Major Medical Training: Moulage and Volunteer Subjects Still Needed

Screen Shot 2013-05-09 at 8.53.43 AMIn preparation for our annual major medical full-team training in May, we need your help.

1. We still need more volunteer role players.  Please pass along the volunteer flyer to your friends, family, neighborhood group and any other community group you think might have interested takers–book clubs, Rotary, Kiwanis, school groups, etc.

2. We need a few team members to help Catrina apply moulage to our willing volunteers.  If you have a knack for make-up and/or simply like the idea of creating gory injuries, please email Caroline Thomas Jacobs and Catrina Christian.

We have a great round of stations planned, including some new twists and look forward to seeing everyone out there!

EMR in Action, ctd.

Today, after pulling an all-nighter for last night’s search, team member Wilma Murray was trying to shake the cobwebs by taking her dog for a walk when she was suddenly called upon to exercise her medical skills:

“We came upon a group of men converged on the sidewalk. They were gathered around a young man who sat (in a rather crumpled position) up against a retaining wall. 

The men were asking him if he was all right and what they could do for him. As I approached, I was told one of the men had seen him sitting there an hour before and when he returned, the young man was still in place. I asked the subject a few questions and getting no response, I took a closer look. His eyeballs were rapidly flickering and he was clearly in distress. I asked one of the men to call 9-1-1, asked another to please hold my dog's leash and explained I was trained in first aid. 

I bent down to the subject's level and introduced myself. My request for consent was met with a vague noise I took to be affirmative. I had no gloves with me (lesson learned), so I had to barehand it. I continued to try to get a response from him and was able, after repeated tries, to get his first and last names. His pulse was 120, respiration 24, forehead cold and clammy but face very hot. But it was the lack of awareness and the rapidly moving eyeballs that most concerned me. 

I saw no visible mechanism of injury or blood and did not conduct a head to toe (another lesson learned) as I instead busied myself with trying to get him comfortable leaning against me while trying to elicit information from him. One of the men handed me a bottle of water and I was able to get the subject to sip a few times. When help arrived, I gave the responders the subject's name, his vitals and told them what I had observed. 

It took six strong men to lift this very thin young man onto a stretcher.  The subject then began to seize and they had to strap him down before loading him into the ambulance. I have no idea if he will be all right, but I can only hope.

Once again, SAR training proved invaluable, but I was made painfully aware of how easy it is to make mistakes or not be thorough enough in a real-life situation. It only encourages me to practice, practice, practice. The good news is that my training kept me calm throughout the whole experience. Thank you SAR!”

EMR In Action

Every year, sometimes, right after EMR is over, Type 2 Team members get called upon to use their training in non-search situations. This is team member Steve Webber's story:

"I was at work and we were taking a co-worker out to lunch for her birthday to the Bravo Italian Bistro in Pleasant Hill. 

The waiter had just seated us when another waiter from the back of the room announced that someone was choking and asked if anyone knew the Heimlich. Without hesitation, I sprung from my seat and approached an elderly man (80+) standing and hunched over trying to discard something from his throat into a napkin his wife was holding. 

The man couldn’t speak or cough; he could only spit into the napkin. I let the couple know that I had first-aid experience and asked if they needed help. Both indicated yes. 

In my head, the conversation went: "Okay Steve this is the real deal … I know this stuff."  I turned to the waiter and said "Call 911."  I watched the man’s mouth and throat very carefully: Was he able to cough? No. I also noticed his lips were turning blue and his cheeks were flushed. 

I reached my left arm across his torso and proceeded to administer five solid blows between his shoulder blades. Nothing. I was preparing for abdominal thrusts and I was thinking, “If this guy goes down, I need to ease him down and then jump into CPR mode,” and then, “I am going to hurt this poor frail old guy.” 

Just as I was reaching around to place my thumb and fist above his navel, he coughed out a piece of meat the size of a shelled peanut.  Thank goodness, no abdominal thrusts needed.  He slowly took in some air, then a little more until he regained normal air intake and facial color. 

The waiter, with the phone to his ear, was asking if EMS was still needed.  The man and wife both indicated to the waiter that he is alright and it is okay to call off the EMS. The man wanted to go to the bathroom, but I convinced him to sit and relax for a few minutes. I didn't want him to be alone in case some other complications came post-choking. 

They both thanked me and I returned to my table. Some patrons and my coworkers congratulated me for a job well done. 

Strangely enough I felt calm and confident. It felt natural. For the rest of the day, I only had several thoughts of the incident. It really never hit me that I may have saved this guy’s life. It felt natural – like “just another day at the office.”  Where did this come from?  This is not like me. Then it hit me:  I have been trained by CoCoSAR; this is what we are trained to do. The quality and repetition of our training gave me the skills and confidence to do this. Another life saved by the Contra Costa County Search and Rescue Team."

Medical Detail: Diablo Trails Challenge

CoCoSAR started off its 2013 medical detail season today with the Diablo Trails Challenge (DTC). Next to the June County Fair , the DTC is the largest event CoCoSAR has to support and is a good way for team members to exercise first-aid skills.

The race consists of a 50K, a half-marathon, a 10K and a 5K run on Mt. Diablo. The 5K, 10K and half-marathon all began and ended at Castle Rock Park in Walnut Creek. The 50K was a point-to-point run beginning at Round Valley Regional Preserve and finishing at Castle Rock Park. All course distances are challenging with steep climbs, descents and creek crossings. 

Start times were 0700 for the 50K, 0900 for the half marathon, 0920 for the 10K and 0940 for the 5K. CoCoSAR teams manned the course before the first started gun went off and until all runners crossed the finish line. The last 50k runner finished in ~10.5 hrs. at approximately 1730 hrs. 

CoCoSAR team members provided medical support (and encouragement) for runners by staffing seven first-aid stations. Members of the bike team also patrolled part of the route to offer aid if needed. Teams treated lots of scrapes, bumps and bruises, handed out many ice packs and took care of a few blisters. Four runners required more advanced, hands-on medical attention.

Congratulations to all runners, with a special shout out to four of our own CoCoSAR team members who competed today: Chris Coelho, John Venturino, Andy Csepely and Alan Mathews.

January Full Team Training: CPR

January’s monthly training was the full-team CPR training, an annual event, during which everyone took the American Red Cross CPR recertification exam. The rest of the time was split between a well-presented overview and demo by Mike McMillan, followed by numerous stations. Team members refreshed (or learned new) skills in infant and adult CPR, choking, using AEDs, and taking vital signs. All of these skills, like most of those learned for SAR, are perishable and need to be practiced often in order to be used with confidence when the need arises.

Alzheimer’s and SAR

The Alzheimer’s Association’s Safe Return® guide describes Alzheimer’s disease as a progressive brain disorder that gradually destroys a person’s memory and ability to learn, reason, make judgments, communicate, and carry out daily activities. As Alzheimer’s progresses, individuals may also experience changes in personality and behavior such as anxiety, suspiciousness or agitation, and delusions or hallucinations.

Alzheimer’s is the most common form of dementia, a group of conditions that gradually destroys brain cells and leads to progressive decline in mental function.
Six out of 10 people with Alzheimer’s will wander. Alzheimer’s disease causes millions of people in the United States to lose their ability to recognize familiar places and faces, or to even remember their names or addresses. They may become disoriented and lost, even in their own neighborhood. They may wander by foot, as well as by car or other form of transportation.
Although common, wandering can be dangerous—if not found within 24 hours, up to half of those who wander risk serious injury or death. Inclement weather, busy roads, and landscape trouble-spots pose a greater risk to the wandering individual.
Brad Dennis, Director for the Klaas Kids Foundation, outlines typical behaviors exhibited by a missing person with Alzheimer’s or dementia:
  • Will usually (89%) be found within one mile of the Point Last Seen (PLS); half found within 0.5 miles. 
  • Will usually be found a short distance from road (50% within 33 yards)
  • May attempt to travel to former residence or favorite place.
  • Will not leave many physical clues.
  • Only 1% will cry-out for help, and only 1% will respond to shouts.
  • Will succumb to the environment (hypothermia, drowning, and dehydration).
  • Will go until stuck; appear to lack the ability to turn around.
  • Will usually be found in a creek or drainage and/or caught in briars/bushes (63%)
  • Leaves own residence or nursing home, possibly with last sighting on a roadway. May cross or depart from roads (67%).
  • Commonly has coexisting medical problems that limit mobility.
  • Has previous history of wandering (72%).
Due to the changes that occur in the brain, people with dementia may have trouble understanding directions and communicating. SAR members should consider the TALK tactics developed by the Alzheimer’s Association when coming in contact with an Alzheimer’s subject.
Take it slow: Approach the person slowly from the front, and speak slowly. Identify yourself and explain why you’ve approached the person.
Ask simple questions: Use questions with one-word answers, and be patient when waiting for a response. Ask one question at a time, allowing plenty of time for response. If necessary, repeat your question using the exact wording.
Limit reality checks: Avoid correcting the person if they answer a question incorrectly. (When checking AxO questions, if they say it’s 1967 and they are in Michigan, accept it).
Keep eye contact: Eye contact and good nonverbal communication will help put the person at ease. Instead of speaking, try non-verbal communication. Prompting with action works well.
The Alzheimer’s Association has developed the Safe Return® program, a 24-hour nationwide identification, support, and enrollment program. The organization works with law enforcement to quickly identify and return to safety a person with Alzheimer’s or a related dementia who has wandered, locally or far from home. Visit the Alzheimer’s Association website for additional information on the disease.