Managing a compromised airway and breathing function are two of the primary life threatening issues that a responder should address immediately. As we determine the condition of the casualty we should look in the mouth and at the rise and fall of the patient’s chest, listen for normal breath sounds, and feel if there is hot and moist breath from the patient’s airway to our ear.
Positioning of the airway by placing the patient in an appropriate position such as the recovery position, or the use of airway management techniques such as the head tilt-chin lift, or jaw thrust serve to keep a patient breathing.
Common obstructions of the airway include:
These particular obstructions must be managed in order to keep the airway free. It is also a good idea to sniff the airway to see what particular toxins may be present hinting towards a more specific Mechanism of Injury, e.g. clorox, alcohol, etc.
In addition to basic airway maneuvers airway adjuncts like a Naso-Pharyngeal Airway can help a patient’s airway to remain in tact even if swelling, or maxillofacial trauma has occurred. As a word of caution if the patient can manage their own airway allow them to.
Once the airway is open and managed our next significant concern is breathing management. Monitoring your casualty and constantly reassessing their airway and breathing for these signs and symptoms will help you to combat these two often preventable causes of death.
Anyone who has ever gone to a bad horror movie can attest to the fact that Hollywood makes the magic. From the finite details in special FX to the exact timing of emotion in acting, if a movie lacks the fine details it will be an absolute failure. Scenario based training draws the same emotions much like the movie industry, especially as it relates to emergency medical training.
As the old saying goes, “the devil’s in the details.”
The devil causes chaos and mayhem and like Murphy’s first law of combat, “anything that can go wrong, will go wrong.” So, when we set out to realize the special FX of medical training it was as such that we realized we can no longer create training scars with poor FX, much the same way we must avoid training scars in any craft we seek to perfect.
The goals of sound scenario-based training are
Focus on the task being taught and tested
Focus and emphasis throughout the testing on the desired outcome as it relates to the objectives.
With the seeming rise of hyper violent events occurring around the World many individuals are seeking training and equipment for being able to respond to a potential casualty. At present the greatest emphasis in Pre-Hospital trauma care is being placed on the integration of tourniquets as a first line defense against massive bleeding.
Today an article ran in USA Today where Doctor’s in the United States encouraged Americans to learn how to use tourniquets. The rise of hyper-violent situations in America has ushered in a new age where safety is an idea of the past. Tourniquets, regardless of their brand, or manufacturer must be applied correctly in order for them to work properly.
Due to recent events and ongoing mass shootings and the potential for terror attacks we are learning as Americans how quickly a human being can bleed to death and just how vitally important it is to be able to stop a massive bleed.
With all of the information out there and products available commercially it can be a bit confusing weighing out the good from the bad. So I thought I would take this opportunity to help clarify a few things about the use of tourniquets and discuss the pros and cons of my top three choices for stopping arterial bleeding.
Understand the use of a tourniquet can and should only be used to control major arterial bleeding on an extremity. The general consensus for lay responders is to place the tourniquet as ‘high and tight’ on the wounded limb as possible.