Thursday, December 8, 2005

Teach all students lifesaving CPR skills

Dr. Elise van der Jagt
Guest essayist

(December 8, 2005) — On Nov. 29, the Rochester region witnessed two extraordinary events.

A Rush-Henrietta school bus driver suffered an apparent heart attack while driving. Although the driver unfortunately passed away, a student took charge, immediately called the district for help and kept the other students safe — surely highly commendable actions.

The same day, a 16-year-old in Naples suffered cardiac arrest during gym class. A teacher immediately performed CPR (cardiopulmonary resuscitation) and two minutes later the school's automated external defibrillator (AED) was attached, giving him two electrical shocks. Within six minutes, the teenager's heart function was restored and he survived.

These two events underscore the tremendous importance of knowing how to perform CPR and having an AED available.

December marks three years since New York state passed a law requiring the placement of AEDs in schools. In that time, at least 19 lives have been saved because bystanders in a school setting had access to an AED.

The day before these events, the newest international scientific consensus and recommendations on resuscitation became available on the Internet ( These recommendations underscore the critical importance of combining bystander CPR and the use of an AED within three minutes to save lives after a cardiac arrest. (The combination doubles the likelihood of survival.).

Sen. Jim Alesi proposes a bill requiring CPR and AED training as a health curriculum requirement for high school students. If they all learn these skills, within a generation, almost all New Yorkers will be prepared to respond to a cardiac emergency. Let's urge our lawmakers to support this bill and meanwhile work with local schools to implement this idea.

Van der Jagt is professor of pediatrics and critical care, Golisano Children's Hospital at Strong, and chairman, American Heart Association New York State Emergency Cardiovascular Care Committee.

Wednesday, November 30, 2005

High School Student Saved By Physical Education Teachers

11/30/2005 6:00 PM
(Katrina Irwin, WROC-TV)

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Three years ago Thursday, a state law went into effect, requiring automated external defibrillators inside schools. Since then 19 people have been saved. The most recent on Tuesday when a 16-year-old high school student in Naples collapsed during gym class. To watch the WROC-TV news report, use the links under the picture of the AED. Select "High" if you have DSL or cable modem, or select "Low" if you have a dial-up connection.

"He was feeling a little dizzy, sat down, was feeling a little better, got up and took about three steps and collapsed," says Courtney Conrad. She and two other teachers in the gym immediately put their first responder training to good use.

"It was scary for all of us, I mean we try to keep our cool as much as possible. Overall you're really scared when something like that happens," says Frank Gleichauf.

They administered CPR, called 9-1-1 and ran for the schools automated external defibrillator, or AED. It's a machine similar to this one that instructs people about how to give a life-saving shock to the heart.

Conrad says, "it said analyzing and it said shock advised and I shocked. And it was terrifying, but on the other hand after two shocks we had a weak pulse, but a pulse. And weak breathing but breathing and it was a huge relief."

A couple years ago the state required all school districts to have these AED machines, at the time some said complained about the unfunded mandate. But nobody's complaining here in Naples anymore."

Superintendent Brenda Keith says, "No one is complaining at all. In fact we're looking at assessing all our buildings to know whether we have enough of the AED's in place."

This was the first time an AED has been used at the Naples school district.

Copyright © 2001-2005 WROC-TV 8

Wednesday, November 23, 2005

Near-Death Scare Shows Need for Lifesaving Tool

By Angelique S. Chengelis - The Detroit News
November 23, 2005

DETROIT-- Red Wings defenseman Jiri Fischer likely would not have survived Monday night without the immediate use of an automated external defibrillator.

A defibrillator, now found in most airplanes, airports, sporting arenas, universities, shopping malls and health clubs, is a computerized medical device that checks a person's heart rhythm and determines whether an electrical shock -- defibrillation -- is needed.

The procedure temporarily stops all electrical activity to let the heart's own natural pacemaker restart in a regular pattern.

Fischer collapsed because of an unexplained, life-threatening heart arrhythmia during a game against Nashville. He immediately was attended to by team trainers and team physician Dr. Tony Colucci. Colucci initiated chest compressions, and a defibrillator was placed on Fischer's chest to shock the heart.

"That is one of the crucial things I want to come out of this, that … (a) monitor should be in every public place," Colucci said. "It should be in any arena, period. Football, baseball, hockey, anywhere there is athletics at a much-peaked level. These are lifesaving machines that should be in every arena, every sports facility throughout the country."

Fischer was revived and transported to Detroit Receiving Hospital, where he will undergo further tests.

"If you don't have those (the chest compressions and defibrillator), you have a different outcome," Colucci said at a news conference Tuesday at Joe Louis Arena.

"That helped and aided in bringing Mr. Jiri Fischer back to a normal sinus rhythm. That was very critical. Again, the message out there is basic CPR and the … monitor and the quick response."

Colucci said a defibrillator is a lifesaving device that can easily be used by anyone. A defibrillator is portable, weighs about 5 pounds and costs about $1,500, nearly half what it cost seven years ago.

"It's fairly simple," Colucci said of the use of a defibrillator. "I had a discussion (Tuesday) morning with my children, telling them how easy it is. You place it on the chest, and basically the machine evaluates the cardiac situation and rhythm, and it tells you exactly what to do."

In September 2004, the Food and Drug Administration approved over-the-counter sales of automatic external defibrillators designed specifically for consumers.

The machine comes with advice for potential users to get some training and is not a substitute for paramedics -- people are supposed to call 911 before grabbing the defibrillator.

Troy attorney Randy Gillary is working to make certain all Michigan high schools have a defibrillator. Gillary and his wife, Susan, started the Kimberly Anne Gillary Foundation in 2000 after their 15-year-old daughter died during a Troy Athens water polo match at Birmingham Groves.

Kimberly Gillary received CPR from a cardiac nurse at the match, but a defibrillator was not available. She was unable to be revived.

To honor their daughter, the Gillarys raise money to purchase defibrillators for high schools. Since 2000, the Gillarys have supplied 300, and there are 127 schools on the waiting list. The first school that received a defibrillator from the foundation was Groves.

The foundation donates the defibrillator and pay for training for up to five staff members.

"We try to focus on the positive," Randy Gillary said. "Our goal is to help other high school children."

A defibrillator was used Monday at Howell High School when Mackenzie Watts, a sophomore and member of the Howell High School varsity swim team, suffered a seizure at the school district's aquatic center.

Emergency crews responded within five minutes, says Chuck Breiner, superintendent of Howell Public Schools. Paramedics administered the defibrillator before transporting Mackenzie to St. Joseph Mercy Livingston Hospital near the high school. But she was pronounced dead at the hospital.

Nate Hampton, assistant director of the Michigan High School Athletic Association, said his organization relies on the staff of the facility in use, such as Ford Field or the Breslin Center in East Lansing, to handle an emergency like the one that took place Monday night at Joe Louis Arena.

Hampton said he and other members of the MHSAA staff encourage school districts to be as ready as they can be for any medical or other types of emergencies.

"Not only do you have to have the proper equipment," he said. "You have the have the proper training of the equipment. Medical emergencies of all kinds scare us. In playing today's athletic activities you try to be ready for all uncertainties."

Wednesday, November 2, 2005

Coincidence? I Don't Think So

By John Gray - 11/02/2005

I don't believe in coincidences. Not really.
I think the world turns in strange ways that put us in the path of certain people at certain times.

Nowhere was this more evident than two weeks ago. At Fox 23 News, I co-host a show called In Focus, which airs Sunday mornings. A producer lines up my guests, and from week to week I have no idea who is coming through the door or what they want to talk about.

My guest recently was a man named Jim King. Last November, Jim was playing pick-up basketball with some friends at a local school gymnasium when he suffered a massive heart attack. In a matter of seconds, he was dead on the floor. They performed CPR and then went looking for help. The school janitor, a guy named Joe Wiley, had just been trained on a new machine the school purchased, called an AED. That stands for "automated external defibrillator."

It's a machine that sends an electrical charge into someone whose heart has stopped and gets them breathing again. A one-second jolt can bring a person back from the dead. Mr. Wiley zapped Jim King, and next thing you know, he was looking up at his teammates wondering what all the fuss was about.

As impressed as I was with Mr. Wiley, I am even more impressed with the machine itself. It's nothing like the ones we saw on hospital TV shows growing up. No big metal paddles that have to be hand-held. This machine, honest to God, an 8-year-old could operate. Not only are there only three simple steps, but the machine talks you through it. If you can make coffee, you can operate the AED and save a life.

Jim was very lucky that he happened to drop dead in a school. Three years ago, the state Legislature passed a law requiring every high school in New York to have one of these machines. They only cost $2,500. I asked Jim about the origins of the law, and he said it was passed in memory of a young athlete whose heart stopped during a lacrosse game back in 2000.

The next day, I attended a fund-raiser for Fear Park in Troy. At the event, a woman approached me with a brochure in her hand. She said, "Mr. Gray, my name is Sandy, and this is a picture of my grandson Louis. Can you help me keep other children like him from dying?"

She went on to tell me that her grandson, Louis Acompora, was playing lacrosse on March 25, 2000, when he was hit in the chest by a ball. His heart stopped, and they could not revive him because no one had an AED. She told me his family lobbied hard, and in 2003 a law was passed requiring them in high schools.

Yes, it was the same boy I just heard about. Coincidence? I don't think so either.

Sandy, along with Jim King, wonders why we don't have these life-saving machines everywhere - malls, apartment buildings, anyplace lots of people live or gather. Our legislature got it right requiring them in schools. Now they need to go much farther. Surely $2,500 is a small price to pay to save even one life. If they want to charge me a nickel more in my taxes that's fine. Money well spent, I say.

John Gray is co-anchor of Fox 23 News. His column runs every Wednesday
©The Record 2005

Tuesday, October 18, 2005

AEDs at College Sports Venues Benefit Spectators

Oct 18, 2005 (Reuters Health) - Many universities with Division I athletic programs have invested in automated external defibrillators (AEDs), to provide immediate treatment to athletes who experience sudden heart attack, but in many cases the emergency medical devices are more frequently used on spectators than on athletes, new study findings suggest.

"Implementation of AEDs at selected athletic facilities at NCAA Division I universities is commonplace and demonstrates a cost-effective survival benefit for individuals attending athletic events or on campus," study author Dr. Jonathan A. Drezner, of the Seattle-based University of Washington, told Reuters Health.

Each year more than 400,000 individuals experience out-of-hospital cardiac arrest, one of the leading causes of death in the United States, according to previous researchers.

In many cases, the most important factor affecting an individual's survival after heart attack is the amount of time it takes him or her to get the necessary defibrillation treatment, to shock the heart back to a normal rhythm. Studies have shown that public access to AEDs in locations as varied as casinos, airplanes and shopping malls, has greatly increased survival among people who experience heart attack away from the hospital.

Research has placed public sports venues and health/fitness facilities at the top of the list of places where people experience sudden cardiac arrest. Whether universities make AEDs accessible at sporting venues depends on a number of factors, however, such as cost, the size of the sporting event, and the extent to which conventional emergency medical services are available.

In the current study, Drezner and his colleagues investigated the prevalence and use of AEDs at NCAA Division I universities, as well as the cost of making those devices available in university sporting arenas. To that end, they surveyed head athletic trainers at 244 universities.

Most (91 percent) reported that AEDs had been available in their universities for about three years, although reports ranged from just one year to as many as 13 years. The number of AEDs per institution also varied, with half of the schools having more than four AEDs on hand and the other half having less than four.

Overall, the trainers cited 35 cases in which the AEDs were used for sudden cardiac arrest, and most of the time, it was not used for students, Drezner and his colleagues report in the American College of Sports Medicine's journal, Medicine & Science in Sports & Exercise. More than three out of every four cases (77 percent) involved an older nonstudent, while less than 20 percent involved student athletes, primarily intercollegiate athletes, the report indicates.

Patients survived in slightly more than half of the cases reported, and the survival rate was even higher (71 percent) in the 21 cases in which a defibrillator was used, the researchers note. For unknown reasons, however, a similar survival benefit was not found among the college athletes. None of them were resuscitated, perhaps due to "underlying structural heart disease (among young athletes)...that may be more resistant to defibrillation and attempts of resuscitation," Drezner speculates.

On average, each defibrillator cost $2,460. Yet, a university can expect to incur up to $2,300 in costs per year for 10 years just to immediately resuscitate one person a year, Drezner and his team note.

These costs, coupled with the current findings that the devices are often used on non-athletes, suggest that "implementing AED should not be limited to the resources of university athletic departments but should be based on a shared expense of a university-wide or community-wide program," the authors write.

Drezner adds that "universities without AEDs should consider acquiring AEDs as part of a coordinated emergency response system and public/community health initiative."

SOURCE: Medicine & Science in Sports & Exercise, September 2005.
Publish Date: October 18, 2005

© Reuters Limited. All rights reserved.

Tuesday, July 5, 2005

A Battle for Kids' Hearts

Tuesday, July 5th, 2005

It was every parent's nightmare.

Louis Acompora, 14, a goalie on Northport High School's lacrosse team, had just blocked a shot in the first game of the season.

Seconds later, he collapsed and died.

His horrified parents, John and Karen Acompora, found out later he was a victim of sudden cardiac arrest.

"He just blocked a routine shot with his chest," said his mother, Karen Acompora. He was otherwise a healthy boy, and was wearing a protective chest plate.

That was five years ago. Since then, the Acomporas have been on a mission to prevent other people's kids from dying from this sudden killer.

And their efforts - including successfully lobbying for a state law to get public schools to stock lifesaving defibrillators - have saved lives all over New York.

Mohammed Shah, 15, for instance, who collapsed between classes at Smithtown High School, is alive today because of his school's defibrillator. And East Hampton Middle School custodian Dexter Grady, who suffered sudden cardiac arrest while playing basketball, also owes his life to Louis' Law.

The Acomporas on Friday received a $5,000 award from Medtronic Emergency Response Systems, which makes automated external defibrillators, at a Jones Beach reception that included a concert by James Taylor.

"We've worked in conjunction with Karen and John for a number of years," said Brian Webster, vice president of Medtronic. "When their son Louis died, they certainly took up the charge of activism to try and solve this. And there have been actual results."

The Acomporas founded the Louis J. Acompora Memorial Foundation, which sent educational packages - including a book, video and PowerPoint presentation on the defibrillators - to 4,000 schools throughout the country.

And Louis' Law, signed by Gov. Pataki in 2002, makes it mandatory for public schools to have the special defibrillators - small, lightweight devices that just about anyone can learn to use.

Like Louis, many victims of sudden cardiac arrest haven't been diagnosed with any kind of heart disease, so the attack is completely unexpected.

In the vast majority of cases in adults, the coronary arteries have been narrowed by fatty buildup.

But when sudden cardiac death happens to younger victims, the cause can be a number of other heart abnormalities, according to the American Heart Association. And adrenaline released during intense athletic activity often acts as the catalyst bringing on the attack like a bolt out of the blue.

Tuesday, May 24, 2005

Lifesaver in Sag Harbor

Tuesday, May 24th, 2005

Bill Keating was driving his son Liam home from a basketball game one winter morning last year, wondering out loud why the coach didn't use Liam more.

In the next minutes, it became clear that his son possessed another set of skills that were far more valuable.

As the two approached a stop sign, Keating suddenly leaned forward in the driver's seat. "Something's wrong," he said, before blacking out and slumping backward between the headrest and the door.

Liam, then 15, jerked the steering wheel to the right, and the car rolled to a stop at a snow bank. His father seemed to be sucking air in, but he had no pulse. To Liam, who had learned cardiopulmonary resuscitation in school just four months before, it was clear that his father's heart had stopped, a condition called sudden cardiac arrest that affects 220,000 people in the United States annually, 95% of whom die.

"I was like, 'This can't seriously be happening.' I was one of those people who said, 'It will never happen to me,'" said Liam, now 17.

"Then when it does, you know it," said Liam, who lives in Sag Harbor , N.Y. "It's kind of like an adrenaline rush where you just start doing it automatically. You remember: two breaths, 15 compressions, when to take the pulse."

Liam's lifesaving action is frighteningly rare. Only one-third of New Yorkers perform CPR when they witness someone in cardiac arrest, a new study finds, contributing to the city's poor 2.2% rate of survival when a person's heart stops anyplace other than inside a hospital. The rate is similar to that of Los Angeles , where it is 1.4%, and Chicago , where it is 1.7%, but is still much lower than in places such as Seattle , where some 18% are saved.

Experts attribute the difference in part to a Washington State law requiring anyone with a driver's license to know CPR. The New York State Legislature is considering a bill that would require all high schools in the state to train students in CPR and in using a defibrillator, a machine that can restart the heart when it lapses into a specific, irregular rhythm called ventricular fibrillation.

Performing CPR is especially imperative in New York City , where it takes an average of eight minutes for EMS to reach critically ill patients after they are dispatched by 911 operators, according to FDNY-supported research that will be presented today in Manhattan at a meeting of emergency-room doctors.

While merging EMS with the FDNY in 1996 nudged survival from out-of-hospital cardiac arrest up from 1.4% and cut response time from more than 11 minutes, eight minutes still can be too late. Ideally, CPR should be started within four minutes of a person's heart stopping to ensure that the heart and brain receive oxygen; defibrillation within six.

With each passing minute, the chance of surviving cardiac arrest falls by 10%. After 10 minutes, it is less than 10%.

But when bystanders give CPR before EMS arrives, the survival rate nearly doubles to more than 5%, according to study author Dr. Robert Silverman, director of research for the department of emergency medicine at Long Island Jewish Medical Center. If more people performed CPR, if defibrillators were more widely available and if cities increased their survival rates to 20%, an estimated 40,000 people would survive cardiac arrest each year, according to the American Heart Association.

"CPR buys you time, allowing the defibrillation to be effective when the ambulance gets there," Silverman said.

That's what happened to Keating, now 58. After Liam lifted his dad out of the car with the help of passengers in the car behind them, he performed CPR for the next 3 or 4 minutes. Police arrived just ahead of paramedics, Liam said, and shocked his father back to life with a portable defibrillator, known as an AED, that was stored in the trunk of the patrol car.

All Nassau and Suffolk County Police patrol cars carry AEDs. In New York , there is one AED for the radio car of each of the city's 76 police-patrol precincts, as well as for each of its harbor, aviation, highway, transit district and public service areas, such as housing projects, an NYPD spokesman said. The program began after a 1994 study of EMS response time and survival rates for out-of-hospital cardiac arrests recommended it, noting that police often arrive at an emergency ahead of EMS and are present at the majority of cardiac arrests.

Also as a result of the 1994 study, the Fire Department added 210 defibrillators on engine companies and doubled the number of ambulance tours on the streets, said EMS spokesman Dave Billig.

"Now the only thing left to do is to get the public involved, to train them to recognize the signs and symptoms of cardiac arrest and begin that pre-hospital medical care before we get there," Billig said. "That's what's going to help save more patients." Two deaths averted at Hunts Point

With studies showing that 70% of all cardiac arrests occur in the home, the federal government has approved the sale of over-the-counter AEDs, and a growing number of businesses are buying them as well.

In October 2003, five peace officers at the Hunts Point Terminal Market in the Bronx saved David Benson, a trucker from California whose heart stopped at the market, using CPR and an AED. It was the second such save in the eight years of the market's AED program, which was instituted because of "problems with EMS getting to patients on time" at the sprawling, 130 square-acre facility, said José Colon, the market's chief of public safety.

EMS arrived 15 minutes after Benson went down, according to Colon . ( EMS arrived 11 minutes after it was dispatched by 911, Billig said. The response time, he added, was "an aberration.") "That's after what we call the 'golden 10 minutes' that are ideal for somebody to get a shock," he said. "The fact that he at least got CPR was definitely a plus. Had we not had the machine, this patient probably would not have been with us."

New York 's Good Samaritan law protects bystanders from legal action when they make a good-faith effort to save a life, but experts recommend taking a first-aid training class both for the skills and the confidence to act in an emergency.

'Vertical response time' is the critical factor

In New York , labyrinthine high-rise buildings, broken intercom systems and sluggish elevators are a way of life.

So although it takes an average of 5.7 minutes for EMS to get through traffic to a caller's address, rescuers spend another 2.3 minutes racing the clock to reach patients in critical need of help — a total travel journey of eight minutes, according to a study presented yesterday in Manhattan at a meeting of the Society for Academic Emergency Medicine.

The response time is similar to Los Angeles (5.8 minutes) and Chicago (four to six minutes), though those cities' data do not include "vertical response times," officials there said.

"If you could knock two minutes off that, you're talking about a fair number of lives," said Dr. Neal Richmond, a former FDNY deputy medical director who authored the study.

The study, in combination with several others being discussed this week, for the first time quantifies a problem that experts have long suspected prevents more New Yorkers from being saved.

Previous studies looked only at the amount of time it took for the city's EMS to get to the address of an emergency. This is the first time the city has taken into account "vertical response" — the live-or-die period between when medics shut off the ambulance's ignition and finally make it to a critically sick person.

The lower the floor the better

The chances of being helped in time are worse in certain types of buildings than others, according to investigators.

In residential buildings, the vertical response time was 3.2 minutes, compared to 2.9 minutes for office complexes, 1.7 minutes for private homes of less than three stories and 0.6 minutes for outdoor calls.

Among the more troubling findings was that an average of 50 seconds were added to calls to residential buildings with elevators, and an additional 54 seconds if the elevator stopped before reaching the patient's floor.

When EMS was given an escort, though, vertical response time decreased from 2.5 to 1.9 minutes.

"Our response times are the best they've ever been, and we're getting to patients quicker than we ever have and saving lives," said FDNY spokesman Frank Gribbon.

"I don't know how you make elevators faster," he said. "We can't change the fact that there are very tall buildings in New York City . What we can do is public education."

The FDNY is offering 22-minute CPR classes to schools and community groups. Here's what else you can do to help:

Open the door for EMS . Among the most frustrating obstacles that rescuers face when they reach an apartment or office building are broken or mislabeled intercom systems.

"Basically, you have to press all the buttons," said Capt. Luis Basso, commanding officer for Station 10 in Northern Manhattan . "If you say, 'It's the Fire Department' or ' EMS ,' nobody answers. Then you go, 'Honey, it's me,' and you get a buzzer go off right away."

If possible, send an escort to show medics the way to the patient. "Some buildings have two different sides, and you're not sure to which side you're going," said paramedic Lt. James Bayreuther of Station 20 in the Bronx . "They should tell 911 if they have a family member they can send out to meet us in front of the building and direct us to where we're going."

If you're on an elevator with EMS , allow them to reach the patient's floor before pressing the button for the floor you want to go to. "Everybody's waiting for a long time in a high rise for the elevators to come down. There's normally one elevator working in most of the projects I've dealt with and it's going to take time and everyone's going to want to get on that elevator," Bayreuther said. "We'll have a call on the 15th floor, but we'll get in the elevator with several other people and when we ask them, 'Don't hit anything below the 15th floor,' they'll hit 7, 8, 9, 10 all the way up.

"It's very frustrating," he added. "A lot of times, my guys run up four or five flights and just forget about the elevator. And that's four or five flights with anywhere from 40 to 50 pounds of equipment between them."

J. L.

Could you save someone's life?

Fear and lack of knowledge often discourage bystanders from helping someone in an emergency, said Michelle Bowman, assistant director of training in health and safety services for American Red Cross of Greater New York.

"In an emergency, the first few minutes can really make a difference between life and death," Bowman explained. By taking a first-aid class, "not only do they get the skills they need to respond in a situation, they also get the confidence to act." The Red Cross emphasizes the steps of check, call and care:

Check to make sure you're not going to get hurt by assisting someone else; check to see if there are any bystanders to help out; and check the victim for consciousness.

Call 911. "Either send a bystander to call, which is what we recommend whenever possible, or make that call yourself," Bowman said.

Care for the victim depending on the type of emergency. "We don't ask a citizen responder to differentiate between … problems," Bowman said. "What we teach them is how to deal with the symptoms and to sustain that person's life until advanced medical personnel can arrive."

Restoring a person's circulation involves chest compressions, while restoring breathing depends on ensuring that the victim's airway is clear and breathing into their own mouth. The depth of the compressions differs for babies, children and adults, and a class is the best place to learn the proper way to perform them.


Stand behind an adult victim and wrap your arms around his abdominal area. Find their bellybutton and put a fist directly above it. Wrap around your other fist as support. Administer sharp upward thrusts to expel the object until the victim either becomes unconscious or the object is expelled. "If they're unconscious, you go through the same steps as you would for CPR because you don't know if that victim is choking or not. When you do the first two initial rescue breaths, if they don't go in, you have a fairly good idea that there's an object lodged in the person's throat."

Insect bites or stings:

See if the stinger is still in the skin. If necessary, scrape the stinger away from the skin with your fingernail or a credit card. Don't remove with tweezers because it might burst the venom sack. Wash and cover the site. Then apply ice or a cold pack for pain and swelling, keeping a towel between the skin and the ice. Continue to monitor the victim's breathing to make sure he's not suffering from an allergic reaction.

Heavy bleeding:

Put pressure on the wound with a gauze pad or any available substitute. Wrap gauze strip around the injury, but not so tight that you stop the flow of blood. Raise the injured body part above the heart to reduce the bleeding. If bleeding continues, add another gauze pad. If the bleeding is really bad, use your finger to put pressure on the artery.

Electrical burn:

Make sure the scene is safe and call EMS immediately. Turn off any electrical current before approaching the victim. When the scene is safe, check for life-threatening conditions such as unconsciousness or respiratory or cardiac arrest. Continue to monitor the victim's airway, breathing and circulation, and administer rescue breathing or CPR if necessary.

Adult CPR:

Tilt the forehead back and check for breathing for five seconds. If the person is not breathing, give them two rescue breaths. Use a face shield and gloves if available to minimize disease transmission. If the breaths go in, look for signs of circulation for 10 seconds by checking for a pulse and signs of breathing. Find the compression by tracing the ribs and putting your hand below the notch where the ribs meet. Give 15 compressions of 1½-2 inches deep, slightly faster than one per second. Give two breaths; you want to do four cycles of 15 compressions and two breaths. Then check for circulation again for 10 seconds. Continue the cycles until you're unable, until the victim's status changes or until advanced help or an AED arrives.


Check for shivering, slow and irregular pulse, glassy stare, numbness, apathy and decreasing levels of consciousness. Remove any wet clothing and place the victim in dry blankets or clothing. Move the victim to a warm environment and apply hot water blankets or heat packs or pads over a barrier, such as a blanket or towel. Rewarm the victim gradually and handle him gently. Give a conscious victim warm liquids to drink. Continue to monitor the victim's airway, breathing and circulation, and administer rescue breathing or CPR if necessary.


"Fainting is really just a type of shock," Bowman said. "It doesn't hurt someone." Put the victim on a flat surface and elevate the legs 8-12 inches. Monitor breathing and consciousness. Don't give the victim anything to eat or drink and wait for him to wake on his own, making sure you maintain his breathing and circulation.


Don't hold or restrain the victim. Protect him from injury and make sure he maintains an open airway. Don't put anything in the mouth. After the seizure, if there's any fluid in the victim's mouth, place him on his side so the fluid can drain. Then allow the victim to rest. Call EMS only if the seizure lasts more than a few minutes or the person has repeated seizures, is injured or doesn't have a pre-existing condition and you don't know why the seizure occurred.

American Heart Association CPR Classes: 1-877-AHA-4CPR
FDNY Public CPR Training:
American Red Cross Training and Certification: 1-877-REDCROSS
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