EMR Class Celebration

Last night EMR students got together for a social event celebrating the return of their Mondays and alternating Tuesdays and Thursdays. No more bucking the traffic or stressing about getting to and attending EMR class. Mondays and alternating Tuesdays and Thursdays are theirs – all theirs – once again!

All SAR members were invited to celebrate completion of EMR 2013 at the Fuddruckers in Willows Shopping Center.  Proctors, students, or just because … it was for the entire team! 

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."

Wrapping up another year of EMR

It's been a long haul. Last night, first-time EMR students and recerts took the written exam and final skills testing to complete their 2013 certification and officially become/retain Type 2 status.

The Command Staff extends their deep appreciation to those proctors and instructors who continue to give hundreds of hours in support of the students each year along with a special thanks to our Medical Squad for the outstanding logistical support. The class would not have been possible without all of you.

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.

SAR Word of the Day

101352Sphyg·mo·ma·nom·e·ter
noun /ˌsfigmōməˈnämitər/ 
sphygmomanometers, plural

An instrument for measuring blood pressure, typically consisting of an inflatable rubber cuff that is applied to the arm and connected to a column of mercury next to a graduated scale, enabling the determination of systolic and diastolic blood pressure by increasing and gradually releasing the pressure in the cuff.

 

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.

Taking Vitals

When it comes to one facet of the “rescue” half of our SAR duties, acting as a medical responder can be one of the toughest aspects of the job. Learning the EMR skills is one thing, but keeping those skills fresh and in practice is another. To help with that, some of the more experienced members of the team (who also have EMT, nursing or other medical credentials) have offered some tips they use for a critical basic skill: taking vital signs.

The following are collected from Jeremiah Dees, Jim Gay, Chris Nichols, Catrina Christian, Frank Moschetti, Tom Bates, Alan Mathews and Dawn Curran:

Respirations
• To count breaths, observe the rise and fall of belly/chest movement.
• Ask a teammate to count the respirations (by observation) while you take other vitals.
• Misdirect the subject so he doesn’t alter his breathing by telling him you are taking his pulse. Fold the subject’s arm back to his chest, holding it there while taking the pulse, with your watch facing you so you can count. This can then segue into counting the respirations as you feel your arm rise and fall.
• Note not only the number of respirations (normal is 12 to 20), but the quality: normal/quiet, gasping, shallow, labored, wheezing, etc.

Radial Pulse
• Take the arm closest to you. Slide your first two or three fingers over the top of the radial artery (below the thumb pad on the inside of the wrist, just below the bend). Count the beats for 15 seconds and multiply by four.
• Some prefer using only the fingertips; others say using more of the pads of your fingers can help with finding the pulse as you cover more surface area. Never use your thumb as it contains a radial pulse and you may confuse your own with the patient’s. Practice to see what works best for you.
• Reaching your fingers around from the top of the wrist and curling the fingers toward the underside can be a more comforting way to take a pulse than grabbing the wrist. This also works well when holding the arm to the chest to count respirations.
• If you can’t find the pulse at first, adjust the pressure. Press harder and then ease up. Some pulses are deeper than others.
• In certain cases, particularly trauma events, checking the pulse for bilateral consistency (both arms) is advisable.

Blood Pressure – Auscultation
• It can help to ask the subject what he thinks his blood pressure is. That can be a useful starting point. Pump up the cuff about 15 to 20 points above the expected systolic (first) number. You should not be able to hear the pulse.
• When putting on the blood pressure cuff, locate the “artery” notation and place that just above the interior side of the elbow over the brachial pulse. Be sure the cuff is put on snugly.
• Place the stethoscope diaphragm on the inside of the elbow at the bend and below the cuff.
• Position the subject’s arm so that it is fully extended. One field technique is to secure their hand in your armpit in order to stabilize the arm extension.
• Do not inflate the cuff until you are ready to take the reading. Make sure the earpieces are in your ears (angled toward your nose), the diaphragm is properly placed (test for sound first), and the cuff is snug before you begin inflation.
• Close the thumb valve on the bulb (right) before inflating, but not so tightly that you can’t loosen it with just a twist of your thumb and forefinger.
• If you hear the Velcro begin to pull apart as you inflate, recheck the cuff; you may have it on backwards.
• Don’t partially inflate and then deflate the cuff and try to re-inflate it. If you begin to deflate it, go all the way, and if you need to start again, start from the beginning.
• Open the thumb valve on the bulb (left) in order to slowly and smoothly deflate the cuff in one continuous process. Pay attention and note the number when you first begin to hear the pulse (systolic) and again when the sound of the pulse fades completely (diastolic).
• Note the subject’s position at the time of the reading: sitting, standing or lying down.
• Do not rely on any visual needle “bounce” as an accurate reading indicator. Generally, the needle may “bounce” during the period the pulse is strongest, but does not react to the first pulse sounds and ends before the last. Don’t be afraid to ask those around you to be quiet so you can listen for the beats.