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The Responder

Dear Emergency First Response Instructor,

Emergency First Response is pleased to bring you the first quarter 2013 edition of The Responder. By scrolling down and clicking on the links below, you'll find the latest information on Emergency First Response programs.

Thanks for reading and please remember that answers to your questions are only a click away via email at Emergency First Response.

How Long is Long Enough?

Howard Snitzer doesn't remember going to the grocery store. He suffered a massive heart attack when he was on his way there and collapsed in the street. With a population of only 800, Snitzer's chances of survival in the town of Goodhue, Minnesota, USA were slim, especially when you consider the odds. Some estimates indicate that only five percent of people suffering from cardiac arrest on US streets are resuscitated.

But Snitzer's story isn't just one of survival. His story is also one of remarkable rescue efforts. He was kept alive by dozens by passers-by, volunteer emergency responders and medical personnel. All together, 25 people took turns performing CPR, keeping him alive for an incredible hour and a half until his heartbeat could be restored to normal. Today, he is alive and well, with no residual effects.

One of the most difficult decisions for any Emergency First Responder is when to discontinue CPR. Course participants learn to to stop CPR when the rescuer is too exhausted to continue, when the rescuer's own life is endangered or when the rescuer is relieved by a higher medical authority. If there are multiple rescuers, no other lives are threatened and professional medical assistance is far away, CPR may continue for an hour or more. So how do rescuers know when to quit?

In September 2012, The New York Times reported on a recent study that found hospital patients have a better chance of surviving when CPR is continued just nine minutes longer than average. The study, conducted in hundreds of hospitals, showed that some doctors were giving up too soon.

During cardiac arrest, blood stops flowing to the brain and it can only survive for another five or six minutes. Conventional medical thinking has held that prolonged CPR is usually futile since survivors typically suffer permanent brain damage. The study, however, found that hospital patients who received prolonged CPR and survived had no more adverse effects than those who were quickly resuscitated. Prolonged CPR can be exhausting, but the payoff can be extraordinary.

Consider Brandon Hopper of Kent, Washington, USA, a 19-year-old with a congenital heart defect who collapsed in the middle of the woods.

“We found some elk and took off running after them to see if we can get some pictures and that's when it happened," Hopper told local media.

He wasn't breathing and there was no mobile phone reception. While one buddy ran to call 911, the other started CPR. Local first responders arrived and stepped in, keeping up compressions while waiting for the medical airlift.

Working as a team to stabilize him for transport, Hopper's buddies, the local first responders, the airlift nurse and the pilot took turns administering CPR in the back of the ambulance in the middle of the woods – for 86 minutes.

"We almost stopped the resuscitation three or four times," the airlift nurse said. “But no one was willing to give up."

After spending three weeks in the hospital and getting a new defibrillator, Hooper works two jobs and lives a normal life.

How long is long enough? There isn't a general rule and doctors from the study reported in The New York Times did say that not every patient would benefit from prolonged CPR. But, for Emergency First Responders, as long as the rescuers are able and not in danger, it's better to continue than to stop. Just ask Howard Snitzer and Brandon Hopper.

Sources:

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Online First Aid and CPR Courses

Several training providers are now offering first aid and CPR courses that are entirely online and have no face-to-face interaction with, or skill review by, an authorized first aid instructor. These online-only courses don't meet first aid and CPR training requirements for dive courses such as PADI Rescue Diver or PADI Divemaster. But, that doesn't mean you should turn these people away. A poor approach to servicing the needs of these customers is to simply tell them that their course is not recognized and they will have to start over completely and take your full EFR course. While that may be the case if individuals require a first aid/CPR course completion to meet regulatory requirements, you can take a more flexible approach for the lay person with no such need.

Aside from having customers complete an entire EFR Primary and Secondary Care Course, you can offer an EFR Refresher Course. This option shows that you recognize their previous training (even if it was an online course) and helps you ensure that all EFR Primary and Secondary Care course performance requirements are met.

The only EFR Refresher Course prerequisite is that individuals have completed some kind of first aid and CPR course in the past. As outlined in the EFR Primary and Secondary Care Course Instructor Guide, you make a note or take a copy of that previous course completion certificate, issue a set of participant materials for review and conduct the skill development session from the EFR Primary and Secondary Care Course in addition to administering the Final Exam. Simply remediate any shortcomings until participants meet performance requirements, then issue an EFR Primary and Secondary Care Course Completion Card.

With this flexible approach, you have likely secured a repeat customer versus having turned one away. If you have any questions, please contact your EFR Regional Headquarters.

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Did You Know? Chest Compression Devices

Emergency medical personnel, such as the San Francisco Fire Department, have used automated CPR devices since as early as 2003. These automated CPR machines, intended for use by trained professional health care providers in cases of sudden cardiac arrest, provide uninterrupted compressions while the device is operating. Using these devices provides consistent, effective compressions – something that is difficult to achieve during manual CPR as rescuers tire.

Two devices are currently on the market. The LUCAS, made by Jolife, and the Autopulse, made by Zoll (formerly Revivant). Both use battery power to achieve compressions.

The LUCAS2 (Lund University Cardiac Arrest System) uses an arch or “U” shaped design with a single piston that is located over the patient's chest. The arch, which houses the battery and controls, attaches to a small plate under the patient's back. The piston compresses the chest when the device is activated and costs approximately $15,000 US.

The Autopulse has a backboard containing the battery and controls, along with a band that encircles the patient and constricts the entire chest. Rescuers need to replace the band after each rescue (approximately $125 US) while the device itself runs approximately $4250 US.

Because these two machines use different methods of compression, opinions differ as to which is more effective. However, both devices allow for hands-free compressions, allowing emergency medical staff to concentrate on other life-saving procedures during a rescue.

Will automated CPR eventually supplant manual CPR for lay rescuers such as Emergency First Response providers? Based on current technology, not in the foreseeable future. Unlike Automated Electronic Defibrillators (AED), which are now common in public settings, automated CPR machines are large, expensive and require significant training to use. Regardless, even if CPR machines became the default, manual CPR would still be necessary if an automated device malfunctioned or if no machine was available.

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Translated EFR Materials - Available Languages

In addition to English, these Emergency First Response course materials are now available in the following languages:

Primary and Secondary Care Final Exams

  • Dutch (product no. 71825DU)
  • French (product no. 71825F)
  • German (product no. 71825G)
  • Italian (product no. 71825I)
  • Spanish (product no. 71825S)

Primary and Secondary Care Participant Manual

  • Dutch (product no. 70370DU)
  • French (product no. 70370F)
  • German (product no. 70370G)
  • Italian (product no. 70370I)
  • Spanish (product no. 70370S)

Primary and Secondary Care Instructor Guide

  • Dutch (product no. 67040DU)
  • French (product no. 67040F)
  • German (product no. 67040G)
  • Italian (product no. 67040I)
  • Spanish (product no. 67040S)

Primary and Secondary Care Video on DVD

  • French (product nos. 70983E/F/S)
  • Spanish (product nos. 70983E/F/S)

Care at a Glance

  • Dutch (product no. 50037DU)
  • French (product no. 50037F)
  • German (product no. 50037G)
  • Italian (product no. 50037I)
  • Spanish (product no. 50037S)
  • Dutch, German and Italian (product nos. 70983 DU/G/I)

EFR Instructor Trainer Guide

  • French (product no. 67010F)
  • Portuguese (product no. 67010P)
  • Spanish (product no. 67010S)

EFR Instructor Trainer Manual with Binder

  • French (product no. 70093F)
  • Spanish (product no. 70093S)

EFR Instructor Manual with Binder

  • Canadian (product no. 70149CA)
  • Portuguese (product no. 70149P)
  • Spanish (product no. 70149S)

EFR Instructor Manual with Binder plus Primary & Secondary Care and Care for Children Guides

  • French (product no. 70150F)
  • Portuguese (product no. 70150P)
  • Spanish (product no. 70150S)

EFR Care for Children Participant Manuals

  • French (product no. 70179F)
  • Spanish (product no. 70179S)

EFR Care for Children Video on DVD

  • Portuguese (product no. 70871P)
  • Spanish (product no. 70871S)

EFR Care for Children Instructor Guide

  • French (product no. 70190F)
  • Spanish (product no. 70995S)

EFR CPR & AED Participant Manual

  • Portuguese (product no. 70185P)
  • Spanish (product no. 70185S)

EFR CPR & AED Video on DVD

  • Portuguese (product no. 70995P)
  • Spanish (product no. 70995S)

EFR CPR & AED Instructor Guide

  • Portuguese (product no. 79215P)

EFR Instructor Course Lesson Guides CD-ROM

  • English/French/Spanish (product nos. 70988E/F/S)
  • Portuguese (product no. 70988P)

Contact your EFR Regional Headquarters to order your Emergency First Response materials today.

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Responders in Action – Emergency Responder Jeremy Harris

Emergency First Responder Jeremy Harris was returning from Las Vegas after the Thanksgiving holiday when he came across an injured motorcyclist on a major highway. When he arrived there was a young man bleeding on the ground, surrounded by people but no emergency services.

Harris got his first aid kit, approached the scene and ascertained if bystanders had first aid or CPR experience. Then, he announced he was an Emergency Responder, gained consent to treat the patient and began his assessment. Harris continued his assessment and enlisted bystander support until paramedics arrived about 15 minutes later. They confirmed his injury assessment of a medium head laceration, concussion, possible broken leg, dislocated shoulder and that he would live.

In an email to his EFR Instructor, Kory Mikesell, Harris said, “I learned advanced first aid some time ago while serving as a Marine and training kicked in. It was your class, however, that served as one of the best refreshers I have had. The tip I learned from your class of announcing myself as an Emergency Responder worked like a charm. I immediately gained command presence and was able to effectively use those around me to assist. I just wanted to give you the feedback and let you know that I appreciate what you have taught.”

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© Emergency First Response 2013.

Emergency First Response Corp.
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Rancho Santa Margarita
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Web: http://www.emergencyfirstresponse.com