 911 pretty frequently for stuff I see when I'm driving, and they never seem irritated to take the call, no matter how many fire engines or whatever are already on the way. They'll want to know where you are and what you actually see. "I'm on I-57 headed south, we just passed the 42-mile marker, and there's a lot of smoke coming from the grass in the median" for example. Not "the highway's--oh my gosh--is that a brush fire? What the?" which is always my initial reaction. Giving them a clear, fast description lets them say "thanks, trucks already en route" and end the call.

It's just as quick, and far more reliable, to say "You call 9-1-1."

(With infant CPR you're going to do a couple of minutes of CPR before you call 9-1-1 -- but this is getting far afield from trauma. Traumatic cardiac arrest has a very poor prognosis.)

1. YOU, GO CALL 911 NOW.
2. Airways are key.
3. Keep patient warm. (One incident involved an asthma attack in the woods on a January night in Minnesota.)
4. Keep patient calm.
5. Get the heck out of the way once the people who know what they're doing show up.

I think I've told this story on one of these threads, but I'll mention it again here: in 2001, my sister had a bad car crash on her way to work one morning. She lost control on the highway, probably due to a blown-out tire, and rolled her car. She broke her arm, her wrist, and two vertebrae in her neck -- but when her car came to a stop, she had no idea that she'd broken her neck. She tried to dig her cell phone out, and when she couldn't find it, she crawled across the passenger seat to try to get out of the car and flag someone down for help.

Several people had pulled over when they saw her go off the highway, and they came running down the embankment shouting that they'd called 911 and she shouldn't move. One brought blankets. That's all they did for her -- reassured her and kept her calm. But that was what mattered. And despite chipping C2 and shattering C7, she didn't injure the spinal cord, and she made a full recovery.

Observation is extremely important. While you are checking the airway and for obvious wounds, check for MedAlert tags. You may not be able to do anything for a patient whose tag notes "Anaphylactic: Peanuts" or "Diabetic"... but if it's important enough to get onto a tag, it's important enough to tell the EMTs as they arrive (and, better yet, during the 911 call).

I'm not suggesting strip-searching the victim; I'm suggesting keeping your eyes/ears open while doing whatever initial evaluation you need to do. Don't get tunnel vision!

You're anticipating Trauma and You Parts Two, Three, Four ....

One thing at a time.

To repeat what Jim and others have said -- your first priority is to call 911 or your local equivalent. Make sure that someone who knows what they're doing knows that there is a problem and where it is. One of the non-fatal Awful Warning stories at my former place of employment was about the guy who was in an inspection pit when the argon feed wasn't properly shut off. Argon's not poisonous, but it's not a good substitute for oxygen, and it's heavier than air. He wasn't wearing an oxygen meter. The first person to walk past the pit and see someone unconscious rushed to help him, and didn't stop to call the emergency number first. The person who saw two unconscious people in the pit... Fortunately someone stopped and thought and headed for the phone, somewhere around the third or fourth iteration; and the rescue team came along with breathing apparatus and dragged them all out soon enough for there to be no real harm.

The trainers for the local First Aid At Work courses had *much* nastier stories about why to stop and think, lest you become a casualty yourself. I'm sure Jim has as well.

Travellers in Europe should be aware that, although there are locally traditional emergency numbers (eg 999 in the UK), there is also a Europe-wide standard emergency number: 112.

(By this I mean the use of 112 is standard across Europe. It will connect you to your local emergency responders. Nobody's running two call centres or anything.)

Several of my friends have babies and "burping" in my normal context just wasn't translating as something useful in the horrible sucking chest wound context. Thank you for clarifying.

'You- call 911, and then come tell me when you've done it'.

'You-' is accompanied by eye contact or pointing or saying 'you- in the blue shirt'. The idea, in those long ago days pre-dating the ubiquitous cell phone, was to get the call for help rolling and to build in a confirmation it had been done.

Now days my default is make eye contact. If they don't have a cell phone and there are other bystanders someone will either offer their phone or make the call. 911 will likely keep them on the line.

True story. My first day living in Oregon we were driving to get lunch. Services were just ending at the local parish church.

We saw the elderly gentleman stagger into traffic one block ahead of us and drop like he'd been thwacked over the head. My husband pulled over and we both ran to him. I said the magic 'You- call 911!' to a specific bystander.

Swear to the diety of your choice, there are in fact people who, when directly addressed and told to call 911, while holding their cell phone in their hand will ask 'Are you sure we need 911?'. In one of the proudest moments of my life, I did not swear even a little bit while telling her yes, actually I was sure.

(Turned out he was diabetic and had skipped breakfast and the service had run long. He ended up spending a night in the hospital but was all right.)

Having been one of the first at an accident scene several times, I have to say that an EMT saying 'Okay, ma'am, we'll take it from here. Thank you.' is one of the sweetest sounds in the world.

I know, there are a lot of landmarks that aren't much use to the dispatcher. Street name and number are good, when they're available. But the main bus station for the town?

Which is why training is important.

Which is why training is important.

You will always do better in a Situation if you've mentally rehearsed what you'll do at least once.

This is known from studies*.

Cool thing is you don't have to repetitively, constantly, or obsessively rehearse. Just one or two times for a new situation.

For instance, when you sit down on an airplane, just quickly run through how you'd evacuate. "I'll get up, I'll NOT touch or take any of my possessions, I'll move forward 7 rows or back 15 rows." People who do a thought exercise like that just once are much less likely to freeze-in-fear if they do need to evacuate.

So go ahead right now and imagine yourself in a group of strangers. Imagine yourself pointing to one person and saying "You, call 911, come back and tell me when you're done."

And then imagine the same situation, but it's a group of non-strangers.

Just with those two imaginations, you'll be better off when you need to do it for real.

-----------
* don't immediately have the references, sorry.

That's a tension pneumothorax in Steve Brust's "Athyra," right?

Over the past 8 years- since I've owned a cell phone- I've taken to calling 911 when I'm on the highway and I see a potentially dangerous problem. For example, there's a large object on the road that could cause an accident via direct damage or swerving.

I'll report it as efficiently as I can as soon as it's safe to call: "Has anyone reported the lumber in the number 1 and 2 lanes of southbound 280 1/2 mile north of Page Mill?" If it's already been reported, they'll tell me.

I think I've now got a reasonable sense of when a potential problem is reportable. Back when I started, though, I'd worry about contributing to a 911 overload: all cellular 911 calls go to California Highway Patrol call centers.

I quickly learned not to worry, because I'd be the first to report it at least 2/3rds of the time. And again, these were for really obvious problems- mattresses, thick lumber, carpet rolls- things cars cannot drive over. Or a drunk driver- someone weaving crazily.

All to say that you should never assume that 911 has been called.

Also, don't assume cellular 911 is e911 (location tracking) ready. i.e. in California, if you don't want the CHP first, then tell at least one person to call 911 using a landline.

If you're dealing with a person who gets agitated during emergencies, and they're already injured, upsetting them can do them real harm.

Note that the UK mobile phone networks don't feed location data to the 999 call centre, so if you dial 999 from a mobile about the first thing you need to be able to tell them is which town you're in, so they can re-route your call. (NB: as 98% of the population of the UK live in urban areas, I say "town". YMMV if you're out hill-walking.)

I think I heard once that Rockall is so small it shouldn't actually show up on a map but it's a major landmark in the otherwise empty sea - it's 570 square metres (6100 square feet). But there's a great need for emergency dial-an-orgy or dial-a-kebab hotlines, I'd bet.

But yes, say your street and town. They don't necessarily know your location. Even if your emergency services do get location data, it's not necessarily correct - your cellphone may be getting a connection from a tower across a municipal border or something. Even what looks like a regular landline just might be a VoIP phone that someone took with them on holiday...

In the end, I gave up and fled the country. Now I can't ask for phone numbers in the local language anyway, so I don't have to worry about it.

Once you get on to C, you will need to check the casualty for bleeding. Pat them down gently, like you're searching for weapons. Pat down everywhere, and check your hands in between sections. So check the head and neck - check your hands - check the chest - hands - stomach - hands and so on. Be careful around pockets where they could be carrying a needle or other sharps. If you just pat them down all over without checking your hands in between, you will be left looking at your hands thinking "Blood. Hmm. I wonder where I picked that up?"

Remember that someone could have more than one sucking chest wound. If they've been shot, for example, they could have entry and exit wounds. Patch one with an occluding dressing as described; seal the other.
Once you've dealt with them, we were taught, roll them onto the injured side to help the intact lung work.

Facial injuries and burns to the face or throat all mean that you could have a compromised airway. Pay attention. (Also: burns to the face or throat could be chemical. Watch out for this if you're breathing for them.)

Rural EMS gets even stranger locations than that sometimes -- "Remember where the kid swallowed the quarter last summer? It's the same place" or "Turn left where the old schoolhouse used to be." And this is after Enhanced 9-1-1 came in and the town renamed and renumbered all the streets and houses for greater consistency.

An American Heart Association program for the basics of CPR at home or work- 22 min.

Or, for those who like the traditional classes, AHA CPR, AED, and First Aid Near You!

Now you really don't have an excuse.

This was at the beginning of enhanced 911. Even though the roads in the county were IDed, they were not all labelled and people were still making the switch from landmark navigation to street and road directions.

My sister and her fellow dispatchers have to work to get useful address out of callers. A lot of people only use landmark navigation.

I've only had someone go down right in front of me twice, both times in a group of my colleagues. The second time there happened to be two of the first aiders present, which was a good thing. Because once we'd checked that we weren't about to put our CPR training into practice, and the restaurant manager came over and quietly told us that he'd already phoned 999, the other first aider watched the patient and I dealt with the person who was panicking and repeatedly saying," He's going to die!"

It took a few repetitions of "No, he's not, he's breathing normally, his pulse is steady, the ambulance is on its way, and there are two trained first aiders here" to get her to calm down so that the patient wouldn't hear her if he started to come round.

One of the things good first aid training does is help you not be someone who make things worse. If you know that you know how to do CPR, you're less likely to panic when someone drops.

I fell on some steps at the beginning of June. Landed on the tops of my feet, and my shins, and from there to hands and knees. It was intensely painful, but I was certain* that no major damage had been done. Only bruising and scrapes.

I was shocky for what seemed a very long time. Nauseated, hot, dizzy, and insisting that I wasn't really hurt, that I'd be okay, no need to call paramedics. Stupid? Potentially fatal? I did stay at the scene with my head down and my feet up, at least. I was too dizzy for anything else.

*I suppose there was every chance that there was significant damage I was too shocky to feel, but I was right. Extremely severe bruising that took four days to stop swelling, and scrapes that are still healing. No pulled muscles, no torn ligaments, no broken bones.

I'm glad you asked that question....

I've just put up Trauma and You, Part Two: Shock. You'll learn far more than you wanted to know.

Untreated, shock can, and does, kill. Jim McDonald can explain the mechanics better than I can, and I think he's planning to do so, in a later post.

If I take a fall, and sustain an injury, I get it checked out. Last time this resulted in a trip to the ER and a few stitches...

(Most embarrassing thing ever, and how I discovered this tendency - I bit my own finger eating a hot dog in middle school. Got it pretty hard, and passed out at lunch. Hard to explain without losing face, to say the least.)

I'm pretty off topic, so I'll stop now.

My assistant and I stopped the car downhill from the crash site (big trucks and everyone else had stopped uphill) and ran to see what we could do. We helped get the smashed windshield out of the way and spoke with the trucker, who was seriously stuck in the cab thanks to the seatbelt and steering wheel. He said he didn't feel much pain but thought his leg was hurt. People were already calling 911; truckers on their CB's and motorists going up the mountain on the other side of the barrier.

The trucker, a dark black man, was covered in diesel fuel and motor oil (cargo was motor oil in quart containers; it shifted and flipped the trailer on the curve), but his left shoulder was curiously red, shading to bright pink and white in the center. Couldn't see any blood, probably because it was mixed with the fuel.

The EMS teams were there within 5 minutes and we left at that time. Not until later did we realize his shoulder had been abraded by the pavement right down to the bone; that's what we had been looking at and wondering what was so white on his shoulder...

The only thing which changes is the call to 911 (we tend to end with, "seek medical attention") because the context is different.

I will say that getting a few of the Army's field dressings isn't a bad idea (4x6 pad, sterile, with long tails to tie off). With a bit of training/practice, they are bandages, pressure dressings, or tourniquets (and the transistions can be done after they've been put on).

I've patched up a few trauma victims and the thing which always astounds me is how training takes over. So I commend a first aid course; even a little training can make a world of difference in how the first reaction goes. If you can't get past the shock/horror of what you are seeing you can't help.

If you see it and the hind-brain kicks in with, "needs a bandage" then you can deal with it.

Kathryn from Sunnyvale: We were driving south on 101, truck hauling a trailer. Traffic got very weird. Then we saw the Saturn, with a very confused looking driver, heading north.

When we called, they asked, "Are you calling about a car travelling the wrong way on 101?"

Shock, as I am sure the post I've not seen yet will go into great detail about, is deadly serious.

It's high on the list of things to look for, and treat.

911, 999, 112 ALL work to get you to the local emergency services in most countries (anywhere with a modern telephone system) - probably 000 as well.

The Powers That Be had the sense to realise that this was sensible because (a) with e.g. Trans-Atlantic TV shows (particularly for kids - Sesame Stree being shown in the UK comes to mind), children may first learn the "wrong" i.e. foreign emergency number; (b) international travellers in an emergency may not remember what country they are in, never mind what the emergency code is for that country - they ARE likely to remember their own country's emergency number.

IF I'M WRONG ABOUT THIS, PLEASE SOMEONE LET ME KNOW!

999 and 112 had a delay, but they worked.

That's actually pretty neat.

What if it'd been worse? Why didn't dispatch add that it was the Pizza Hut as well as the address? The Pizza Hut is out near the road, away from the line of shops and apparently the ambulance guys didn't think to look there.

I fell in a snow-filled crack in the top of a granite dome in the Sierras quite a few years ago, and found myself with my arms supporting me on the edge of the stone but nothing under my feet, and with nothing to brace myself against to climb out. So I was actually in Extreme Peril and couldn't help myself, but it looked like a very calm situation.

I was with a friend who was perhaps 60 feet away, and there were a couple of other tourists about 20 feet away. So I tried yelling, in a kind of moderate tone "Um, help?" They kinda looked at me. I tried a little louder. "Help!" No response. Even a little louder. Nope. And I just couldn't bring myself to go to full-on screaming and yelling mode since I knew all I needed was a quick hand out.

I only got out once my friend started looking around for me, saw what was going on and walked over to pull me out (on her own). At that point the other people wandered over and were like, "Oh... are you okay?"

I think I lack the Command Tone skill. I don't think those people were unusually oblivious; I crashed my bike very hard in front of dozens of people at Fisherman's Wharf one day a few years ago, and as I was lying dazed on the sidewalk for a minute or two, no one even walked over to ask me if I was okay. (An expression of concern would've gone a long way in making me feel better.)

I think it's just that people seem to have this conditioned response not to "make a fuss" about potential-emergency situations. To the point where they won't even look at what's happened, or they'll mock people who do. There's obviously some tone and volume level that breaks through that without them assuming you're panicking, I just dunno what it is.

Maybe you need to think loudly about how visible you are and how much trouble you're in. Not a joke - I'm usually pretty 'invisible' to people, so they don't notice me, maybe don't even really hear me. If I start thinking 'visible and conspicuous' I get a lot more attention.

As a first approximation, try using the lowest part of your vocal range, at the highest volume. It's natural to pronounce high volume at high pitch, but that sounds like panic (because it's natural to get loud when you're panicking).

In the situation you describe, a panicky tone would have gotten them to come running. Don't knock a panicky tone. Sometimes it's your friend.

when I did my EMT training, I remember during the part for the heimlich maneuvar, the instructor went through the script: approach the person, ask if they are choking. If they can say anything at all, leave them alone, cause your help might make it worse. If they can't speak, go for the heimlich. And then the instructor said option 3: if they say nothing and then go into the bathroom, then you follow them, because they might be choking and can't deal with "making a fuss".

So, you're talking about a very real response. But being aware of it means you can change it if you want.

I think I lack the Command Tone skill.

This is probably more a function of conditioning than any sort of inherent character trait. i.e. how you were brought up, what your parents told you, etc. In short, it's how you've been trained.

And people react the way they've been trained, so the thing is to train yourself to do something different. The best way to do this depends on what conditioning you need to override. You might find Kareoke helps. Try it a couple times. If you can't sing, even better. If the conditioning is about not being in the spotlight, the center of attention, take the spotlight. If it's about being in control, then find an "improve theater" that you can try out. Most of improve is out of your control and you have to respond in a spur of the moment way. perfect training against freezing up. If it's specifically about talking to people, strike up conversations in public places with a dozen strangers over the next couple of weeks. Or maybe there's something else that would let you practice and condition yourself so that you're used to a command voice.

There's obviously some tone and volume level that breaks through that without them assuming you're panicking, I just dunno what it is.

For me, the tone is one of leadership rather than authority. which means it really isn't a command, but compelling. You're leading them to somewhere they're willing to go. If you think they're not willing, that they won't follow your lead, then that's probably what will happen. So, it is fundamentally a tone of confidence. You aren't worried about them saying "No" or ignoring you, because even if they do, you are confident that you'll find another way. If they don't call 911, you know you will get someone else to do it.

The way to find what the tone means for you is to practice and condition yourself to take on those kinds of situations.

Community theater is a useful forum in which to practice trying on voices other than your own; stage fright is also useful as "artificial danger"--it gives you practice in remembering what to do, and doing it, even when you're terrified.

Of course, not everyone has my particular response to something going horribly wrong. I hope I don't have this particular response for too long. It's not the reaction I want to have.

*source of great shame and resolve to do better if it ever happens again.
**I know this is not the response that will save lives.

(Sorry, now I am having this vision of practicing the command tone with my roommate. "No... more volume... I'm just not feeling the compulsion to obey here.")

Thanks for the confirmation. Comforting, isn't it?

Jacob Davies @ 67
I'm often not very good at calling attention to myself - particularly if it's me that needs the help (social conditioning, yay!). But I'm great at standing up for other people - so if someone else needs help, I'll call loudly - and if nobody else is taking charge, or I'm sure the person who is doing so has absolutely no clue (standing up the person who is fainting, for example), then I'll step in and take charge, complete with authorative tone of voice - I just wish I could use it when I wanted to!

We don't, as a culture, point at our equals. We point at employees, servants and children.

Invoking a sense of being in one of those categories helps to make people respond; esp. when they are at a loss.

A case of someone doing things really well.

I was riding with a friend. We were heading back to the barn. Guy across the wash called out to ask if either of us had a cell phone.

Yes, we did, but back at the barn (about 1/3 of a mile).

"I think I'm having a heart attack."

I told Matt to go back to sit with him, and took off (I was the better rider).

Matt, of course, had the key to the gate. I hopped it (trusting Leus to not run off), climbed back over, while dialing, and was gallopping back while talking to 911.

The guy didn't get worse (so Matt wasn't doing solo CPR, waiting for me to show up and start team), and the ambulance came to take him away.

But the guy didn't just give up when we said we didn't have one on us; he told us what was wrong. He was willing to make a, small, fuss.

I also enter the non-emergency numbers, for when it's a matter of "my drunken neighbors are singing karaoke at the tops of their lungs" rather than "we just saw a car burst into flames on the freeway in rush-hour traffic". Having made both those calls, I'll not-quite-gladly take the drunken neighbors, any day.

I won't give details in order to preserve privacy, but a couple hours ago I was in a situation where I saw that someone pretty clearly needed emergency help. I wasn't physically present to do any kind of first aid, but having read these posts about the importance of calling 911 instead of fckng around, I grabbed my cell phone and called 911.

By nature I'm in the "not make a fuss" crowd, and it was kind of scary dialing 911 when my mind kept saying "Maybe everything is okay, you're just wasting their time." I wasn't even thinking about these posts at the time but later I realized that doing that mental rehearsal was what got me off my butt and calling.

It turned out that by the time I got through, someone else had called and the situation had been taken care of. But I didn't know that, and the details I did know strongly implied that everything was not okay and it wouldn't be a waste of their time.

I hadn't called 911 ever in my life before this. It had been drummed into me that you don't call 911 unless someone is visibly, obviously dying right there in front of you, like with their arm or leg chopped off, or something, and since that wasn't quite the situation, I was pretty freaked out about calling. But they were really nice to me and took care of things very professionally.

So, let me tell you guys, you won't get in trouble for calling 911 if you have reason to believe medical help is needed. People don't have to be actually dismembered before you call.

Twice to report a car accident that occurred right in front of me.

Once to report a man standing against the median wall of an interstate highway.

I think of it as a reflexive deed.

On one of these occasions - ladders on the M1 heading into London - I was told that yes, they'd already been reported, but thanks anyway. A colleague spoke to me a couple of days later, having apparently driven past and seen me, and told me off for, as a lone female, putting myself at risk of attack. Actual risk of getting attacked, with lots of traffic going by and a 20 ft concrete wall by the road? Approaching zero. Risk of getting hit by a car, admittedly greater than zero, but how could I have lived with myself if I'd heard of a pile-up with fatalities and known I'd not done what I could to prevent it?

On the other hand, I had occasion to call 911 a couple of times on behalf of other people, which made it much easier to overcome that reluctance for more personal emergencies.

Practice (useful, nonetheless): I called when I saw a city bus go by whose electric sign said "please call police". (Never did find out what that was about; 17 years later, I'm still curious.) That was my first call ever, and I was intensely nervous: fifty people would have called before me and my call would be extraneous and I would be wasting their time. But no, they wanted all the details, and nobody else had called first. I called when I saw tree branches smoldering where they were touching electric wires.

I've never been told that I shouldn't have called; when I asked, I was told I made the right decision. When family medical emergencies came up, the 911 operator talked me through what to do while waiting for the ambulance to turn up. It's all been highly reassuring.

I'm not sure about that approach. The general mindset of the training was to learn procedures by rote, making as few decisions as possible, because dithering over whether there might be a spinal injury does not help open the airway. Seems like a single well-practiced technique would be more useful than two methods and a delicate judgment call.

Came out of my house one evening to get in the car and go out, smelled smoke that didn't smell like a fireplace. After a few moments of messing around getting stuff in the car, happened to see the sparks from the broken wire where it was dangling against the pole the car was parked by. Called the fire department. They showed up very very fast.

We got in the car and went out, as planned, because it got the car out of their way.

Since I have only very minimal first aid training, my Designated Role is to call 911. Most recently, I called to report an accident at the Berlin exit on a particular highway in Connecticut, to find it had obviously already been reported-- as soon as the dispatch picked up they asked if I was calling to report the accident at the Berlin exit. But they didn't seem upset to have yet another report-- just informed me that emergency services were on their way. So I'll add to the chorus that, even if you think somebody has already called, call 911 yourself. Can't hurt, might help.

We have new protocols in the UK: if the patient is not breathing, we go straight to chest compressions.

1 Dead, 27 Hurt In 6-Car Crash

Good Samaritan Killed Aiding Stranded Motorist

MESA, Ariz. -- A good Samaritan was killed and 27 other people were hurt after he stopped to help a motorist whose hood had popped open on U.S. 60 in east Mesa, police said.

The incident started when a dark sedan, its hood up, stopped in the road two lanes from the shoulder.

The victim came to his aid. But soon after, five other vehicles struck the Xterra, the victim or one another, said Department of Public Safety Sgt. William Rogers said.

Three people were seriously injured, Rogers said.

...

The good Samaritan was a 61-year-old man from Laveen whose wife witnessed the incident from their sport utility vehicle. He was pronounced dead at the scene by emergency workers, Rogers said. The unidentified man was partially pinned underneath another vehicle.

The downside is that the x-rays discovered he has lung cancer (he's a long time smoker). It's treatable but his long-term survival is questionable.

A factory training safety film, in German. No, you don't have to speak German to ... heh heh ... get the point.

In the interests of safety, here is a totally NSFW video (showing What Not To Do With Fireworks, Part #28574). (NSFW, but, surprisingly, Safe for Teresa.)

And here's a news story:

NY man blows off arm with firecrackers

The Consumer Product Safety Commission's annual warning.

And the reason why such warnings are needed. Annually.

Beginning at 4:42.

Whoever was searching for any ejected children (before they confirmed there weren't any) has my sympathy. That will not have been a pleasant thing to be doing.

What's worse than searching is finding.

Big Slingshots are Dangerous

It's unlikely to have been something that people could carry routinely themselves to self-administer.

As for the drug Tamiasyn itself, it had made it all the way to animal trials, but the company went into Chapter 7 bankruptcy in February of 2010.

If it ever works, it'll be really neat.

Just out of curiosity, what do you guys use the IO drills for?

To get vascular access when we can't get a vein. Used in multi-system trauma and cardiac arrest when the one thing that's worth diamonds and pearls is a way to get fluids and drugs into the body, and finesse and comfort aren't really high priorities.

Also, the UniTam looks more complicated (with a hidden drill bit that advances and retracts), and much harder to sterilize between uses. The EZ-IO looks like a sealed unit, to which a disposable bit is attached, making sterilization relatively simple.

The UniTam gave me a very strong "design school project" feel, a product design based on a list of requirements that ignored a vital part of the product's life-cycle (in this case, what happens to the device after you've saved someones' life, and need to get ready for the next incident?).

I'm glad this has been brought back up to the top of the comments: it's really good to re-read this material. Jim, I don't think I can say often enough how vital what you've done with this series is. I speak as someone who's been in a couple of situations that this information would have been/was vital. The one thing I'd add here: if what you've done doesn't work, and you've followed this advice: it's not your fault. You did what you could. It's not your fault. Praise: no blame.

Also, thanks to Jim for writing this series; and for working as EM. This work saves lives.

Also, I'd like to say that these 10-year old posts are still being read and valued. Thank you for writing them, and for your service as an emergency responder.