Randy Cassingham's Blog

Posted by Paul, NY on July 4, 2009:

Yeah Bro! Nothing like that rush, and the Talmud is right.

When my family and I moved to a small town on Long Island 13 years ago from NYC, I looked forward to becoming a firefighter, specifically a first response medical crew. One doesn't get that chance in the big city. I've got 5 kids and when we hit 60 stitches in one month, I decided it was time to get more serious training. I'm also a scout leader and teach the boys maybe more than a basic first aid. Thank you for your article. We can't impress the importance of being CPR certified too strongly. If you get a group of 7-10 people together, my department will come out and train you. I think most other volunteer fire and ambulance companies would. Ask yours if you are not a member.

I teach my children and my scouts that one has an obligation to give back to the community that nurtures you. At 53, I'm too old to go running into burning buildings though many of my company would disagree for themselves but I can handle an ambulance and memorized all the street locations in our town.

After 911 we had a major influx of new members which has now dropped off. All volunteer companies need members. Even if you only sweep the truck room, its important in getting the ambulance out. Good luck to all first responders.

Posted by Sheila, Calgary, AB Canada on July 4, 2009:

Timely story for me as I am due to turn the big 5-0 on Friday, November 13 of all days, if you are superstitious.

I have kept myself certified in First Aid for the past 20 years. Started as a job requirement - Early Childhood Professional - but continued as a desire to be update and able to help if needed. Here in Canada you are excepted to re-cert in First Aid every 3 years and, if possible, every year in CPR.

I have used my training to help two choking victims. An infant Mom had given popcorn to was projectile vomiting. Nature had solved the problem but I was able to educate the Mom on not feeding popcorn to the infant anymore.

Then a co-worker at lunch one day was talking and eating and next thing we knew choking. Coughing did not dislodge so Heimlich was applied and then I insisted she get checked out as I had learned at my latest re-cert (weeks before) that Heimlich could injury you internally sometimes. Good thing I insisted, she is a tiny 90 lb soaking wet thing and it turned out she was just recently pregnant with her second child, she was fine but at least we knew for sure.

Posted by Ken, San Francisco on July 4, 2009:

As you say, it IS difficult to find a particular driveway in a rural area. It would be far easier if everyone in a rural area had their own reflector code since finding reflectors at night would be much easier. No two reflector codes can be the same. Drive up and down the road to make sure. Mount them on your mail box. Let's say white over white over red. Or whatever. Get everyone in your town to do it.

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Codes don't help when you're looking for an address, and an address is what "enhanced 911" gives the dispatcher. Don't make up a code when all you have to do is buy reflective numbers and put them on a reflective sign! $10-15 will do it. -rc

Posted by Marcie, Los Angeles on July 4, 2009:

Thank you so much for what you do. I've had to call paramedics to my house a number of times due to my partner's heart and diabetes complications. I'm always amazed at how you emergency workers can stay so composed in the midst of a crisis. I can't thank you enough for being there when we need it the most. What you do is truly valiant and generous.

Posted by Andy, Portland OR on July 4, 2009:

Congratulations on a SAVE ... I know the outcome isn't often very good, and he still has a long way to go before he's fully recovered. I've had cops tell me that 25 minutes of doing CPR by yourself while waiting for the ambulance is the longest 25 minutes of your life.

I was a volunteer EMT in Granby CT many years ago (I've been in Oregon for 20 years) and know how dedicated you need to be to do the best for your patients. Granby is about 35 square miles and is still a fairly rural town, although it has bedroom community pockets. We also covered East Hartland, to our west, and some of our coverage area was almost an hour from the nearest hospital ... although when Hartford Hospital put their helicopter on line it brought them much closer. We were a "scramble" unit ... meaning that we had pagers or were near a phone and responded to pick up the ambulance enroute to a call (which added to response times). The police were our first responders, because they were already on the road, and we had everything from cops with minimal first aid training to some of the ambulance squads best EMTs. In fact one of the best is now the police chief, and I'd trust him with my life in _any_ capacity.

Connecticut at that time had their own training curriculum and did not recognize National Registry, but they now follow the National Registry curriculum. I was one of eight in our squad who took another 100 hours of advanced training to what Connecticut at that time called EMT-I (on top of the EMT-BLS), which gave us three appliances ... EOA, MAST and basic IV therapy (lactated Ringers and D5W - no drugs). EMT-D was another training level that could be added to BLS for defibrillator.

For a while the Canton Ambulance had _two_ EMT-Is, a husband and wife, and at least one of them was available in town 24 hours a day, 7 days a week. That is way too much to expect from two people.

I recently was told by someone who is still in the squad that Granby is considering going to full paramedic level ... a HUGE commitment for a volunteer unit.

Hartford Hospital's helicopter can reach any place in the state within 12 minutes from liftoff. ANY EMS certified person can call for the helicopter, if they feel it is needed. They had expected an inappropriate call rate of about 15% until EMTs were used to the protocols but after 6 months in service, the hospitals helicopter staff told us that they had _never_ had a call that they felt was inappropriate. There were some in which they assisted to get the patient into a ground ambulance, rather than transporting in the helicopter, but they said that even those calls had not been inappropriate.

Living in a city now, with the fire department paramedics responding within minutes (during the day they hang out at the community center gym ... 2 blocks away), as well as ambulance medics, we're not very far from trained help if we need them. But, as in Colorado, there's a lot of open country not very far from the city where an ambulance can be a _long_ way away. Having had my last training over 20 years ago, I really don't feel a lot of confidence that it would all come back to me if I stopped to render care at an accident miles from trained help.

I keep thinking that I really should at least renew my CPR certification. Maybe your success will inspire me.

Posted by Steven Denver, Colorado on July 4, 2009:

Perhaps this makes no practical sense since most of us would not be able to distinguish between ventricular fibrillation, ventricular tachycardia or bradycardia, or no cardiac rhythm at all ("asystole"), but given that Automated External Defibrillators (I have read that the Philips model is the only one approved by the FDA for use without a prescription and specific training) seem to begin at around US $1,250.00, meaning they are beyond the financial reach of many farms, homes or apartments, is there information on how to rig a MacGyver-type defibrillator from such things as extension cords? Since I realize that such information might violate all kinds of medical/professional or even legal guidelines I certainly wouldn't expect or ask for you or any of your readers to get into jeopardy, nor would I want to create further risk for a person who has experienced a "heart attack" or those around them. Still, when minutes are critical, I have to wonder if there isn't something that the American Heart Association and other medical professionals would have recommended or done (in addition to CPR) before there were AED's on the market?

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I've seen a couple of such things on TV, and I rolled my eyes both times. There is no way to give the right level of current for the right amount of time with an extension cord, period. Don't even think of trying it. Odds are much higher you'll kill a healthy person doing that than help an ill person, so it isn't even worth thinking about. -rc

Posted by Ellen, Waterville, Maine on July 4, 2009:

Thanks for all you do, both with True AND with being a real-life hero. After reading this, I immediately looked outside to be sure that I can see my neighbors' house numbers. They all have numbers, but I'm sure mine are too small. Now I'll make a change!

Posted by Bob in Mesa, Az on July 4, 2009:

Step-by-step "spoken" directions for their use may not help the 8% of the population with hearing impairments.

Aren't there new methods being suggested for CPR that recommend using only rapid chest compressions and not the mouth to mouth, as there is enough O2 in the blood to enable the brain to survive?

Of course, I understand that specific training in this method is recommended.

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Yes, there is an issue with "talking" AEDs for people with hearing impairments. Lay CPR training does emphasize compressions over breaths, but that will only work for so long. -rc

Posted by Larry, Chatsworth, CA on July 4, 2009:

I had chills running up my arms by the 2nd paragraph after "SUNDAY" and a watery eye by "DRT" -- as a fellow 50 "something" I'm glad your 50-something email friend convinced you to share this story.

Kudos for all you've done and accomplished.

Posted by Marc Pomerantz, M.D. Chicago Western Burbs on July 5, 2009:

As a General Surgeon with many days of E.R. experience and a year in Viet Nam, I have saved several lives - the experience NEVER gets old. I know just how you feel.

You're right, the MacGyver trick would almost never work. It's not just the amount of current. Timing is also super critical. A shock during the wrong time in the cardiac cycle can actually cause the heart to fibrillate. Also the current should be direct, not AC.

Incidentally, the 60 cps that Tesla chose is the most lethal cps possible because it is so close to the timing of the normal cardiac cycle. This is one of the reasons that electrical shock is so dangerous. No one knew that at the time, and changing it now would be impossible.