Beginner First Aid

8 basic life saving skills everyone should know

Good article, but it could have been a lot shorter y simply stating "Get trained in first aid and CPR." I really think this should be a requirement for high school graduation.

CPR is useful, but not terribly effective; I think First Aid saves more people overall.

The best figure I have heard is about a 30% save rate. A lot depends upon your definition of "success." When it comes to saves, I am 0 for 2, but I comfortable that at least I was able to make a positive effort, and I'll bet the relatives appreciated that,as well. I am in favor of extensive training in both CPR and at least rudimentary first aid.

We had an incident some years ago where a hunter shot himself in the thigh. He bled to death before rescue people arrived on scene, finding that the only first aid his companions had rendered was to loosen his belt (!)

Recently I read about a cop that shot himself in the leg with his Glock while in his patrol car. Apparently he had been fiddling with his firearm for whatever reason. When he attempted to re-holster it he had an ND and was struck in the leg. Despite being able to radio it in instantly he died of blood loss before help could arrive. My guess is that he hit the femoral. It really goes to show that if you carry a gun you probably should also care a TQ and know how to use it.

I have a FAK with me a lot of the time, but not all of the time. I suppose I really should pack a kit in my truck, but in my own defense I do so when I'm traveling out of town.

Another note: Most of the time I do carry a gun, so I should take my own advice and add a TQ to my vehicle kit. I don't anticipate carrying one on my person at all times, though.

Triangle bandage can make a pretty good TQ.

Getting a high femoral/inguinal hit is pretty much difficult to stop, period. A TQ won't go there, and if you're trying to apply your own pressure, you'll probably not succeed.

I have a TQ in my range bag after my buddy nearly shot his leg doing holster draws (PSA: if you own a SIG, de-cock it before re-holstering).

CPR success rates of 30% are, IIRC, in-hospital only. Closer to 5-10% traditionally in the street. Highly dependent on time to CPR and first shock. Some of the "push only" CPR rates look better, but time will tell.

Beginner first aid:
Air goes in and out, blood goes round and round. Change either and you're in trouble.

the State of Florida is a shall issue state, and I'm one of the first 5000 carry permits... I carry my fullsize pistol off body, and it is not charged as it doesn't ride in a dedicated holster... but in addition, the trauma supplies ride in the outside pocket.... 4" Israeli compression bandage, CAT tourniquet, QuickClot, Kerlix, petroleum gauze, duct tape, irrigation syringe, gloves and cleanup towelette

I notice alot of pooh poohing CPR success rates (defn when the patient is actually discharged from the hospital following CPR). Seattle success rate is greater than 50%. It appears to be dependent on a chain of factors most of which can be taught, but in particular minimizing interruptions in chest compression.

We invite other locations to take a stab at exceeding our mark...

CPR works. A lot. Even most of the time! ��

The 30% figure is in my head from a project in Seattle in the early 80's where there was a push to qualify everyone in basic CPR - undoubtedly that represents a very best case scenario.

On the other hand,my CERT trainer, a very experienced fire captain, stated that he witnessed about 300 cases where CPR was administered; in his opinion, only about seven were successful; i.e., the patient walked out of the hospital after treatment. That is probably more realistic.

Current CERT training for a mass casualty situation is to dispense with CPR - more lives will be saved if the effort is devoted to other victims. But that is a different situation from the more normal situation where help is available.

Elapsed time does seem to be critical in achieving a good outcome, which is why CPR training is desirable and recommended

That mirrors my experience, about 10% success rate (roughly 75 codes worked).

Lono, you have a source to back up that figure?

I heard that O'Hare Airport in Chicago used to be heart attack central in the 1980s. It was one of the world's busiest airports, with plenty of overweight, under-exercised, stressed-to-the-brink businessmen traveling through. Supposedly they had close to 1,000 heart attacks per year. The airport was able to reduce the number of deaths substantially by installing AED throughout the airport and by training the staff in the use of AED and CPR.

Can anyone confirm/elaborate on this?

Reminds me of a Saturday night live skit.

Why sure - http://www.kingcounty.gov/healthservices/health/news/2013/13090401.aspx

The 2013 figure is a 57% survival rate in King County. The 2013 EMS Annual Report gives a good indication of how this is done.

Thanks, that is a really interesting report. One wonders - are seismographs picking up the compressions resulting from all that training? We thought it was just football fans.....

CPR success rates are climbing pretty dramatically in King County. We have a lot of trained civilians that keep the patient going until we show up and get the patient to the hospital. Additionally, we've changed protocols which has increased survival rates. There's constant research into the protocols and we're seeing positive responses.

That said, without the quick intervention of a Aid Crew and Medic crew (Advanced Cardiac Life Support) and a good, nearby ER, CPR only prolongs the scenario but doesn't effect the outcome. CPR is only a stopgap to keep oxygen flowing to the heart and brain.

First aid is, in my opinion, far more valuable in a remote situation like backpacking or survival scenario. CPR in the wilderness doesn't save the patient like in the movies. First Aid does!

You simply have too much time between the incident and arrival time in a hospital for CPR to work effectively. Without reasonably competent first aid, a lot of victims simply bleed out who would otherwise survive.

As a former EMT I must disagree with the use of "pressure points" .I tried to use the upper arm point. Twice. Didn't work. Talked to 2 paramedics who had more street experience than I did. (One of them had 7 yrs. on the job) Their experience was the same as mine. In both cases paras showed up and stopped bleeding w/hemostats, fortunately, as basic EMT at the time we were not authorized tourniquets. This was back in 1980's.

My experience with CPR as an EMT-B over 10 or so years is 2 saves out of around 20 cardiac arrests that were run as BLS calls. Saves in this case defined as went home. The biggest determining factor for my experience was rapid notification of EMS, a lot of these calls were folks who had been down for a while and found unresponsive. Both of the saves were witnessed attacks with quick notification and transport to local definitive care. In my case that local definitive care is going away as hospitals close or beds are absorbed into larger, more distant facilities, we used to have a hospital in town and one next door giving us less than 5 minute transport times, now we' re looking at up to 15 minutes, a big difference. More rural areas of the state have much longer transport times and this is a factor, perhaps alleviated by more ALS or ALS intercept.

Pressure points have worked for me once, with a hand through a window and arterial bleed. I compressed the brachial against the bone and the flow decreased dramatically, although this poor guy probably still has my fingerprints on his arm 'cause I was afraid it wasn't going to keep working and squeezed for all I was worth.

I still carry a blowout kit in my bag and have one in reach in each vehicle, that way I can have at least a chance with the rare but quickly fatal big bleeds and punctures even on myself. I don't know about getting a TQ around my own leg while sitting in a car, for example, but at least the materials are there and I won't be trying to improvise and waste time looking for something to use.

I keep a large-ish trauma kit in my range bag, a small one in each car, and a Patrol Officer's Pocket Trauma Kit upgraded with some Combat Gauze in my laptop bag. The POPTK is so small and cheap there's no excuse to not carry one.

I like the AMK Trauma Kit The addition of QuikClot significantly helps stem serious bleeders and if you're on your own stopping blood loss before you pass out from blood loss should be fairly high on your priority list.

Thanks Lono.

I know King Co. and Miami-Dade Co. are big in the EMS fields. Amazing to see those results. I notice though that there's a large community push to CPR and something like 2800 AED's out in the area. Undoubtedly this contributes (and probably reinforces the ARC recommendations on AED's) . I don't know how feasible it is in other parts of the country, but nonetheless, great results.

Yeah, it definitely takes a village, or a commitment to ALS and AEDs, or the whole chain of efforts in the Medic One documents. Yet for all the AEDs King County is a pretty large place, so I reckon a similar effort in Alabama or LA should yield similar results. The effort is worthwhile I think - if you start CPR knowing that another responder will be running for an AED, and ALS or BLS are coming within 4-8 minutes on a good day, and you have a better than even shot at resuscitating this person and their walking out of the hospital alive, you change your attitude and no longer think of the 5 or 10 percent long shots to survival. That's especially important for saving family members lives, when I don't want the long odds in the back of my mind.

I prefer Combat Gauze, and there's no tourniquet. It comes with the components to make a pressure bandage, which is slower than using a pre-made one.

I have a question to the PMs/first responders. Guy is down with an MI, CPR is performed, he gets to hospital and is brought back to life. What is the average life expectancy after that - if anyone knows and/or has tracked that stat? Just wondering.

The survival rate with only CPR is about 12% and 60% with CPR and AED in my area. Don't know the survival numbers starting from the ER.

Too many variables.

Why did his heart stop? How long without O2/CPR? Any reperfusion injuries? Did he need to get a stent (or a bypass, or some other major intervention) to keep from repeating? How's his cardiac function afterwards? Is he compliant with medical treatment for the next 40 years? How old was he to start with?

Best case scenario, a young person, in good physical condition, with a random arrythmia, and early CPR, has a chance for a normal life span. worst case, some obese guy with a bad heart and cholesterol, smokes, needs a triple bypass, could be dead 5 years later. The big question is, are those "bonus" years?

Thanks for the answers. Just something that popped into my head. And MD, I hear ya re" best/worst cases.

Without CPR the Success Rate would be 0%

Bruce, you go right to the point! We may not save every life, but we do save Some lives.

Yes; its better than 0% and less than 100%