Lifeguards refused to give CPR - BYSTANDERS revive 3 year old drowning victim.

[irishgirl]

I’m a doctor (a baby, junior, junior one, but still, a doctor), and I’m currently doing 3 months of cardiology, which means (joy of joys) I’m on the cardiac arrest team.

Although there are pocket masks everywhere around the hospital and it is highly unlikely that I would ever be more than a few feet from one (especially since I carry one one on my keyring), were I ever to find myself needing to do CPR without one, I’d just do chest compressions until someone arrived with the proper equipment.

It was emphasised to everyone at ALS training that whether or not one chooses to do mouth-to-mouth is a personal choice, and that if you choose not to do it for reasons of your own health and safety, that is perfectly acceptable. You do whatever else you can until proper help and equipment arrives but you don’t put yourself at risk for the 15% chance that you can successfully resuscitate your patient (and that’s in a hospital). There are documented cases of TB, SARS and Hepatitis B and C infections from unprotected CPR. The risks are not theoretical, and in case your only experience of a resuscitation is ER or * House* there’s usually vomit and possibly blood involved.

Before ABC comes SS:
Shouting for help
Scene and personal safety
Shaking the person gently

Deciding whether or not to do mouth-to-mouth comes under Scene and Personal safety- before you even check for a pulse.

COR consists of opening the airway, performing chest compressions, and ventilation…even if you aren’t ventilating you should still be doing everything else.

[catsix]

I learned what irishgirl did when I took first aid and CPR training. You shout for help and then you make sure it is safe to give aid first, before you even touch a person.

We were taught about universal precautions and then told any choice not to follow them is a personal decision. I wouldn’t be stickin my mouth on anyone without a mask. I don’t know what they have, if anything, and I don’t want it in my mouth. Catching something from their saliva might be unlikely, but people who are receiving CPR have a tendency to throw up if air gets into the stomach, so there’s definitely bodily fluid involved.

Doesn’t matter how old they are either. I’m not touching anybody without gloves and I’m not giving CPR without a mask. Not for the tiny chance that the person is comin back weighed against the risk that I catch a nasty disease.

[Boyo_Jim]

@Rhubarb

First, I did not realize you were present during their training. I’m not saying that the standard set by the American Heart Association requires a mouth shield (although it recommends it strongly), I’m saying that their employer might to protect themselves from litigation by an unscrupulous individual.
Second, I am not speaking to the lifeguards’ state of mind, rather to the state of mind of their employer who provided that training.

If the employer was so concerned about liability suits, those lifeguards would have masks and gloves. Far more likely that, being a state agency, they have some degree of immunity from civil suits, and they didn’t give a shit. I’m not saying this was the case, it’s just more probable than your theory IMHO.

Also, employers rarely provide their own CPR training – they farm it out to the local hospital or AHA affiliate. And to bring in lawsuits again, it seems to me as if the employer might be more vulnerable if they, post cpr training, tell their employees to ignore parts of it, which they would be doing if they issued such an order, and again, doubly liable for issuing such an order and then not providing the gear, effectively rendering their lifeguards impotent.

Sorry about the run-on sentence.

But who knows, the lifeguards could have saved a half-dozen people the day before, and not had their supplies restocked. Not.

[buttonjockey308]

@Boyo Jim

Not to mention that the followup story contains some very questionable claims that smell of bullshit to me. Specifically:
If he was spitting up and vomiting and had a puse, it would have been almost impossible (and wrong) for the civilians there to administer cpr. In fact, it;s extremely unlikely they eould have tried, so they would need to be lying about thisl The lifeguards later thought he might need cpr? And gave him some? Maybe if the kid had flopped over and stopped breathing AGAIN, which no one claimed. And they eyewitnesses at the beach directly and specifically contradicted the “official” version. The story was damage control, nothing more and nothing less.

Of course it was damage control, it’s a gov’t agency. That said, the cardinal rule of treating kids in the field is that when kids crash, they do so RIGHT NOW I’ve been on calls where kids were up, walking around and talking to us one minute, and the next, we’re riding a stretcher into the ER doing compressions.

It’s absolutely possible that the kid was spitting up, coughing, and/or making noise one minute, and dropped off the next, requiring CPR.

And for what it’s worth, a lot of eyewitness accounts are fuzzy at best, and fiction at worst, makes it damn hard to know who to believe.

[Heckxx]

Boyo Jim, I’ll concede that yeah, I’m ignorant sometimes, yeah it does seem like its a cover up, and yeah I can’t conclude that they “certainly would’ve done something”.

But still, I’m hearing alot of professionals and CPR trainees here explaining the rules of safety, and I think it is just as likely that the beach officials are covering this up as it is that the bystander’s are lying or mis-interpreting what they saw. Probably not lying, but for some of these witnesses who know little about CPR and all…they could’ve easily misunderstood what they saw and immediately assumed, “he needs help!” when the boy really needed to rest or something. Again pardon my ignorance for any sort of medical technicalities.

Some other scenario possibilities:
-The beach has had no previous emergency incidents and the lifeguards were all new/young recruits. Confusion can easily arise.
-There were many bystanders trying to intervene, and therefore the lifeguards were confused on what was going on. And possibly, the bystanders might have expected the lifeguards to come out immediately when they had to go somewhere else to pick up the mouthguard.
-The lifeguards are under-equipped by their lazy boss, but when the boy needed CPR, one book-smart smartass lifeguard firmly says, “nope, i can’t do this without a mouthguard!”, even if his action was the right thing (according to medical practice), the bystanders would’ve been shocked at his seemingly un-emotional response and tone.

As a trained and employed medical people, I think the lifeguards had every right not to help the boy without proper safety to themselves. Yes, they probably should’ve been alittle better prepared. But when such a unfortunate situation arises, the choices are grim either way.

[SeaDog]

Quick question for the medical folks because I may be remembering my training wrong.
CPR is for a situation where no breathing and pulse are present yes?
I seem to remeber (and please correct me if I’m wrong) that chest compressions, if a pulse is present, could be dangerous as you my interupt a already weak heart beat?

As for the OP, I would never be able to look at myself in a mirror again if I stood by and watched a child die out of fear from my personal safety. We ain’t talking about throwing ourselves under a bus here. We are talking about the remote chance of catching something which may or may not kill you in years to come. I can understand why the medical folks would be more hesitant as they do this time and time again, increasing the chances of a infection. But me as a regular guy whose once in his life has to take that small chance to save a life, thats a no brainer.

[Lord_Ashtar]

@buttonjockey308

You can beat your chest, you can posture, you can call people chickenshit, but if that (potentially) HIV+ three year old pukes bloody stomach contents into your mouth, which in turn gives you HIV, which, in a dozen years or so turns into AIDS and kills you, and you can’t see YOUR kids grow up. Would it have been worth it?

Yes.

[Heckxx]

You can beat your chest, you can posture, you can call people chickenshit, but if that (potentially) HIV+ three year old pukes bloody stomach contents into your mouth, which in turn gives you HIV, which, in a dozen years or so turns into AIDS and kills you, and you can’t see YOUR kids grow up. Would it have been worth it?

@Lord Ashtar

Yes.

food for thought:
What about a surgical doctor that administers life-saving surgery without the safety of a mask or gloves? What about a 911 paramedic attempting to save a live without protection to himself, and thus risking his own life? Is it better that the highly trained professional potentially loses his life to save the life of another? Or does he have an obligation to be smart and not a reckless hero?

Although I’m sure many doctors and paramedics wouldn’t risk their own life for more than selfish reasons, even if you could find one who is totally morally valued, there are still risks in that they should not take for the better good.

Reminds me of and situational ER room, where you spend 5 hours trying to revive someone who is nearly hopeless, when you could’ve saved 5 people who were semi-critical and waiting outsite.

[Lord_Ashtar]

@Heckxx

What about a surgical doctor that administers life-saving surgery without the safety of a mask or gloves? What about a 911 paramedic attempting to save a live without protection to himself, and thus risking his own life? Is it better that the highly trained professional potentially loses his life to save the life of another? Or does he have an obligation to be smart and not a reckless hero?

Anyone who’s job it is to save lives who doesn’t feel comfortable putting their mouth directly on someone else’s when necessary and doesn’t take the precaution of having the protection they need is irresponsible and in the wrong profession.

In the OP’s case, the moral thing to do is to save the child. Period.

[Ponder_Stibbons]

@Diogenes the Cynic

Yes, trying to save a child’s life is noble but putting yourself in danger is stupid.

Were the fire fighters and cops who died in the WTC “stupid” for running in there?

You bet! What kind of moron puts his own life in danger to save someone else? What is this world coming to when random idiots decide they have to “save somebody”. We’d all be better off if everyone would just MIND THEIR OWN DAMNED BUSINESS!! :mad:

That having been said, not everyone is a hero. But damn, if a life guard isn’t prepared to be, well, a life guard, what the hell good are they?

As I catch up reading, I see Telemark has posted a report that contradicts the initial news that started this thread. In fact, it seems to indicate that a lifeguard did, in fact, perform his duty. Huh. With these contradictory stories running around, it makes me wonder what really happened. We may have all just gotten worked up over a complete work of fiction. That would certainly be annoying.

[irishgirl]

Yes CPR is only supposed to be done on people without a pulse who are not breathing. It used to be the case that compressions were stopped after each shock was given or after each 30:2 cycle, while a pulse was checked.

This is no longer recommended, compressions are continued for 2 minutes after a shock and a pulse is checked after that 2 minutes is over. The new guidelines are also that if a person has no medical training they should not waste time by checking for a pulse at all.

In a person with a non-shockable rhythm, a pulse is only checked for if they show signs of life. The theory is that in some people the myocardium is “stunned” after a shock, and it takes a while to get going after the shock, so checking for a pulse wastes valuable time that could have been spent making sure blood was circulating around the body.

In people with a non-shockable rhythm you’re aiming to make them shockable, and checking for a pulse while there are still no signs of life is fairly pointless. in the rare cases where CPR alone restarts a heart, the person will usually display definite signs of life (coughing, moving, that kind of thing).

CPR alone, is, despite most people’s impressions, rarely enough to get a stopped or failing heart beating effectively again. For that you want electricity and plenty of it, CPR is mostly there to buy the brain and heart time, and to try to convert a non-shockable rhythm to a shockable one.

Medical and paramedical personel are there to save lives, true, but NOT AT THE EXPENSE OF THEIR OWN SAFETY. If someone wants to take risks, well, that’s their choice, but that’s what it is, a choice.

I find it perfectly possible to believe bystanders were doing chest compressions on a child with a pulse, since it has been known for bystanders to perform CPR on a corpse in full rigour mortis (meaning death occurred at least 4 hours previously)!

Death is not the worst result of CPR- carried on for too long or incorrectly, the worst result of CPR is PVS.

An example of a Paediatric Life Support protocol from a UK hospital. Note especially the sections “Precautions” and “Sequence of Actions”.

[scotandrsn]

@Lemur866

If the lifeguards can’t be expected to perform CPR without a mouthguard, and they can’t be expected to carry a mouthguard around because they perform CPR so infrequently, why bother having lifeguards in the first place?

THANK YOU! The idiotic bullshit I’ve been reading in this thread is appalling.

[Scumpup]

@Diogenes the Cynic

Then you’d be a selfish, chickenshit, punk, unworthy of respect. If you could live comfortably with that, you’d be even more of a punk. No, you’re not REQUIRED to risk getting a disease (even though the chances would be low), but wouldn’t make your choice very admirable or ethical.

Exactly right.

[Heckxx]

@Ponder Stibbons

As I catch up reading, I see Telemark has posted a report that contradicts the initial news that started this thread. In fact, it seems to indicate that a lifeguard did, in fact, perform his duty. Huh. With these contradictory stories running around, it makes me wonder what really happened. We may have all just gotten worked up over a complete work of fiction. That would certainly be annoying.

Somehow I missed **Telemark’**s post (i only saw Annie;s)…but this is what I’ve been thinking as well. The progression of this thread has veered so far from assumptions from the orginial newscast to false facts. I think too many people are painting this picture in their head of what they think happened, and it is beginning to appear way off from even the original newscast.

As i find as the foundation of alot of arguments…confusion. Confusion is all to blame, I think. Confusion–>misinterpretation–>conflict

[scotandrsn]

Next we’ll be hearing about lifeguards refusing to swim out to save someone because the fact that the person is drowning shows the water is too dangerous.

[Heckxx]

You can all argue about the morals of the situation IF the mouthpiece was not present and IF the lifeguards did absolutely nothing;

But until someone convinces me that the news report that Telemark posted is false for some reason, I personally consider this a closed case. The Boy lives. The Lifeguards did the right thing, within very good reasons, and without any moral dilemmas. The bystanders caused a slight scene of confusion.

Let me know if i forgot something

[ralph124c]

This reminds me of the terrible loss of life in the Worcester, MA fire of 1997. Basically, a bunch of firemen were sent into a burning building, to try to save some homeless people (although no one was in the building). Lives lost for nothing, and to save some people who were living in a homeless shelter. Is it/was it worth it/ I don’t have the answer-all i know is, most people care very little about the homeless-should lives be sacrified for them?

[SeaDog]

Thanks for the info Irishgirl

[scotandrsn]

@Heckxx

You can all argue about the morals of the situation IF the mouthpiece was not present and IF the lifeguards did absolutely nothing;

But until someone convinces me that the news report that Telemark posted is false for some reason, I personally consider this a closed case. The Boy lives. The Lifeguards did the right thing, within very good reasons, and without any moral dilemmas. The bystanders caused a slight scene of confusion.

Let me know if i forgot something

Why doesn’t the link you re-posted youself convince you?

…After the DCR gave their statement, CBS4’s Eileen Curran asked if they spoke with anyone on the beach who was present during the incident. They said no…

If you can’t smell the bullshit right there, I recommend you take your nose in for service.

[crazyjoe]

Sorry to the medical professionals here but if you are:

1. A first responder or a person whose job it is to save lives
   and
2. Someone is in need of life-saving
   and
3. You are on duty
   and
4. You are not carrying the required equipment (forgot it, didn’t pick it up that morning, etc)

You better bet your fricking life I expect you to deliver CPR, MtM, or whatever else is required to try to save the life. It’s your fucking job, people count on it, and if you don’t have the equipment you need, you shouldn’t have reported in for work that day until you got it.

Personal choice my ass. Unless a mugger just up and stole all your damn mouthguards, you should have them, just like surgical gloves and masks.