[Didn't Expect to Come Back, but...] First Save

Cory

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So, I didn't expect to return to this forum, but after my latest experience I have learned some things, and I wanted to come back because I want to have this forum as a resource. So I want to apologize to every member of this forum now for what has happened in the past, and hopefully you can accept my apology.

First Save:

So, as some of you know, I worked as a lifeguard at a pool this summer. (yes, I'm only a wannabe EMT/medic) And it was a slow summer for the most part. I felt more like a cop than someone guarding any lives. I treated a nosebleed, and two bee stings. But then on my second last day of the year I had a real situation. [I have written this so many times from incident reports to school essays, that I really am just going to give a cut and dry explanation.)

We had ten day camps come to the pool, making somewhere around 90-120 kids in the pool at any given time of the day. It was madness from the minute we opened.

Anyway, at around 2:20 I happened to look up from my area and notice a crowd forming around the steps at the three foot entrance. I spotted the lifeguard from that area in the crowd, and seconds later I saw her sprint off inside. I knew immediately she was going to call 911. So, frantically I signaled my senior lifeguard, and we cleared the pool. I took off for the crowd. My expectation was a broken leg or arm (a common topic regarding the safety risks of the steps)

When I got there, I realized the situation was much worse. On my approach I saw a boy and a woman at the middle of the crowd. There was a three year old boy laying unconscious just outside the pool. His eyes were rolled back, and vomit was spewing from him. So, noticing the vomit, I immediately grabbed a CPR mask off of one of the lifeguards chairs. There was a woman giving him chest compressions, she was not a lifeguard but I ignored that and continued.

So when I got there, I was berrated with insults and jeers from the crowd. I walked up to the two, got down just in front of the boy's head, and immediately told the woman who I was and that she needed to continue chest compressions (he most likely had a pulse, but he had gone unconscious under water[still wet, wet drag lines coming from the waters edge] so I deduced that he was in essence a choking victim, which would require chest compressions anyway)

Sparing many details that you all would most likely already know (traumatc things for me, but most of you have all seen it before) we did five sets on him, each time watching him fade in and then back out, until on the fifth set, instead of making a struggling noise and clenching his teeth, he just started crying. So we rolled him into a recovery position.

Now, being it my first time, and a bunch of lifeguards at a pool that has never in it's 50 years having had a bad emergency situation (or even transport), a lot of emtional stuff came after all of this. But basically, after we rolled him, I looked up to see tw EMT's three cops and the chief of police and the fire chief all staring back at me. The boy was released hours later with no complications.

It was an elightening, ensuring and yet disturbing experience for me. It both confirmed and made me question my choice of EMS. But later I realized that this had in fact definately confrimed it. So I am taking an explorers course at a local hospital just for a starting place ( I still don't know if EMS is an option, and even if i is it will most likely be the hospital's ambulance service)

Now, I figure a lot of those details about how the procedure went and how his body reacted and what I was feeling wouldn't be as interesting to a bunch of EMTs as it would be to my English teacher or a jaded pool manager. But I do have very detailed stroies re-telling it written if you want to read them (let me know, don't really expect anyone to, but you're more than welcome to PM me about it) But keep in mind this was a VERY cut and dry telling.


-Cory-
 

medic417

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Congrats on your efforts. If you decide on EMS be advised if you claim saves you must accept blame for the failures. Best advise is do your best for every patient and move on.
 

Cory

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Yeah, we did a lot wrong in all reality, it was a miracle he had no broken ribs or depleted alveoli from the force of the CPR we were giving to him. Basically my uncle (the fire chief) told me to just not worry about the quality of our care because the boy survived and was 100% in just a few hours, but I still do worry and I took some time to critique everything we did (mainly the fact that a bystander initiated CPR while a lifeguard left, but I couldn't have helped that)
 

exodus

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So exactly why was CPR initiated? Where was it indicated? Did the boy have a pulse? Did the AED shock him? Do you have ANY idea what CPR is for? Do you know what it does... I'm sorry, but you may have hurt the boy more than helped. He's CHOKING. Abdominal thrusts help that, not chest compressions...
 

Cory

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So exactly why was CPR initiated? Where was it indicated? Did the boy have a pulse? Did the AED shock him? Do you have ANY idea what CPR is for? Do you know what it does... I'm sorry, but you may have hurt the boy more than helped. He's CHOKING. Abdominal thrusts help that, not chest compressions...
He was an unconscious choking victim, which requires chest compressions. Plus, he was not breathing, so rescue breathing was a must. The AED was not necesarry, the pool is next door to the city FD. The woman said she didn't "feel" a pulse, but my guess is it was faint and she couldn't tell (she apparently put her ear on his chest to get a pulse)

Yes, I am fully aware what CPR is for. And again, the boy was released and perfectly okay. I got a letter from the Red Cross, the FD, and the hospital all confirming my actions to be correct, and a successful resusitation.

I am going to just guess that you missed the part about him being unconscious, but hopefully you weren't suggesting I give abdominal thrusts to an unconscious victim.
 

Akulahawk

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If you do decide to continue to educate yourself in EMS, do your best to learn what is being taught to you. Do your best for every patient, know you've done your best, and move on. You must learn to accept both sides of things: the glory for the saves and the blame for the failures. The biggest failure, however, is to not learn from your mistakes.

Oh, and stick around! The people here might occasionally get a little grumpy about stuff, but if you're willing to keep your eyes and ears (and mind) open to things, you can learn a lot.
 

ffemt8978

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So exactly why was CPR initiated? Where was it indicated? Did the boy have a pulse? Did the AED shock him? Do you have ANY idea what CPR is for? Do you know what it does... I'm sorry, but you may have hurt the boy more than helped. He's CHOKING. Abdominal thrusts help that, not chest compressions...
Actually, it depends upon to what level of CPR a person is trained to. While I fully expect a lifeguard to be trained to the Healthcare Provider level, I am not sure that it is required in ALL areas.

The Healthcare provider level is what teaches the abdominal thrusts for an unresponsive victim, along with things like pulse checks and AED application. The lay rescuer course teaches CPR only for an unresponsive choking victim, and from the sounds of the original post, CPR was initiated by a bystander prior to his arrival.
 

Lifeguards For Life

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So exactly why was CPR initiated? Where was it indicated? Did the boy have a pulse? Did the AED shock him? Do you have ANY idea what CPR is for? Do you know what it does... I'm sorry, but you may have hurt the boy more than helped. He's CHOKING. Abdominal thrusts help that, not chest compressions...
that was just being discussed elsewhere. i had thought the same thing. this story doesnt seem to flow quite right
 

Lifeguards For Life

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yeah on a second read this story doesnt flow at all
1. you state you happened to look up and notice this event. how do you miss any submersion or emergency where the water is 3 feet deep and clear

2.If the pt was vomiting why was there no attempt to clear the airway or even assess to see if the pt. was breathing or not?

3.why do you think you were greeted with insults and jeers from the crowd?

4. you state the pt. most likely had a pulse, shouldnt you find out if the pt. has a pulse or not?

5.from what parameters do you gather that the pt. was indeed a choking victim? did you ask the crowd of people that obviously wittnessed said event before you?

6. EMt's showed up on scene and just watched?
 

Cory

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that was just being discussed elsewhere. i had thought the same thing. this story doesnt seem to flow quite right
I don't see why you say that. If you are implying that it did not happen then I am sorry, but it did.

Actually, it depends upon to what level of CPR a person is trained to. While I fully expect a lifeguard to be trained to the Healthcare Provider level, I am not sure that it is required in ALL areas.

The Healthcare provider level is what teaches the abdominal thrusts for an unresponsive victim, along with things like pulse checks and AED application. The lay rescuer course teaches CPR only for an unresponsive choking victim, and from the sounds of the original post, CPR was initiated by a bystander prior to his arrival.
Well, my certification says CPR/AED professional, but it is a Red Cross course. Although we were taught to give compressionas to an unconscious choking victim.

Again, I am trained in AED, but we are next door to the FD. And I never checked for a pulse, what the woman told me when I got to her was 1.) she had cleared his airway, attempted to give mouth to mouth but his chest didn't rise, and 2.) she felt for a pulse (later learned she out her ear to his head) heard nothing and immediately went into chest compressions.

I would have told her to stop, but again it was clear that he had been dragged out of the pool already unresponsive. So, again, in essence he was a choking vinctim. Following my training we continued CPR. I have no doubt in my mind that the rescue breathing is what saved him ultimately.

She was the one who initiated CPR before I even knew anything had happened. She was a day camp supervisor, and trained in basic CPR (she didn't even know what a CPR mask was) She had apparently insisted the lifeguard call 911 while she began CPR, and being the scared 17 year old girl that the lifeguard was, she just took off running.
 

medic417

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http://www.americanheart.org/presenter.jhtml?identifier=3025002

"If the choking is not relieved, the child will become unresponsive. When the child becomes unresponsive, shout for help, lower the child to the ground, and start CPR. If someone else is present, send that person to phone 9-1-1 while you start CPR."

Looks like he did what AHA says to do. Leave the kid along.
 

Lifeguards For Life

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I don't see why you say that. If you are implying that it did not happen then I am sorry, but it did.




Again, I am trained in AED, but we are next door to the FD. And I never checked for a pulse, what the woman told me when I got to her was 1.) she had cleared his airway, attempted to give mouth to mouth but his chest didn't rise, and 2.) she felt for a pulse (later learned she out her ear to his head) heard nothing and immediately went into chest compressions.


she had cleared his airway, yet he was still vomiting, hence airway probably not clear? You both know that the breaths didnt go in? she felt for a pulse by listening to his head? sounds like you're advising you're cpr was inefective.

maybe you should consider recertifying in CPR or re enrolling in english class, to tell your story so that it makes sense
 

Lifeguards For Life

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hottrotter18

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I would have told her to stop, but again it was clear that he had been dragged out of the pool already unresponsive...
She was the one who initiated CPR before I even knew anything had happened. She was a day camp supervisor, and trained in basic CPR (she didn't even know what a CPR mask was)
First of all, im glad that everything worked out for the better!
now...

Its obvious that you have more training in this situation than the woman who was giving chest compressions.
You need to take control of the scene. I would have told her to stop doing compressions, and immediately begin with checking breathing rate, and if he did in fact have a pulse.

You say it was obvious he was unresponsive when pulled out of the water... who's to say that the woman giving the victim compressions didnt make him pass out from doing so?
 

Cory

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yeah on a second read this story doesnt flow at all
1. you state you happened to look up and notice this event. how do you miss any submersion or emergency where the water is 3 feet deep and clear

2.If the pt was vomiting why was there no attempt to clear the airway or even assess to see if the pt. was breathing or not?

3.why do you think you were greeted with insults and jeers from the crowd?

4. you state the pt. most likely had a pulse, shouldnt you find out if the pt. has a pulse or not?

5.from what parameters do you gather that the pt. was indeed a choking victim? did you ask the crowd of people that obviously wittnessed said event before you?

6. EMt's showed up on scene and just watched?

I am not lying. I made it clear in the OP that it was a cut and cry version.

1. I was at the other end of the pool, this was not in my area, I would have never been able to see it. The pool was shoulder to shoulder, and the majority of people were already flocked around the stairs. Even people who were right next to the boy said they hadn't seen it happen.

2. Please read my latest post. The airway was cleared immediately, and no breathing was heard.

3. Are you kidding me? I "think" I was greeted with insults and jeers? Are you implying that I made that up? When I ran up, three ladies from a day camp stood right in front of me and said, 'You're a bunch of lifeguards and you don't know CPR?" Too which I replied that we did. One of the women found me afterwards and gave me a formal apology for it.

4. AGAIN, I didn't initiate CPR. The woman doing CPR when I arrived told me she was certified, and that he had no pulse, was not breathing, had a cleared airway, and from there I went to work. He had already been in resparitory arrest for almost a minute, I didn't want to waste time.

5. AGAIN, there was a trail of water leading from his feet to the water's edge. He was soaked. I had guessed that the vomit was most likely due to the pressure change. The lifeguard who had pulled him out and ran for the phone was soaked when I saw her, she hadn't been soaked just 20 minuted before this occured. PLUS, even though she had cleared his airway, vomit was still coming out. That is why I had the mask in the first place.

6. When I saw the EMT's for the first time, I had the boy in a recovery position for almost a minute, trying to get his attention and comfort him. When I looked up, EMS were waiting for us to move. We looked at them, got up and they wrapped him up in a blanket and put him on the stretcher.


Good enough?
 
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Cory

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I don't see why you say that. If you are implying that it did not happen then I am sorry, but it did.




Again, I am trained in AED, but we are next door to the FD. And I never checked for a pulse, what the woman told me when I got to her was 1.) she had cleared his airway, attempted to give mouth to mouth but his chest didn't rise, and 2.) she felt for a pulse (later learned she out her ear to his head) heard nothing and immediately went into chest compressions.


she had cleared his airway, yet he was still vomiting, hence airway probably not clear? You both know that the breaths didnt go in? she felt for a pulse by listening to his head? sounds like you're advising you're cpr was inefective.

maybe you should consider recertifying in CPR or re enrolling in english class, to tell your story so that it makes sense
She listened to his chest, not head, my bad. And AGAIN this is the reason WHY nI had grabbed the mask. I don't need to re-certify.
 
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ffemt8978

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Knock it off.
 

Cory

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First of all, im glad that everything worked out for the better!
now...

Its obvious that you have more training in this situation than the woman who was giving chest compressions.
You need to take control of the scene. I would have told her to stop doing compressions, and immediately begin with checking breathing rate, and if he did in fact have a pulse.

You say it was obvious he was unresponsive when pulled out of the water... who's to say that the woman giving the victim compressions didnt make him pass out from doing so?
Yes, well I will admit it wasn't until afterwards that I learned for sure that the lifeguard saw him passively floating the surface, she pulled him out, rolled him over (that is when the pressure change enduced vomiting) and then the woman immediately snatched him. A testament to why the guard should've stayed.

And yes, her CPR was a total mess at first, and I am still upset that another lifguard didn't relieve her (my intention was to do two person CPR and monitor her compressions) but when I got there, I stopped things, she went on to tell me about her assessment, and from there I told her to continue and I would do rescue breathing. I went by what she said. Might have been a mistake, but by her calm nature towards what had happened she seemed professional, and NO ONE else was doing a damn thing. I HAD to react. You all have to understand the staff, the crowd, and the situation better. That woman was alnoe in a sea of gawking faces. Both shocked patrons and frozen life guards, me and her were the only ones doing anything other than yelling.
 
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hottrotter18

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And yes, her CPR was a total mess at first, and I am still upset that another lifguard didn't relieve her (my intention was to do two person CPR and monitor her compressions) but when I got there, I stopped things, she went on to tell me about her assessment, and from there I told her to continue and I would do rescue breathing.
All im trying to do is pass more ideas onto you of what else you could have done better, which im sure you've thought about alot.

While she was stopped and telling you her assessment, check that pulse.
make someone get an AED.

I went by what she said. Might have been a mistake, but by her calm nature towards what had happened she seemed professional, and NO ONE else was doing a damn thing. I HAD to react. You all have to understand the staff, the crowd, and the situation better. That woman was alnoe in a sea of gawking faces. Both shocked patrons and frozen life guards, me and her were the only ones doing anything other than yelling.
Its your job to react. you did what you did, because thats what your trained to do. Emergency situations test test peoples ability to think under pressure.
The lady lifeguard, from what i've read, was definitely in the wrong to run away from the child, and pass off care to a bystander. She should have had someone else call 911.

Only thing to do is to learn from it.
 
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Akulahawk

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All im trying to do is pass more ideas onto you of what else you could have done better, which im sure you've thought about alot.

While she was stopped and telling you her assessment, check that pulse.
make someone get an AED.



Its your job to react. you did what you did, because thats what your trained to do. Emergency situations test test peoples ability to think under pressure.
The lady lifeguard, from what i've read, was definitely in the wrong to run away from the child, and pass off care to a bystander. She should have had someone else call 911.

Only thing to do is to learn from it.
And if you fail to do so... is the true failure.
 
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