EMS World

SEP 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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THE TRIP REPORT: TURNING RESEARCH INTO PRACTICE 18 SEPTEMBER 2018 | EMSWORLD.com Treat Proximal Third, Mid Shaft Fractures and More Find out more about Sager Splints models and application at www.sagersplints.com Email MINTORD@aol.com / Call 800-642-6468 for the name of Your Authorized Sager Distributor One Person Application Sager Splints immobilize long bone fractures of the leg, providing optimal and secure immobilization. h Sager Splints can be used to immobilize fractures of the Tibia & Fibula h Traction can be applied to proximal third & Mid Shaft Fractures of the Femur Use the Sager Traction Scale to set the amount of traction needed – Sager Splints do the rest. The Sager's dynamic function permits traction to decrease automatically as the muscle spasm releases. Your Patient will always have the correct amount of safe, secure traction. The authors also indicated that par- ticipants often mistook cyanosis, emesis, and gasping for obstructed airways. In one instance a worker delayed chest compres- sions and stopped CPR intermittently to per- form back slaps. Fear of hurting the patient was a common theme, particularly when bystanders did not remember exact ana- tomical landmarks. Further, the chaos of the scenes was distressing, sometimes limiting the bystanders' ability to hear instructions provided by their AED. One of the scarier statements indicated that two bystanders "attempted to cut an elongated S-shaped defibrillator pad into two separate pads because the defibrillator they had used dur- ing training used two smaller pads." Making sense of the experience was try- ing for some bystanders. Some were unable to drive home following the event because they were shaking so much. Some feared they weren't allowed to speak about the incident to others. For those cases in which the patient died, participants wondered why their efforts "didn't work." It is also evident that everyone reacts differently to these events: Some indicated after the patient died that they were comfortable because they'd done their best to help, while others indicat- ed they were "messed up," unable to sleep, and experiencing symptoms of depression (even when the patient lived). CPR Can Be Stressful This study is an important addition to the lit- erature. CPR instructors may want to include more information about how cardiac arrest victims may present and fully address mis- conceptions regarding perceived barriers to act and the chaos that might be present. Further, while other studies have suggested long-term psychological struggles are rare among lay rescuers, instructors may want to explain that those who intervene may have trouble dealing with the event afterward. The authors did a commendable job explaining their study limitations, which included possible recall bias (difficulty accu- rately recollecting the event) and selection bias (only bystanders referred by paramedics on scene received follow-up). Also, because of the small number of participants, the results may not be generalizable. Finally, they noted that because all but one of the victims was a colleague of the bystander, the degree of stress may have been increased. July's quantitative study suggested bystanders do perform quality CPR, and this qualitative study indicates we may need to do a better job providing information when training the public in CPR. For bystanders, providing CPR may be an extremely stressful, once-in-a-lifetime event. It might be a good idea to say "thank you" or "good job" to let them know what they just did was important to help the victim's chances of survival. A few words might go a long way. ABOUT THE AUTHOR Antonio R. Fernandez, PhD, NRP, FAHA, is research director at the EMS Performance Improvement Center and an assistant professor in the Department of Emergency Medicine at the University of North CarolinaÐChapel Hill. For More Information Circle 18 on Reader Service Card

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