Monday, June 18, 2012

HEARTFELT MEMORIES

UP DATE:  6/25/12     Read comment reply on what to do if you choke in a restaurant!

Sunday was a special day to honor fathers -- those present in our lives and/or those who live on in our memories.  Fortunate are those who are able to enjoy family get-togethers -- often with several generations enlivening the gathering.   Hope each of you enjoyed the day in whatever manner has been meaningful to you.

I didn't forget the day in which we pay tribute to those significant fathers in our lives.   My thoughts have been with my East Coast life-long dear friend whose husband, a father and grandfather, passed from this life a few days ago.   Their sons, all fathers themselves, were gathered around.  I'm sure their families would have been together with their mother for that poignant day -- so soon after their father's death.   I'm reminded again to treasure the time we have with one another.

The day for me was unique as I journeyed down a partially clogged freeway to the city of Orange for my required cardiopulmonary resuscitation (CPR) certification two year renewal in an American Heart Association class.  I'd previously taken CPR through other organizations, but this is the third renewal I've taken with this particular AHA instructor who continues to be the best I've experienced.   The CPR  technique has changed through the years as medical research has revealed the most beneficial administrations shown to save lives.

The current criteria for applying CPR is not only more effective but has been simplified.   We receive training to provide emergency aid to infants, children and adults.  Recent years training has included use of an Automated External Defibrillator (AED.)   Ability to provide the Heimlich Maneuver for dislodging airway obstructions has always been part of the program. 

I've never been in a situation that requires I administer CPR, or an AED either professionally or personally.  I had thought I might be faced with that need only a few years ago on Hawaii's Big Island.   We arrived in Kona at night and as our car climbed the narrow two lane winding coastal road toward Hilo we rounded another sharp curve.  Suddenly my driver son's voice sounded alarm that he thought he saw a man waving his arms and heard him yell, "help."  We pulled to the side of the road, established there had been an accident with a car nosed into a tree off the road and proceeded to determine what help might be needed.    

The father of this family was standing outside his car saying he thought he was okay, but was concerned for his wife and adolescent daughter.   None of the three evidenced external bleeding injuries or obvious broken bones, but the females seemed especially unnerved as might be expected.   The daughter complained of a slight headache having bumped her head against the back of the front seat.   My son had immediately phoned for emergency help, but given the location was told considerable time would pass before help could arrive.  We never had a thought other than to wait with the family though there seemed to be little we needed to do.     

Meanwhile, another car stopped with a man who upon learning of the situation walked around the curve with his flashlight and began signaling visible cautions to all cars coming from either direction on this hazardous roadway.   The accident victim said another car had forced him off the road in an account which he described also to the police officer who arrived before the emergency vehicles.   After my son's report of our involvement only as helpers, confirmed by the accident victim, and the medical help appeared, the officer said we could leave.   

I've always wondered if the daughter was okay, and hoped she was.   Before the help arrived she had seemed to be getting sleepy.   Other than the slight headache she had no other symptoms, but medical personnel would have determined if she might have experienced a concussion or even internal bleeding -- closed head trauma.

In a situation years earlier, I was sitting at a restaurant counter with friends when I overheard a woman sitting at a small table behind me inquiring of her friend whether she was alright.  There was escalating anxiousness from the concerned woman in the minutes following about what to do.   The mid-level restaurant chain's young manager with whom we had been talking was observing the women with concern but hadn't concluded action was warranted.   As the situation developed, finally I turned to view the women and quickly concluded someone needed to act.  I told the manager, you need to call 911 now -- that woman is having a stroke.  She was still sitting upright in her chair when the emergency personnel arrived and took her to the hospital.   The next day I learned she had a massive stroke - cerebral vascular attack (CVA) or brain attack -- from which she did not survive the night.   

Interestingly, the restaurant manager said his hesitation in calling for help was based on corporate guidelines.  If the manager phoned the restaurant would be expected to pay for the emergency call and transportation  if the customer/patient didn't absorb the cost for any reason.

Many years prior to that situation, before I entered my present profession or had CPR training, my immediate family and I were seated in a booth at our local deli for dinner one evening.  My son and I had the outside seats opposite each other.   We had finished ordering when I looked up at this silent adolescent's face which had a startled wide-eyed look accentuated by a slackjawed open mouth.   Instinctively I gestured and we both stood simultaneously.  I understood the respiratory system and placed my closed fist against his diaphragm, giving a forceful sudden push which forced air to exit his mouth dislodging the offending obstruction -- a lifesaver candy!

We both immediately sat back down.   This all happened so fast, the rest of the family hardly noticed and I didn't want to alarm everyone by upsetting the mood of the evening, much less scaring my son.  I have jokingly commented that I gave him life twice.

(Note:  The Heimlich Maneuver is best performed differently that what I did with my son though the concept is the same.  I had not been trained on the correct best procedure then.)


The CPR training intends to educate everyone that if a person has an airway obstruction preventing them from breathing they'll put one hand over the other at their throat in a signaling choking gesture.   Hopefully, everyone will learn this gesture, but my experience is that not everyone automatically reaches to their throat in a situation when they can't breathe -- certainly my son didn't, but maybe I acted before he might have done so.

I'll be quite content to not encounter any need to provide CPR or require it for myself in the future.  In fact, I'll prefer that to be the case.  The reality is, that we never know when, where, or under what circumstances we may encounter situations where our assistance is needed, whether or not it's CPR.   Or, we may be the ones needing help from another.   I think it's likely that others reading this have had much more harrowing experiences than those I relate here which I welcome your sharing. 



25 comments:

  1. It is always well to have as many of the public educated in simple life-saving techniques as possible. Kudos!
    Cop Car

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    1. I definitely agree. The American Red Cross also provides excellent classes and instructors that I've been trained by or renewed with -- so plenty of opportunities to learn several life-saving techniques.

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  2. You certainly helped many people. I gave a pill to my cat, a Korat, named Mitsou – a beautiful grey cat with emerald eyes, about 2 months ago. The pill got lodged in her throat. I tried to push on her stomach and do the maneuver – it did not help and she died in my arms – I am still so upset about it, she was such a lovely and affectionate cat.
    Yesterday we celebrated both Father’s Day with my husband and eldest daughter here in Memphis and our 45th wedding anniversary. I spent some time scanning old wedding photos for my post.

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    1. Glad you could be with your family and could also celebrate your wedding anniversary. Congratulations on your 45th! Alas, my family members reside in distant States and my husband died several years ago, two months to the day prior to our 43rd wedding anniversary, as I've written about previously.

      So sorry you were unable to save your cat who may have been experiencing what may be a pretty rare occurrence. That event must have been a heart-breaking situation.

      The diaphragm in humans, which is what needs compression, is higher on the body, just above the stomach level. Rescue breaths, when appropriate, need to go just to the diaphragm level also. Developing these skills is quite easy with the function readily visible in CPR class practice using a dummy mannequin.

      Your experience suggests to me that pet owners, whether cat, dog, possibly other select creatures, might want to ask their veterinarian to demonstrate where to place their fingers, (or hands if a large pet, possibly) to administer compressions and how to most effectively administer CPR for their particular pet.

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  3. It's great that you have those life-saving skills. I know several people who have been saved by CPR, and they are very grateful.

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    1. That's encouraging, Dick, that others could make a difference in peoples lives.

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  4. I took a class in CPR from the Red Cross many years ago. We practiced on a dummy. It was quite realistic, because the chest would rise and sink as we blew into its mouth and compressed its chest. I recently read that mouth to mouth is no longer necessary, and simply compressing the chest is more advisable. I have never had to use my training and hopefully never will.

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    1. Mouth-to-mouth criteria has altered and decreased, but is still administered in certain situations.

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  5. I think you have had some amazing life-saving experiemces and I say God Bless You for that. I haven't been in a situation that required my knowing CPR and now, I'm not sure I am physically capable of being able to administer it OR the Hymlic Maneuver...I pray I am never in a position to find out....
    Vaganondes situation was so very heartbreaking---I feel for her with all my heart. At best, life is not easy, is it?
    I'm so devistated by my brothers death that I feel incapable of doing anything right now....I pray this eases in time.

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    1. OldOldLady: Think of you with the recent loss of your dear brother. Other than the situation with my son, and simply recommending action be taken with the lady in the restaurant, I really haven't had to do much. I've heard of many others who've actually been very involved in actually providing life-saving CPR.

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  6. You have my heart racing
    this very early morning.
    Have never came across life threatening
    situaitons like these and hopefully do not.
    Have a good day in your part of the country.
    Very hot day expected
    in the 90's. I will garden when day breaks...

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    1. Thanks for your visit. Fortunately, these life threatening situations are infrequent, but as I've discovered, we never know when or where one may occur. Yes, we will have a hot day today, too. Good that you'll garden early.

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  7. I enjoyed this post...the part that struck me was the manager's hesitation in calling...to often people hesitate or will not help because of personal fears or worries about being sued. Bless you and others who are not afraid to "Stand and Deliver"

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    1. Thanks for stopping by, gsb. Yes, I, too, was becoming perturbed with the restaurant manager, probably in his thirties, quite sensible and mature from my previous interactions. The women were both older, and the victim was obviously bewildered by what she feeling in these early stroke minutes -- may have thought it would pass, or maybe she'd had similar warning signs other times that did when she had ignored them. Her friend may have been waiting for the victim to give her instruction to seek help. My friends didn't recognize the seriousness of the situation. I didn't really think I should inject myself into the matter -- that the woman's friend and the mgr. were addressing the situation, but I began to see that wasn't happening.

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  8. Joared: We are very alert to emergencies on the Big Island. We have so many of them. I witnessed a rescue operation not so long ago right in front of my house, which overlooks Hilo Bay. Two young men got in trouble in the water and were drowning. The rescue helicopter hauled a survivor up and deposited him on my neighbor's lawn. The other victim was dead by the time they were able to get to him. It was so sad to see his body being put into the ambulance. He was only 19.
    The water is very dangerous here, and so are the highways.

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    1. That would be sad to see lives being lost and be unable to do anything except watch the rescue crew. I grew up and learned to drive on narrow two-lane roads, so have some sense of the care that needs to be taken to not speed or cross the center line, especially on those climbing, curving, mountain roads day and night. You probably know that particular stretch of road I described.

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  9. Good post, and you got me thinking about CPR.

    I know a woman whose husband died for lack of a defillabrator. Too scary. We had a CPR person in the last office of my employment. Good idea, but I would be too frightened to touch someone.

    I did save a little boy from choking once. He promptly began to scream his head off, and I was afraid his Mom would come out of her house and yell at me thinking I had somehow harmed him. Too awkward. Dianne

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    1. Everyone has to determine what they feel comfortable doing. Some people may be interested in learning about the life-saving interventions, which include CPR, simply for possible personal use with family -- or to know what to do for themselves -- what to do if they live alone and choke -- or maybe they have infants in family they would be able to assist while holding the child in their arms. The class addresses the issues surrounding initiating life-saving interventions with another person, including with strangers.

      For example, I've thought if in the future the circumstances were such I was unable to administer CPR myself, I would know what needed to be done and could, perhaps, provide direction to others more physically capable.

      The AED talks, tells the person using it exactly what to do, automatically diagnoses whether or not it's appropriate to administer an electrical shock that allows the heart to reestablish an effective rhythm.

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  10. i so admire your knowledge and ability to give care to others!

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  11. I certainly hope that someone like you is around if I ever have a stroke or breathing problem. One time I was in a restaurant with a young friend eating a steak dinner. A piece of the meat lodged in my throat causing me to cough ceaselessly. No one came to my aid and I managed to get to the restroom where I finally coughed up the offending piece of meat. I guess I wasn't in any danger, but it was a stressful situation.

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    1. Darlene, you've described a situation our instructor who has worked in emergency rooms and many other life-saving settings specifically described.

      Individuals choking in a public place such as a restaurant are inclined to go to a rest room for privacy so they won't disturb others -- DO NOT GO TO A REST ROOM, OR WHERE YOU MIGHT BE ALONE. IF YOU'RE CHOKING.

      You need people present, even if no one can administer the Heimlich Maneuver. in case you cease being able to breathe, since you'll soon become unconscious and fall. At least then, there's a much better chance someone will call 911 for emergency help. There are only a few minutes without oxygen to the brain before permanent neurological damage occurs.

      A CPR class will provide instruction for what individuals alone can do to help themselves if they choke. I recommend people of all ages take an inexpensive CPR class. The knowledge you will learn is surprisingly simple and uncomplicated.

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  12. Most informative post. I have had this choking problem, although not as severe as those you mentioned. My doctor showed me a self administered Heimlich . Stand with back against hard surface like a door, double fist on chest in center with fist applying pressure. again and again. Most times the offending object will be dislodged.

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  13. Also here is another version of self administered Heimlich



    The Heimlich Maneuver for CHOKING (ONESELF)
    When you choke, you can't speak or breathe and you need help immediately. Follow these steps to save yourself from choking:
    Make a fist and place the thumb side of your fist against your upper abdomen, below the ribcage and above the navel.
    Grasp your fist with your other hand and press into your upper abdomen with a quick upward thrust.
    Repeat until object is expelled.
    Alternatively, you can lean over a fixed horizontal object (table edge, chair, railing) and press your upper abdomen against the edge to produce a quick upward thrust. Repeat until object is expelled.

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    1. Glad your choking problem was resolved, Chancy. The latter method you describe for expelling an object is the one most frequently recommended by the different organizations from whom I've received CPR training.

      The basic premise is application of pressure from the diaphragm forcing oxygen upward through the airway to push the offending object out.

      WHERE THE PRESSURE IS APPLIED IS VERY IMPORTANT to affect the airway, pushing air through the trachea dislodging the object. Everyone needs to understand that pressure is not applied to the stomach which could cause the contents to expel through the esophagus with possible spillage into the unprotected airway from the mouth.

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