No Shock Zone. Part XII. Emergency care of shock victims

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Copyright Mike Sokol 2010 – All Rights Reserved

In a survey in the July, 2010 issue of RVtravel.com, 21 percent of RVers who responded reported that they had been shocked by their RV. What follows is the 12th segment of a 12-part series about basic electricity for RV users and how to protect yourself and your family from shocks and possible electrocution.

This series of articles is provided as an educational tool to help make you aware of some accidents that might occur during an RV trip.  This article discusses some basic safety skills and techniques that can help you respond during an emergency. Reading these articles does not fulfill requirements for CPR, AED, or First Aid certification, although the articles introduce concepts used in certification courses. The author, LT Safety Training, RVtravel.com and HOW-TO Sound Workshops will not be held liable or responsible for any injury resulting from reader error or misuse of the information contained in these articles. Always consult a certified professional regarding campground safety and how to respond during an emergency.

RV Safety: Providing Care in an Emergency.
Although RVs and campsites are usually safe environments, accidents can occur anytime. Some of these accidents could easily become life-threatening, especially when the victim suffers cardiac arrest due to electrocution from RV or campsite wiring problems. In addition, the remote location of campsites often makes it harder for trained medical personnel to reach the victim, which could delay care.

RVers may consider enrolling in full certification programs like: "CPR and AED for Community" or "Wilderness First Aid," but everyone should know some basics on how to provide emergency care in the event they find someone unconscious and unresponsive.

Cardiac Arrest (The Heart Stops)
According to RVtravel.com about 21% of RVers surveyed have been shocked by their RV.  This is especially troublesome since most of these injuries are preventable -- the shock is likely due to bad electrical maintenance, poor connections, or faulty wiring in an outlet or extension cord.

A severe shock through the chest cavity can result in Cardiac Arrest, a life-threatening condition that happens when the victim's heart stops beating or is not beating normally. This results in little or no blood flow throughout the body. Vital organs (ex. brain) don't receive oxygenated blood and begin to die within a few minutes.

Besides electrocution, cardiac arrest can also occur due to a heart attack (buildup in coronary arteries), respiratory arrest (breathing stops), and drowning. Some people may even have a heart condition that leaves them susceptible to abnormal electrical activity in the heart.

The Heart, Lungs, and How They Work (The Basics)
The pulmonary (lung) and cardio (heart) systems must deliver oxygen to the organs, and other parts of the body.  The lungs start the process by creating a vacuum (as the diaphragm contracts and relaxes), which brings oxygen into the body. The oxygen entering the lungs then enters the blood stream where it is carried throughout the body by the rhythmic pumping of the heart. The heart is a muscle that has special tissue running through it which conducts electricity. Electrical impulses carried through nodes in the heart cause the heart muscle to contract and relax.

As the heart contracts and relaxes oxygenated blood from the lungs is pumped to organs, and carbon dioxide is carried back to the lungs for exhalation.

So What Happens When the Heart Stops?
Vital organs in the body need oxygenated blood to survive. When the heart stops (ex. due to shock from an electrified RV) vital organs shut down due to lack of oxygen. Within minutes vital organs will begin to die. Brain damage occurs in about 4 minutes and clinical death occurs after about 10 minutes.

How Can You Increase the Chances of Survival?
Because the heart has stopped or is producing an abnormal rhythm (cardiac arrest), the lungs, brain, and other vital organs cannot function.  CPR (Cardiopulmonary Resuscitation) can help circulate oxygenated blood throughout the body when the heart doesn't work. AED's (Automated External Defibrillator) and Advanced Medical attention are the most effective ways to restart the heart, but CPR while waiting for trained rescue crews can help increase the victim's chances of survival.

Basically the idea is to pump the heart externally and get oxygen into the system through a combination of compressions and rescue breaths. Then when the AED and/or advanced medical personnel arrive they can restart the heart so the victim does not need CPR anymore.

First, identify if the victim is in cardiac arrest. If they're breathing normally, that means their heart is still pumping so no CPR is required. Dial 911 and notify the emergency operator of the situation. Follow any directions the operator gives you. Try to keep the victim comfortable and warm while staying with them until emergency personnel arrive. However, if the victim stops breathing it's time to begin CPR immediately.

The process of single rescuer CPR is not too hard to remember: 30 chest compressions, then two rescue breaths, and continue alternating. However, untrained campers might be unwilling or unable to perform mouth to mouth resuscitation correctly. Due to that fact, the latest American Red Cross training programs emphasize "Compressions-Only CPR" until trained rescue personnel can arrive. While traditional CPR (30 compressions, and two rescue breaths) is usually the most effective technique, Compressions-Only CPR can be helpful to increase survival rates.

Compression-only CPR is useful because it decreases bystander apprehension about providing care, and (when in doubt) compression-only CPR is better than nothing. Doing nothing will almost certainly lead to death.

Use hard and fast compressions at the rate of about 100 times per minute to externally pump the heart. That's about the beat of the Bee Gees song "Staying Alive." Hands should be placed in the center of the chest as shown in the picture below and rapidly compressed. The depth of compression is different depending on the victim's age. Just use your best judgment on age.

Adult = 1.5 to 2 inches deep

Child = 1 to 1.5 inches deep

Infant = .5 to 1 inches deep

When dealing with an emergency situation you should stay calm and provide the necessary care. The American Red Cross, and other certification courses can teach you the skills you need to help many victims, including victims of electrocution. But, even without a class you can still learn some of the basics, and most EMS (911) dispatchers are trained to coach you over the phone.

Also, there are a number of free SmartPhone apps for Compressions Only CPR (and other rescue skills) that show you hand position and rate of compressions.

The most important thing to remember is to always call 911 first to tell the operator of a possible electrocution before beginning any CPR! A severe shock from a Hot-Skin RV can not only cause cardiac arrest, but will likely cause electrical burns and damage to underlying tissue. Electrocution from a highly energized source like a power line touched by a ladder, or if the victim is wet, may even cause damage to the central nervous system.

Also, know how to test for and avoid electrical shock hazards with your RV by reading the rest of the NoShockZone articles, which is the best way to prevent electrical injuries in the first place. And be sure to immediately report any electrical problems to the campsite management. Don't just move onto another campsite leaving the problem for the next camper who might not be as prepared as you are.

Finally, when in doubt compressions-only CPR is your best way to help an unconscious victim in cardiac arrest. Doing nothing will almost certainly result in death, so your efforts may indeed save their life.

Feedback
After you've read this article at RVtravel.com, take a trip over to www.NoShockZone.org and send us your comments and suggestions. We love to know how we're doing with this important project.

Read all the segments in this series.

Mike Sokol is the chief instructor for the HOW-TO Sound Workshops (www.howtosound.com) and the HOW-TO Church Sound Workshops. He is also an electrical and professional sound expert with 40 years in the industry. Visit www.NoShockZone.org for more electrical safety tips for both RVers and musicians. Contact him at mike@noshockzone.org.