The Anatomy of an Emergency

You’ve daydreamed about being the hero a thousand times, but what will you do when an actual emergency strikes? Will you keep walking like everyone else, or will you have the courage to act? Separate yourself from the crowd by understanding how you can help before the ambulance arrives.

By Clay Rozell

Clay Rozell has been a firefighter/paramedic in Texas for five years, holds a bachelors degree in Public Communication and is pursuing a Master’s degree in Emergency Management.

Emergencies happen, whether by accident or design.  A positive resolution is directly related to the initial actions taken by those involved. How you perceive, analyze, and react in the initial minutes can actually save lives. This article will give you the basic information paramedics have to successfully discern and treat emergencies in the field.

The first thing any first responder will tell you in an emergency – “calm down.”  As easy as that sounds, with the amount of adrenaline being pumped through your body, you will be breathing harder, running faster, be more alert, and on edge.   Take a few deep breaths, get your bearings, and fight the tunnel vision.  The more you can disassociate yourself with the situation, the more clearly you can think.

You must first determine if there is an actual emergency, and then call 911. People tend to freak out even if they PERCEIVE an emergency, regardless if there is any legitimacy to it.  Paramedics and first responders will tell you that their job is more about managing people than managing emergencies.  Without fail, the pack mentality will immobilize people, if you have the fortitude and ability, now is the time to step up and give people direction, simple instructions “Call 911,”  “Calm down,” “Walk over there” etc.

The Two Types of Emergencies

In an emergency situation, simplicity is your friend, the less you know the less you can over analyze.  The majority of paramedics who fail their final exam do so because they OVER think the answers and begin advanced life saving techniques when the basic techniques would suffice.  So lets cover the basics, there are only two types of emergencies and injuries that occur, medical and traumatic.

Traumatic injuries are those that have inflicted a bodily wound like a stabbing, baseball bat to the stomach, explosion etc.  Medical emergencies are everything else, heart attack, stroke, ruptured appendix etc.  Despite the differences in the physiology of both traumatic and medical emergencies, the initial treatment and stabilization is going to be the same.

Remember your ABC’s

The basic and most important technique first responders use once they arrive on scene is to check for and stabilize the patient’s ABC’s; Airway, Breathing, and Circulation; in that order.  Although you will most likely not have the formal training or equipment on hand that the EMS guys have, you have the ability to address these basic needs.

First Responder ABC's

The effects of poor or improper CPR can cause unnecessary damage to the person, too many rescue breaths can effect a bodies PH level, compressing the wrong spot will not be as effective and could damage internal organs and other possible detrimental injuries.  A CPR class is cheap and can be completed in a day, the time and money spent is a great investment in yourself and your community.  Don’t attempt medical attention if you don’t know what you’re doing — but this shouldn’t keep you from organizing and being a leader in an emergency situation.

Airway

Check to see if the person has an open airway.  If they are talking they have an open airway, if they are unconscious a quick breath in their mouth will tell you immediately if air is getting into their lungs.  If you do not see their chest rise or feel resistance stop there and address this issue.  Try repositioning their head (some unconscious individuals’ tongue, when on their back, will fall to the back of their throat and block their trachea).  Is something blocking their air passage?  Heimlich maneuver?  Obtaining an open airway is the priority, do what ever it takes.

Breathing

If they are talking, they are breathing.  Look for chest rise and fall, get down and listen to see if you hear air moving.  If the person is not breathing and you have confirmed they have an open airway, get breathing for them.  Most adults breath 10-15 times a minute, kids more frequently.

Circulation

You have a few locations to choose from when checking for a pulse.  The pedal pulse is on top of the foot, femoral can be checked on their inner thigh close to the groin, radial pulse can be found on the wrist, and the carotid on the side of the neck. The body begins shunting blood to the extremities to protect the core, so you would expect to find, in extreme shock or blood loss, to not have a distal and radial pulse but you would feel a carotid.  If there is no circulation begin chest compressions, 30 compressions for every two breaths.  The mistake most make during CPR is not compressing deep enough, expect to break a few ribs and keep going.

Once you have identified and addressed the ABC’s, stop any excessive bleeding by applying pressure directly on the wound.  Do not stop applying pressure, if they bleed through the cloth/gauze, just put another one on top and keep pressure.  A tourniquet is a last resort option for severe bleeding.  The goal is to stop the bleeding.

Background Information

Medical, as opposed to traumatic, emergencies are more difficult to treat because they are internal.  EMS is going to want a history of the problem and a 24-48 hour timeline of what they ate, drugs they took, attempted remedies etc. to try to determine what is causing the problem.  Although the EMS guys will ask all these questions once they arrive, it would be beneficial if you gathered the info as well just in case the patient passes out or cannot communicate when help arrives.  Three important questions to ask are their age, any drug allergies they have, and when the issue started (the treatment might be different for stomach pain that started five minutes ago and pain that has been going on for two weeks).

Wait for Help to Arrive

By the time you have identified the emergency, called 911, stabilized any patients, and obtained the necessary background information, hopefully the professionals will be close by.  At this point there is little more you can do, continue to keep everyone calm and comfortable and monitor his or her condition.   When help arrives, they will be in hero mode so do not be upset if they initially give you the cold shoulder. First responders prefer to get their information from the patient if all possible (see the ABC’s above) to determine their condition but if you feel they need more information you can interject it.  Save the play-by-play narrative for your buddies at the bar, just give EMS the highlighted version.

Armed with basic information, some common sense and the ability to remain calm, you can navigate yourself through an emergency until help arrives.  Make no mistake though; a short article like this does not make you proficient.  To be truly prepared, a CPR class or EMT-Basic class would be optimal.  Nothing can duplicate the information and hands on training those classes provide, not only will you be prepared in an emergency situation, but those involved will be better off because of your training, why rely on someone else?

Clay Rozell has been a firefighter/paramedic in Texas for five years, holds a bachelors degree in Public Communication and is pursuing a Master’s degree in Emergency Management.

This brief article is only a launching point for further study and proper training. It is not intended to train individuals in performing medical techniques and should only be used as an introduction for further research.

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  • David

    First rule of first aid: Look for further danger. Don’t ever forget that. Don’t go running in and risk becoming a victim too.

    Couple of other pointers that apply to experienced first aiders too:
    If the person is unconscious try to get somebody else to help. If you’re stood over an unconscious woman it can look suspicious. Especially if you’re loosening tight clothing to help them breathe.

    If they’re awake talk to them. A) it will take their mind away from it (sometimes) B) it’ll let them know what you’re doing so they’ll be calmer.

  • http://www.primermagazine.com Andrew @ Primer

    David, great points! Thank you for including them.

  • Brigid

    The ABC’s are now CAB’s. The American Heart Association recently changed their stance that Circulation in the primary concern during CPR and rescue. Since it takes more than a few compressions to get the blood properly flowing throughout the entire body, when in doubt compress. You can give breaths all you want, if you don’t compress that oxygen isn’t going anywhere. Also just because they aren’t breathing doesn’t mean their isn’t still oxygen in their blood that can’t continue to be circulated.

    Also going straight into compressions, even if it turns out to be a unconscious choking victim, will allow for what ever is blocking their airway to pop out. DO stop compressions once the person is awake.