911

Someone Please Rescue 911: Teach Them to do CPR Correctly

/ Jordyn Redwood / Leave a comment

I’ve been teaching CPR for almost thirty years. Can you believe that? I hardly can.

I’m pretty passionate about CPR because time after time studies have shown that this is the patient’s best path for survival— high quality CPR given as soon as the patient needs it. It’s not rocket science and it’s pretty easy to research. Here’s a Google link to a bunch of images that show the algorithm for CPR.

What you want to be sure of is that you’re using the most recent guidelines. For the American Heart Association (AHA), their most recent set came out in 2015. The AHA reevaluates their CPR guidelines based on research every five years. Next update will probably happen next year, but the educational materials likely wouldn’t be released until 2020.

In episode nine of this season’s 911, Hen and Howie rescue a boy from a submerged vehicle. He is unresponsive and pulseless once he reaches the shore. They begin CPR (just compressions) and after every set of compressions they do a pulse check. After about a minute, they revive the patient.

Did you know that even healthcare providers are not that great at determining whether or not there is a pulse? It’s true. On top of that, imagine trying to do a pulse check with cold hands, in the dark, in the rain. Not easy to be sure.

The reason the pulse shouldn’t be checked that much is that it ultimately delays compressions and we don’t want to do that. Every time compressions are stopped, the blood perfusion to the heart also stops and it takes several compressions to reperfuse the heart. Some fire departments have gone to doing two hundred uninterrupted compressions for this very reason.

In lieu of this issue, I did like this episode quite a bit. It’s Hen’s origin story and I do think it highlighted some of the issues minorities face in the fire service.

911— let’s just stop messing up the little things.

911: Let’s Provide Some Medical Care

/ Jordyn Redwood / Leave a comment

In the Season Two/Episode Eight airing of the FOX television show 911— there was a great scene on how to really provide no medical care.

The setup: A gay couple is getting ready to go on a bike ride. Much time is spent in a musical montage showing their lives together. It’s clear they have had a loving relationship and remain deeply in love. One gentlemen goes to load a bike onto a SUV when, in a series of unfortunate events, he gets pinned by the SUV to the entrance gate— akin to Anton Yelchin’s accident (though they do show in the episode the SUV was placed in neutral).

He is discovered by his partner who then calls 911. Upon arrival, there isn’t much done for his lover. He is essentially declared dead on arrival.

Then, the gentleman who discovered his partner, goes unconscious while a firefighter has his back turned. Literally only a few seconds have expired when the firefighter discovers he’s passed out. They provide one and a half cycles of CPR and kind of shrug their shoulders declaring that he’s died, too.

This is unacceptable management of this patient. It’s essentially a witnessed arrest so they were correct to start CPR immediately, but at the very least, he should have been connected to an AED for rhythm analysis and probable defibrillation. A very common reason for sudden collapse are arrhythmias that will respond to electricity. There’s no reason why this gentleman’s treatment  should have been so sparse. It would have increased the drama and the tension of the episode to have this patient get a full resuscitation.

911 S2/E2: Determining Death

/ Jordyn Redwood / Leave a comment

In Episode 2 of this season’s Fox series 9-1-1, a devastating earthquake has hit LA county.

The team is searching for victims when they come upon a patient where only her lower legs are visible. The paramedic reaches down and assesses her pulse at her foot and determines that she’s dead. Time to move on.

Can you feel someone’s pulse in their foot? Yes, you can. He’s palpating what’s called the dorsalis pedis pulse.

Should it be used to determine if the patient is dead? To this, I would say no. The problem is, when the body goes into shock, it shunts blood toward the central aspects of your body to ensure blood flow to your vital organs so even though the person is alive, you may not be able to feel the pulses in the feet. This is why when checking for life, the use of central pulses is encouraged— for instance the femoral or carotid pulses. Also, this victim could just have two broken legs with compromised blood flow to her feet causing the lack of pulse.

However, I’m not going to give them too much grief for this. In a mass casualty situation, sometimes you do just need to move on and save who you can.

Medical Review of Fox’s 9-1-1

/ Jordyn Redwood / 4 Comments

I’m so happy to be back blogging! I hope everyone had a fantastic holiday season and is ready for a new year. Today is officially my 20th wedding anniversary! Can you believe that? I know I can’t. It’s crazy to think how much time has gone by.

Considering the occasion, I thought it would be best to write a positive (well, mostly positive) review of a new TV show— Fox’s series 9-1-1. I know . . . you can pop your eyeballs back in. This is truly a rare event considering much of this blog’s time is spent skewering medical inaccuracies in print, movies, and the small screen.

9-1-1 is a series devoted to dispatch, police, and fire calls. I’ve watched the first two episodes and was pleasantly surprised at how much I liked it. Now, it does have some problems. Writing completely to stereotype would be the biggest.

Let’s look at what they did well.

1. The characters face consequences for their actions. I’ve said all along that it’s okay for medical people to do bad things in fiction, but there must also be consequences for their actions. The point of this are many. It increases the conflict in the story AND reflects real life. Too many times in fiction medical people are shown doing bad things without consequence. One firefighter is shown facing some serious repercussions for his poor (saying that lightly) choices.

2. There is respect for HIPAA and also how hard that is for medical people. HIPAA is the patient privacy law. Because of HIPAA, most of us who work on the front lines (EMS and emergency departments) rarely ever hear how our patients do after they leave our care. This is, flat out, not easy for any of us and it makes closure difficult.

3. Shows the problem of poor coping mechanisms. It is true that healthcare people do not always have the best coping mechanisms. Hello, to all the nursing units with the mandatory chocolate drawer. Some develop addictions  and can have bad co-dependent relationships. It was nice to see highlighted that the stress of this work does take an emotional toll.

4. Highlights the difficulty of work/life balance. Of course, all professionals face work/life balance issues, but I also feel like the nature of our work makes it hard to feel like you’re getting a break. If you’re taking care of a medically/terminally ill loved one at home, and then go to work doing the same thing— there can be little room to breathe.

5. Medical information was not distracting. The medical information was kept pretty light in the first two episodes and not too distracting. There were a few minor medical errors I’ll keep close to the vest for now.

Have you watched the new Fox show 9-1-1. What did you think?