On this episode of the WorkSAFE Podcast, we sit down with Drew Toma, the creator of Save with CPR. He is a career paramedic, Emergency Medical services (EMS) educator, and CPR instructor.
Preventing injuries on the job is a priority for any employer. It’s important for employees to be safe and healthy, and to manage work comp premiums where possible. However, injuries and emergencies do happen. Knowing whether something requires a 911 call, or simple first aid, makes a big difference in outcomes.
Listen to this episode of the WorkSAFE Podcast, or read the show notes below.
Emergency response: Two essential skills you need
For Toma, there are two essential skills you need to respond to an emergency. First, you need the ability to stay calm. If a 911 call is necessary, then you need to be able to relay information about the incident. They’ll activate resources, or send the right responders to the scene. Operators need clear information to know who they should dispatch.
Second, you need the ability to differentiate between an immediate threat to life, and all other injuries. Toma classifies this as anything that prevents oxygen or blood from getting where it needs to go. For example, if someone is in cardiac arrest, where the heart stops beating, is in a critical situation. Neither blood nor oxygen is circulating to their organs.
Learning life-saving first aid skills
In the event that someone’s heart stops beating, cardiopulmonary resuscitation (CPR) is taught as a life-saving measure. However, Toma highlights another important skillset gaining popularity: Stop the Bleed.
“There have been a large number of incidents where people suffer significant cuts, lacerations that result in what we call hemorrhage, which is the fancy word for bleeding,” Toma explained. “The problem is it takes several days for your body to replace this blood, but you can lose it in a matter of minutes.”
When it comes to workplace incidents and trauma, it’s vital to know how to intervene when someone is bleeding heavily, until first responders can take over.
Problems that happen with emergency response
In an emergency situation, emotions run high. As a result, Toma points out that people often don’t call 911 soon enough. Even if they wait just a short time, first responders still need time to arrive. Minutes, even seconds, make a difference in a situation where someone’s life is on the line.
The importance of basic healthcare literacy
For Toma, the most difficult emergency calls aren’t the expected ones. Rather, it’s the calls where just a few minutes or a bit more knowledge could have made the difference between life and death.
Some employers see CPR or workplace first aid training as an additional cost. “The thing about that is, every minute that you have delayed in chest compressions, your chances go down by 10%,” he explained. “If you’re doing CPR and you’re not a healthcare provider, it’s at least an 80% chance that it’s on somebody you know.” Simple first aid skills can lay the foundation for saving someone’s life.
A key example: Opioid overdoses
Opioids are a class of medication useful in healthcare for managing pain. When someone administers them properly, and a healthcare professional monitors them, they are safe to use. However, it’s a powerful medication. Taking too much, intentional or not, can have critical consequences.
Opioids are a central nervous system depressant. They lower situational awareness and slow breathing. As a result, the body gets less oxygen than it usually needs. If someone overdoses, their body has much less stored oxygen to help keep them going. Consequently, they starve for it and can slip into cardiac arrest.
Giving rescue breaths is a simple process that can save a life. First responders have a reversal agent, Narcan, that aids those who are overdosing. But providing oxygen in those key moments before they arrive can minimize long-term damage and more importantly – help keep that person alive.
Cardiac arrest management
An automated electrostatic defibrillator (AED) is a tool used in cardiac arrest management. When someone goes into cardiac arrest, an AED can be attached to their chest. It interprets if and how electricity is moving through the heart. If that electrical rhythm is abnormal, then it uses an electric shock to reset it. That shock is called defibrillation.
Toma compares it to calling a phone company for help when your internet goes out. One of their first recommendations is to turn off your router and then turn it back on. “The AED does not start the heart, it actually restarts the heart,” he highlights.
Most importantly, someone’s heart has to have some kind of rhythm to use an AED. Chest compressions are essential if the heart isn’t beating at all. Once it has a rhythm, an AED can be used. “That’s why making sure the airways are open and the breaths are important, because the AED is actually restarting the heart and it’s supplementing your resuscitative efforts,” Toma added.
The reality of emergency situations
When most people imagine emergency situations, they think of the latest drama on TV. But the reality is, each situation is different. From the health issue, to the responding crew, to the type of workplace, no two 911 calls are the same.
First responders often manage care on site
A popular expectation is that when an ambulance arrives, paramedics will immediately scoop up the patient and rush them to the nearest hospital. And in many trauma situations, that may be the case. But a cardiac arrest is different.
“Medical shows are the bane of my existence,” Toma joked. “When that ambulance shows up, we have everything that the ER has as it relates to this cardiac arrest. Now there’s some, you know, odds and ends that we don’t have. But the first 20, 30, 40 minutes of that cardiac arrest management, we have all of the same tools. We have all of the same training and knowledge and abilities.”
Rushing to the hospital is often a distraction in the first critical minutes that someone is without a heartbeat or air. Consequently, during some emergency calls, first responders will work to stabilize patients on-site.
Tools supplement first aid efforts
“One of the things about AEDs and breaths and even Narcan is they’re not going to be as effective as you think if you don’t have the basics down first,” Toma added. In any emergency situation, employees need to know how to ensure an airway is clear and receiving oxygen, and how to give chest compressions that circulate blood in the blood. While tools are extremely helpful, without essential training, they can’t save a life on their own.
First steps for employers
Setting a workplace up for success in an emergency is important. Employers should decide what their goals need to be when it comes to training and investing in equipment.
Review your resources
First, employers should review what resources are available to them. Is your business located in an urban or rural area? How long would it take emergency services to get to your workplace?
Toma points out that depending on where you live in the United States, EMS isn’t a required service. As a result, ambulances may be understaffed or require a long wait time. In these situations, having trained employees is invaluable during a workplace incident.
Invest in equipment
No matter the size or location of a workplace, having the right equipment on hand in an emergency is useful. Whether it’s a fire extinguisher, first aid kit, or AED, no one regrets having the tools they need when they need them.
Make first aid training work for you
In certain industries, CPR training is a requirement. Employees must know it based on the work they do. For example, those who work in healthcare settings, like nursing homes or hospitals. An instructor carries out these courses, often over the span of 3-4 hours. But for workplaces that might be short on funds for formal training, Toma recommends flexibility.
“I’m personally not a believer in forbidden knowledge, right?” he shared. “You can show them YouTube videos. You can buy the mannequins on Amazon, and you can just practice some of the small pieces.” Any knowledge is more powerful than no knowledge at all.