Self Defense Medicine Session 11: Circulation Airway Breathing (C.A.B.)

Okay, folks. Let's talk about our actual patient assessment and this type of algorithm, if you will, that we need to discuss and actually go through, as we're checking ourselves for self-aid and also our friends, loved ones, bystanders, or someone else as buddy aid. Okay. Now, if you've taken a CPR class before or any other first-aid class, you may have heard the term ABCs or, Hey, we need to check the patient's airway, breathing, circulation. And, for years, that's been the standard is airway, breathing, circulation, and we check it in that order.

And if we find it broken in that order, we fix it first before we move on. Well, we've, we've changed that up a bit. Okay. A few years ago we realized, well, if we study a little bit about anatomy and physiology, okay, we learned that well, there's something more important than just having a really good airway and breathing. We've actually got to worry about circulation.

So they've changed it up. And now it's circulation, airway, breathing, and that's the same algorithm that I use, and same type of patient assessment that I use to teach my students, that we're going to teach you guys. Now, if you ask 10 different medics, and doctors, and nurses, they're going to give you all sorts of different acronyms and different assessments. And those are all fine for their actual application. I like to keep it real simple.

And three things seems to be about that mark. So, starting with circulation. Well, the first thing we've got to worry about: Is there any bleeding? If they're bleeding outside the body, we've got to keep the blood in the body, inside the container itself. Okay.

That second C, there's actually a second part to the C: for circulation. It's do they have a pulse? You got to check for a pulse. After we've checked to see if they're bleeding, and we've controlled all the bleeding, we need to check and make sure they still have a pulse. If they don't, then you start chest compression, you start CPR.

If you haven't taken a CPR class recently, within the past few years, I highly recommend it. So, you can go find a American Heart Association has a great curriculum, and a highly recommended CPR and AED course, or automated external defibrillator course, from American Heart Association. We teach it occasionally at some of our classes. It's a great class, and it teaches you what to do if there is no pulse. Simple, we give them one.

But we'll talk about that on another later subject. Now, we're going to move on from the circulation. Now we're going to move down to airway, and then breathing. So, airway, let's talk about airway. What does airway mean?

Well, airway means do they have an open airway? Is it a patent airway? Now, whether we're talking about: Hey, they can breathe through their nose, or their mouth, okay, that's great. And if we need to open up that jaw so we can use a couple of different techniques for that, which you'll learn in a CPR course. The next is breathing.

Are they breathing? If we look, listen, and feel for 10 seconds, and with an open airway, if they're not breathing, we breathe for them. Again, that's going to be a CPR course. Again, I highly recommend you take an American Heart Association course in CPR and AED. Now, how does that help us during a violent altercation, or with self-defense medicine?

Very simple. In any environment, we're going to check the patient, and we can use this even outside of self-defense medicine. Okay? Doesn't have to be specifically for this type of environment. But it's simply: circulation.

Are they bleeding? Yes or no? Do they have a pulse? Is the airway open? And are they breathing?

If we've got those three things intact, folks, you've got a viable patient and you can keep them alive until the medics get there. Now, let's talk about how we actually check for a pulse. Okay? Now there's different locations on the human body where we can actually check for a distal pulse. And that's the one we're looking for: distal.

Meaning far away from, further away from the heart that's possible. So, there's the legs and there's the foot. There's the wrist, the arms. And there's also one that we're looking for, though, it's called the carotid. It's actually located in the neck.

Because, again, we're making sure that we have blood flow to the brain, heart and lungs. We're not so worried about if we have blood flow to our hands or feet, although that is important, and it's nice to have, but we want to make sure that we still have a pulse, up in the neck, that make-that's still supplying blood, and adequate blood, to the brain, heart and lungs. So, Rob, if you come out here and help us out, I'm going to show you guys how to do that. We're going to start with our two fingers these two- your index finger and middle finger. Now, we're gonna' use the pad of your- the pads of your fingertips, okay?

And only these two fingers. We're going to look in the- on Rob's neck here, we've got this line, this imaginary line, this midline, okay. Up and down the middle of the body. And then we've got this 90 degree angle over here. We're going to kind of go somewhere in the middle almost at a 45 degree angle.

And we're going to, with the pads of our fingers, gently push, and you're going to feel for- you may have to search around, that pulsating pulse, okay? And once we find it, we want to keep our fingers in line with that artery. See if we can find it there, there it is, okay. And now once we, if we can find it, great, we're going to check it for 10 seconds. We're going to spend 10 seconds, you may spend 10 or 15 seconds looking for it, but the idea here is you need to practice this.

And this is something you can practice with your friends or your loved ones, okay? While you're sitting there watching TV or another PDN video. And simply just get used to finding that pulse on each other, that way whenever it's a high stress environment, or there's a lot of attention going on, a lot of adrenaline, you can still locate it. And we're going to, once we've, we've had the we've identified the location of it. We're going to check and feel it for 10 seconds.

If we don't feel a pulse within 10 seconds, we're gonna go ahead and start chest compressions. You're going to execute your CPR training that you've taken from American Heart Association. So, be sure you use those two, the two these two fingers and the pads of those. We don't want to use a thumb or other fingers. You can actually almost get a pulse out of your own thumb, which is something we don't necessarily want to count right now.

But you're feeling for that pulse, in the neck, it's called the carotid, the carotid artery, carotid pulse. We're going to feel for 10 seconds. One-1000, two-1000, three-1000, four-1000, five-1000, six-1000, seven-1000, eight-1000, nine-1000, ten. And I want you guys to actually say that out loud while you're checking for the pulse. It's going to do a couple little things.

One, it's going to calm you down. And actually you're going to start thinking about what it is you're doing in the next step, instead of panicking, and getting frustrated, or having anxiety about what's going on.