Question and Answer Session with a Pro

As we travel around the globe, discussing First Response Training International’s new and innovative CPR and first aid programs, we get a chance to hear everyone’s thoughts and concerns. For the most part, lay rescuers agree that this training is necessary. A hundred percent of those asked would like to ease another’s pain or save a life if the opportunity arises. But, there is often hesitation in their responses. When questioned why, they ask “What if I cause further injury? What if I don’t save their life?” These are very real and legitimate concerns for someone who does not perform CPR or first aid on a daily basis, so we decided to go to a pro

Across the globe, there are professionals that perform these lifesaving measures every day, and although their training is different and the tools they have available to them are great, there is also a lot of commonality.

We were fortunate enough to catch up with Rebel Coombes, a North Carolina Paramedic and TDI Diver, to have him answer some of the most common questions and concerns we hear. 

Q – Rebel, let’s start with what you as a professional consider to be a lay rescuer. This is not a common global term, so I’m hoping to define it a little better for the sake of this article.

A- I see a lay provider as anyone who is not an Emergency Medical provider.  

Q – Over the years, lay rescuer training has gone back and forth and so has the message going out to the public regarding CPR only vs. CPR and ventilation. Can you comment on this with anything you’ve witnessed?

A- I have seen a lot of research, the most recent of which points to the residual volume of the lungs. As divers, we know we have tidal volume and residual air left in our lungs after exhalation. This is oxygenated air that allows cellular respiration to occur, as long as the blood is flowing, whether spontaneously from the heart or from chest compressions.

Q – I think one of the single biggest concerns I’ve heard is the risk of breaking bones while doing CPR. This runs a close second to “I’m not doing mouth-to-mouth on a stranger.” From what I know, when CPR is done correctly, it’s common for there to be fractures or breaks. Is this correct? 

A- It is true that ribs and the sternum can be broken. This is painful, but if they do not get the heart to push blood around, the victim will not live. There is a good chance of bringing someone back to a full life and those injuries will heal.

Q – You’ve already answered the question about breaking bones during CPR, but could a lay rescuer cause other injuries?

A- The chance that we will not be able to revive someone with a neurologically intact brain often revolves around the CPR done before we get there. The lay rescuer is a vital link in survival and doing nothing can have tragic consequences.

Q – What are your thoughts on the best technique for dislodging something from a choking infant, child, or adult? 

A- There is actually a difference. For infants, five back blow and five chest thrusts is the best method. For adults and children, the abdominal thrust is the best method. It is important to remember not to stick your fingers anywhere that teeth can bite you. The people who are choking are panicking. They are fighting for their life. 

Q – Here’s a big one. I’ve heard many misconceptions on how incidents look. Maybe we watch too much TV or movies. How do you recognize real trouble, or when to act? 

A- The best way I can describe this is generally you will know when someone is in real trouble. The look of panic in their eyes, the color changes in their lips and face. If the patient can talk, you are ahead of the game. If they are talking, try to calm them and let them know we are on the way. The average response time is less than 14 minutes, but that seems like an eternity while you are waiting for us.

Q – When people take basic first aid courses, a lot is covered in a relatively short amount of time. This means they may not have learned how to deal with every situation they can assist with. What is the likelihood of “helping over hurting?”

A- As a general rule, do not do anything you have not been instructed to do. If you do not have the training, it is possible to harm them. The dispatcher can instruct you over the phone on basic first aid, like holding pressure on a wound or stopping the bleeding. They will even provide assistance on CPR, which again, is a vital link in the chain of survival.

Q – How often have you seen lay rescuers provide help that was critical before you arrived on a scene?

A- MANY, MANY times. We have been fortunate to have laypersons from law enforcement to everyday people who were there when needed. The family often does CPR with the dispatcher’s advice before our arrival.  Circulation is key to survival.

Q – Have you seen the law support lay rescuers….or even professionals such as yourself?

A- I have, from off duty EMS and fire personnel to people responding to one of the apps on their phone telling them a cardiac arrest call is going on. 

Q – As we said previously, basic first aid courses can only cover so much, and everybody wants to do their best, but what types of first aid attempts have you seen on scenes that were problematic or unhelpful?

A- There have been a few times we have arrived on scene and seen someone placed on a non-rebreather mask on 2 liters per minute of oxygen. These suffocate the victim. With a mask, you need at least 6 liters per minute. 

Q – Do you think re-certs and refreshers help prevent these types of situations? 

A- They could if the responder understands the equipment and education behind the tool.  Refreshers may help people remember what setting goes with which tool.

Well Rebel, I want to thank you for your time and the highly informative responses. Non-professionals have a lot of questions and concerns, and it is very helpful when someone like yourself can relieve some of those concerns so that when the time comes, they can respond.

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