Episode-1279- Ken Jensen on Mass Casualty Triage — 14 Comments

  1. EMT Basic in Ohio here. The ABC of CPR has been changed to CAB, giving priority to chest compressions over giving breaths. You still give breaths but you start chest compressions first on a apneic, pulse-less patient. The rational here is, oxygen is typically still saturated in the blood so moving that around to the brain first is more important than giving breaths first. I encourage everyone to get CPR certified. Coincidentally I am taking my CPR refresher course tonight! Great podcast, I remember the mass casualty part of my training was very boring and dry, this podcast made more sense than the training I got.


    • Priority to compressions is fine, I get that. Though I think the morons behind “hands only CPR” should be smacked with a large frozen fish, something preferably in the mackerel family.

        • The problem with this theory is that it is suggested that if a person collapses you “push hard and fast on their chest”, really?

          They figure more people will do it because it is simple and you don’t have to breath into the person. (touch a strangers mouth)

          Well the big hole is you DON’T DO CPR to anyone until you check for a pulse and breathing. This is part of basic CPR training, and anyone having had that has already pretty much demonstrated that they are fricken willing to do CPR. If you have had CPR training you know that doing it to someone that doesn’t need it can cause harm, a lot of harm. You also know it is quite possible for a person to have a pulse but not be breathing for a variety of reasons.

          You also know that both breathing and compression are not as simple as it looks and to do it right you need some training.

          Hence hands only CPR is likely to possibly kill some people, harm some others, save no one and only be practiced by someone with no training.

          I wonder how many people with CERTIFICATION in CPR said they would refuse to give breaths? Frankly unless there is no other option a person with out training should not be doing CPR. The training isn’t hard, it takes about a day and you test with a “ressaannie” and actually experience what it takes to do it right.

        • Let me add though your link was about what a 911 dispatcher would guide someone to do, I get that.

          I have heard many commercials on the radio that simply advise, “if an adult collapses push hard and fast on their chest until help arrives”. I find such “public service announcements” to not be of public service and to be grossly irresponsible. Perhaps you haven’t heard one of these abominations?

  2. Ex nuke myself… just found survival podcast recently and like what I’m hearing on them. Nice job Ken… even if u were a twigget…

    • Funny today we have an interview with Steven Scott of Terroir Seeds, Steve also mentioned to me he is also Ex nuke, you guys are popping up everywhere.

  3. When I was a member of CERT (Community Emergency Response Team), we took part in disaster drills. It was amazing how real it felt during the exercise. Trying triage when you have people screaming and pulling at you, hits home the seriousness of it all. The drills were a great place to make mistakes and learn lessons.

  4. I totally agree Jack, compression only CPR makes NO sense. I think everyone trained in CPR should carry a barrier on their key chain. I have one made Ambu. They are very cheap on amazon. I bought a bunch and put some in my go bag, glove box, first aid kits and of course key chain.

  5. One thing I would add having been a first responder in the Military and helping at numerous auto accidents and other emergenies even when not on duty. In these situation even normally calm, well educated people will be panicking and running literally in circles yelling and panicking. It is totally chaotic!! I usually am the only rational person who is able to bring leadeship to the situation leading to saving the person.

    I would highly recommend that you suggest to all your listens to take a basic first aid course or even an EMT basic course as a prep for every day emergencies. Most people are well meaning in these situations but their lack of basic life saving techniques can actual kill or hurt the person worse.

    I love the show. Keep up the good work.

  6. Just a couple of quick thoughts on Hands Only CPR. My point is not to argue with any of you, but you are way off base with regard to hands only CPR. Since 2008, the science has been published by the American Heart Association that hands only CPR is a vital life saving tool and rescue breaths don’t add much for survivability. People should still be TRAINED in hands-only and try it on a dummy, but hands-only is a perfectly useful skill. Activate your emergency response system (call 911) and push hard and fast in the center of the chest. If we can train people to do that, we will save lives.

    For reference:

    The American Red Cross agrees:

    and has a goal of training 5,000,000 people in hands only CPR.

    I am not sure how many people commenting or reading these comments have actually performed CPR on a warm body, but as a current active EMT running with the Ocean Park Rescue Squad in Virginia Beach, VA, I have. Most of the time when people go into cardiac arrest, they vomit. So often, that as part of the standard kit for a cardiac arrest, we carry in a portable suction machine. I don’t care who you are or how certified you are and even with a barrier device or pocket mask, getting into someone’s vomit covered face is not fun. I might do it for wife, parent or child even without a mask, but for a stranger, no way am I getting into that without proper personal protective equipment. Further, while searching for mask or looking at your patient wondering how you are going to wipe up that vomit, what you are NOT doing is providing life-saving chest compressions. Broken bones, punctured lungs and other collateral damage can all be addressed as required, but if blood is not going round and round, the patient will die. It is far more important that air going in and out.

    Please, everyone, get trained in as high a level of First Aid and CPR as you can. It surely helps us all, but it is a great dis-service for this forum to shame anyone for learning Hands Only CPR or suggesting it is not as effective or useful a skill.

  7. I agree that compressions only is extremely valuable for the unknowing or the uneasy. I also agree that they vomit because every breath, a little bit of air goes in the stomach instead of lungs, and they can’t purp… Until they spew. I don’t care that the breaths don’t add much, they add some. And until they spew, I will continue with it, then if I am uneasy enough that I can’t use my dynamed CPR mask even… Then would be a great time for compressions only. To answer ABC vs CAB, I think it is valuable to know, but was beyond the point we were getting across in the topic, and although I practice CAB from memory, I remember the old ABC pneumonic.

    You cannot bash the twidgets… We know who REALLY ran the nuclear reactors, especially with green supervision!

    I really enjoyed being on the show and would enjoy doing more. I just added the roll of tape to my official BOB list.

  8. Hands only CPR IS VERY EFFECTIVE. Our EMS system went from around 10% save rate to over 50% save rate with hands only CPR. I am not saying we don’t perform respirations, but it is a very low priority compared to everything else that is going on. We do a tiered response with first responder doing only hands only CPR and then as more help arrives we go to other life saving techniques. Defib, drugs, et tube, transport and er for definitive care. Do the research and find the value of it. I can’t believe the amount of saves we are getting. I see it with my own eyes, so I know the value. On average I do CPR once a month. Before this I often felt that most “saves” were not really saves, because we might bring them back to die soon there after to complications. Now we have lots of viable saves, 54% was the last number I heard. We have done lots of training, and we have had growing pains, but the results speak for themselves. Especially when they come in the firehouse a week or two later and shake your hand and say thanks.