John M. Vogel jvogel at crl.com
Sun Aug 20 01:14:35 EST 1995

Hiya Nico!

Nico Garcia (raoul at primavera.mit.edu) wrote:

: It is in common usage for the problem. For example, an unconscious
: person's throat can partially or fully cluse with their head in the
: wrong position, restricting breathing. Take a CPR course for the
: artificial respiration techniques, and the demonstration of the
: problem. It's a misnomer true.

Right on!  In every CPR course, they teach that the most common cause of 
a blocked airway in an unconscious person is poor positioning of the 
head.  Just flex the head back and that should at least open the airway 
(do *not* do this in the case of a suspected spinal injury, I know you 
know this, Nico, but for everyone else, find out how to do the jaw thrust 
maneuver in your local CPR class).

: Don't insult Carl without cause. I assume he knows enough about
: biology/modern first aid to avoid this error. The reason to put
: something in an epileptic's mouth during a seizure is two-fold: to
: keep them from biting down on their tongue, and to make sure their
: mouth is open to provide an access for suction or oxygen airways for
: professionals on the scene,

I know you're a medical professional, Nico, but the Epilepsy Foundation 
does *not* stand by this (I'm not associated with them).  I've never put 
any kind of object into a seizing person's mouth, and never lost a person 
having a seizure due to asphyxiation.  I don't have any concrete evidence 
for this, but I would suspect the leading cause of death during a seizure 
(besides eclampsia and badly managed airways) would be Status Epilepticus 
(grand mal seizures unendingly or one right after the other).

: There are two commonly used widgets: one is a bite stick, a taped and
: padded tongue depressor (cost, 2 minutes of time and 50 cents of tape,
: use once). The other is a knobby threaded plastic widget that fits
: your hand: you poke the tip between any gap in their teeth, and twist
: it in by hand to open the mouth. (cost, maybe $10? anyone know?)

Oral airway?  (curved piece of plastic that you right side up or sideways 
and twist it into position when it's in?)

One other rule that is taught in Red Cross First Aid.  Always check 
for hazards around the scene before you intervene.  Think!!  It does no 
good for the victim or you if you get injured/killed because you weren't 
paying attention (i.e. oncoming cars, poisonous fumes, gases, 
electricity, etc).

: 		scene as soon as possible. Become cheerful grunt labor,
: 		getting their bag or the OJ when they ask, providing

But Nico!  OJ won't let you carry the bag!  His bloody clothes are in it! 
<GGGG>  Sorry, couldn't resist.

: Of course, if you're expert already, use the techniques you know.
: Remember, I am not a doctor: this is not a prescription, it is merely
: what my personal experience (and some ambulance experience) show as
: the right steps for handling seizures, in the right order.

Right you are!

John, R.N.
jvogel at crl.com

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