Orleans Citizens Fire Academy Chronicles - Week 3

CPR and first aid training
An Orleans Fire-Rescue EMT demonstrates proper delivery of CPR chest compressions. Note the green LED display on the mannequin's left shoulder. The green lights mean the chest compressions are satisfactory. (CCToday photo)

The third class of the Orleans Citizens Fire Academy focused on CPR training, AED training and provided an introduction to the "Stop the Bleed" program.  This session was led by a paramedic and an EMT from the Orleans Fire-Rescue Department.

When we arrived for class we knew this would be a working session.  Each table in the room had a CPR mannequin laid out, the center table was filled with Automatic External Defibrillator apparatus and Stop the Bleed bags were lined up at the rear of the classroom.

Our instructors began with some basic instruction in hands-only CPR.  As with everything taught in the fire academy so far, this program begins with situational awareness.  Are you in area where you can safely work?  For example, are you in a road or parking lot where you might be hit by a car while working with the patient?  Next, you check the patient - speak to them, shake them, look for signs of breathing.  

If you're not seeing signs of life, the next thing you should do is call 911 and put your phone on speaker.  That gives you two hands to help the patient and allows the dispatcher to stay on the line with you.  In many cases, a dispatcher can walk you through procedures while you wait for help to arrive.

Participants learned quickly that the process of providing CPR chest compressions is a lot more involved that it looks on television.  First, one needs to make sure one's compressions are sufficient to circulate blood through the heart - and that you fully release the compression to allow the heart to re-fill with blood.  Today's CPR mannequins have electronic sensors that show whether your compressions are sufficient to aid the patient.  In the story photo, note the green LED's on the mannequin's left shoulder.  Those lights will be green if your compressions are satisfactory.

Many of the older members of our class remarked about how fatiguing it was to provide chest compressions for a few minutes.  Imagine needing to do that while waiting for an ambulance to arrive. The instructors talked to the class about their own experiences giving CPR and how exhausting it is even if one or more people are switching off.  As one instructor said, the LUCAS device, introduced in last week's class, is truly a miracle.  It can deliver consistent chest compressions automatically, even when the patient is being carried down a stairway or moved into an ambulance.

Next, the class was introduced to the AED - automatic external defibrillator.  These devices are being installed in many public places these days.  They are capable of shocking a heart out of a disorganized beat (known as fibrillation), which can save a patient's life while waiting for the ambulance to arrive.

As its name implies, the AED is fully automatic.  When you power it up, the device gives spoken instructions on what the operator should do and when.  Once shock pads have been applied to the patient and connected to the machine, the AED analyzes the patient's heartbeat and decides if a shock from the AED is appropriate.  If so, it walks the user through the last part of charging and shocking the patient.  

Many in the class remarked that they have seen AED's in public places they have visited but had no idea how they were used.  Class members observed they were much more comfortable using an AED now they had seen a hands on demonstration of how they work.

The Stop the Bleed program has become very popular on the Lower and Outer Cape following recent shark attacks.  Instructors took the class through the steps of patient assessment and the various options for controlling a bleed.  

As with CPR, the first step is situational awareness and safety.  The next step is always to call 911 and put your phone on speaker.  Next, one locates the bleeding and then the class was instructed on how to compress the wound by various methods.

The instructors went through the contents of the Stop the Bleed kits available at Nauset Beach and went over how to use each item in the kit.  They stressed that if a patient has been impaled the object should be left in place, as removing it might release an uncontrollable arterial bleed.

Once again this week, class members were impressed by the proficiency with which the rescue personnel handle the various devices and supplies that were presented.  Our rescuers practice so many times they have virtual muscle memory for many of the tasks necessary to help a patient in distress.

Rescuers again stressed that if you feel like you might need 911, you should call 911.  Do not attempt to drive to the fire station and do not try to "push through" whatever it is that's happening.  


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