Originally Posted by datlas

You do make a good point. If sca on bike and you go down, CPR is worth a try.

If you are taken down by a crash and have a full arrest, it's likely game over.

But I get your point that in the heat of the moment it may not be possible to know which caused which.

Originally Posted by RUOkie

Ok rehab doc chiming in here. I agree with surgeonstone 100%. To the point that my roadID expressly states that if I'm found on the side of the road, DO NOT INTUBATE OR DO CPR!!! Just like that. I don't want to be the good outcome from an anoxic event

Originally Posted by Rx Rider

10 visits to the ER have taught me what a waste of time it is going to the ER. mind you I've never had a heart condition or stroke or such, all boo-boos.

Originally Posted by surgeonstone

Listen, don't argue with me on this one. We are talking about accidents, trauma. In trauma, the dead stay dead, the living may have a chance if you act quickly. There is nothing you can do out "there" cycling save pressure on a spurting vessel, calling 911, maybe applying a tourniquet IF you know when to apply and how. The kind of stuff OP is talking about can be handled at home with a good wash and proper dressing application. I for one, will not clutter my ride for the possibility of this happening. Now back to cardiac arrests. I have handled thousands of trauma cases and believe me when I say, CPR on a person in cardiac arrest FROM trauma is a futile exercise. If the heart has stopped from exsanguination then CPR is silly. The patient needs blood . When I have resuscitated the trauma case and gotten a blood pressure and vitals back, I have always regretted it due to the anoxic brain injury that will have occurred. Yes, I have opened chests, massaged flaccid, empty hearts, poured in blood, rushed the dying to the OR, but again I say, in trauma, the dead stay dead. Our efforts are towards that golden hour where you see death approaching and rapid incisive action can save a life. Now having said all that, if out cycling and my 59 year old heart just stops, please at least thunk my chest and do CPR. But if you see me in a puddle of blood with a stilled heart, say a prayer and leave my chest alone.

Originally Posted by bsektzer

First off, I'm no MD. I was a lowly RRT for 28 year, and I worked ER's, Trauma Units, and various ICU's almost exclusively during that time, so I've been through more codes than most people will ever see. My experience with trauma induced arrests would overwhelmingly support surgeonstone's assertion.

However, what concerns me is the fact that 99 time out of 100, the first person on the scene is not going to have the medical skill or experience to distinguish a trauma induced arrest from an SCA that resulted in trauma when the victim went down. I fully understand that in many cases, it will be obvious. Missing limbs, compound fractures, obvious skull deformations, voluminous blood, these sorts of things combined with asystole pretty much tell the whole story. But what about the guy who has an SCA event while riding, falls and in the process of going down, lacerates his scalp. Let's further assume, for the sake of argument, that his guy is on Plavix because he has known CAD. So here you've got someone down without a pulse and a fair amount of blood on the pavement. If I'm that guy, I sure as hell hope the first person to come to my aid has NOT read this thread.

And just so you fully understand my misgivings about a blanket approach that says "if there's trauma and no pulse, move on", on February 12th of this year, I was that guy who had the SCA. I was successfully resuscitated for 3 minutes before EMS showed up. I was down for another 2 minute before they hit me with the AED, and yeah, after the first 120 joule jolt, I did wake up just "like in the movies". BTW, I'm back on the bike, and damned near back to the form I was in before the event.

In any case, I think the real point is having the training and equipment on hand to render intelligent basic first aid (and I do mean basic) is a good thing. I'd hate to see the value of that idea get lost in a discussion of "corner cases" vs coroner's cases.

Originally Posted by tagaproject6

It took you 10 visits??? Not a lot of people outside of the medical field know what constitute an "emergency".

Originally Posted by Rx Rider

they were all forced visits. my job at a steel roll slitting company earned me the nickname stitches. better than bleedy I guess.

Originally Posted by slowandsteady

Not all trauma involves copious amounts of spurting blood. Maybe after a surgeon gets done with a patient it does....

Originally Posted by NCbiker

Surgeon with 25 years of trauma experience
Or
Newbie certified Firefighter/First Responder/EMT

Hmmm, I wonder who I should believe?

Originally Posted by mihlbach

This is not meant to be a jab at Surgeonstone. His opinions here obviously have valuable, but you should never just have blind faith in someone outright because they are a doctor no matter what their experience. Medicine is a business as much as it is a life saving/prolonging endeavor. I'm not a doctor (of medicine, anyway), but I do teach med students, and I can tell you there are some real idiotic opinionated greedy egotistical and untrustworthy people out there with MDs. Fortunately they are a minority. Nonetheless the blind faith that some people put in MDs advice on this forum (and elsewhere) disturbs me.