Randy Cassingham's Blog

Posted by steve olathe ks on June 29, 2009:

I worked as an orderly in my small home-town hospital. There, the job of "orderly" meant doing everything from bedbaths on day shift, to maintenance and security on evenings, and ER on nights. I later rode an ambulance as well; no EMT's or Paramedics at that time, Advanced First Aid, a bottle of O2, and some air splints was all we really carried.

The feeling you describe, Randy, I felt a couple of times, fortunately. More often, though, it was the sadness that nothing I did, or could have done, helped. The worst thing, as you know now in your home area, is going on calls for friends.

Thanks for sharing your story. My prayers for your patient.

---

Indeed that's a big change from my previous stint: in a small community, the odds that you'll know your patient go up exponentially. As you saw, it's happened several times already. It can be gut-wrenching, since it's harder, and sometimes impossible, to emotionally detach. -rc

Posted by Felix, Dutch Flat on June 29, 2009:

The local VFDs (two of them) always have reminders up about having good street numbers posted, visible day or night. Here's is another good reminder how important that is.

---

Yes, it's truly a huge problem, especially in rural areas where people are more likely to want to remain anonymous. Works great -- but they often haven't thought about emergency situations. (VFDs = Volunteer Fire Departments) -rc

Posted by naleta, Michigan on June 29, 2009:

You earned that good feeling! I work with a couple guys who are both EMTs and volunteer firemen. I have told them before and will again that I'm glad they are around. I haven't personally needed their skills, but it's people like them (and you) who save lives every day.

Posted by Henry - Maryland on June 29, 2009:

Wow! That's as much excitement as most people would ever want but is faced by the EMTs all the time! Congratulations! You're really right about what a defibrillator does. I have an ICD implanted one that's gone off four times and can attest to its ability to make you jump! Fortunately, the ICD was responding to a spurious signal my heart was suddenly producing. The doctor only kept in from going off a fifth time by moving the contact wire in my heart. It's apparently almost unknown within the medical profession for this type of anomaly to occur so long as mine after implant. He said, "You're unique!" Thanks! Meanwhile, you're truly a Life Saver and a good writer, too!

---

An ICD is an Internal Cardiac Defibrillator -- sort of like a pacemaker, but it only fires when it detects v-fib, so someone at risk doesn't have to wait for someone with an AED to arrive. It runs at a much smaller power because it's attached directly to the heart ("internal" is the key word!) But yeah, I can imagine it'd really make you jump anyway! Especially when it goes off erroneously, which is indeed rare. -rc

Posted by Hyman, New Jersey on June 29, 2009:

My son just completed 9th grade. As part of the orientation at the beginning of his school year, ALL incoming 9th grade students, the upperclassmen involved in the orientation and many of the faculty became certified in CPR and AED. Parents were also invited to be trained - at no cost to the parents or students. The course was the ECSI CPR and AED training - a two year certification. One quarter of the students in the school were therefore trained to save lives. I believe that they plan to do this every year, so that at least 50% of the student body will always be certified.

---

Cool idea! -rc

Posted by Mark, Ridgewood, NJ on June 29, 2009:

Wonderful story. It was almost like a screenplay and even though we knew the ending, it was very suspenseful. That is great writing!

Posted by Ana-Marie, Oakland & San Francisco CA on June 29, 2009:

Bravo and big huge THANK YOU to both you and Kit! I'm filled with admiration for what you did that night and for the stand you and Kit take for your community. What a wonderful and inspiring recount of your experience.

One of the groups I support with preparedness education is the Medical Reserve Corps (MRC). I had the great honor of addressing 2,000+ MRC supporters at a conference in Dallas in April -- and you are absolutely correct about the great need to support EMT services across the country. I will do my best to share this story far and wide!

Posted by Ann, Sterling VA on June 29, 2009:

WOW! What an eye opener! My hubby has atrial defib, and I think maybe I should learn CPR! Good job, Randy, to you and Kit and Kim and all involved!

---

A-fib is not too serious, especially compared to v-fib, but yeah: I encourage anyone who is commonly around people with cardiac problems to learn CPR -- especially if they care about that person. -rc

Posted by Malene, Vermillion on June 29, 2009:

I have great respect for what your team has done. Furthermore, I am thankful that not only were you able to help the patient and his family, but also that you are in a position to rally the efforts of millions of readers.

As someone who has been on the receiving end of medical aid, I can assure you that the help is sincerely and deeply appreciated. However, I haven't personally thanked those who have helped me either. It's not an issue of forgetting "little niceties"; I was in no condition to notice the faces of the people helping me---nevermind get their names. And my family members were in a state of shock too deep to think about anything beyond saving my life. Sometimes the best we can do is "pay it forward."

SO thank you for everything you do, AND thanks to the other readers for everything they do to make this world a better place!

---

I was in fact referring to family members, rather than unconscious patients, on the "thank you" bit! I certainly understand, and agree "paying it forward" is a great way to do it. -rc

Posted by Tom, Florida on June 29, 2009:

Having spent 25 years as Firefighter/Paramedic, I can remember AEDs being used experimentally around the time the first Life Pak 5 came out and being totally resisted by EMS. This was in the 70s and medics weren't about to give up any part of running a code. What idiots we were. Well I was glad to see things change and I feel the early defib is the pt's best chance. Hell, I've gone after more than one person with stacked shocks and had him wake up and ask me why I was punching him and then want to get up! Then you got to knock the guy out with versed and intubate him. But more and more are leaving the hospital these days.

One thing about MJ. Did his Doc have any narcan? or any other acls drugs? The people who performed the post did not say anything re. ASHD as a pre-existing cause. Be a shame if he just went into resp arrest due to demerol and the doc did not have any tools.

---

Good question about the narcan, which in Colorado is a BLS drug now. (ALS = Advanced Life Support, typically "paramedic"; BLS = Basic Life Support, typically "EMT". Narcan reverses the effect of opiates, such as heroin and morphine, which depress breathing.) But I don't know the answer. -rc