I read ["Dangerous Suspension"] and found it very enlightening. I'm a full-time paramedic and a volunteer firefighter, as well as one of the team leaders of the local rope-rescue team. More than once, in state-run and team-level training, we've suspended another firefighter for lengths of time to simulate the window-washer scenario.No more of that without safety precautions.
Brian Bartolick, CCEMT-P
Perinton, New York
Several years ago, a training evolution involving a stokes basket in a vertical lift configuration left the person tied into the stokes and unable to move her legs.There was a delay in the evolution that left her legs dangling 20 minutes or so, and the subject passed out.I believe an article appeared in Fire-Rescue Magazine.
Would purposeful movement of the legs on the part of a suspended victim prolong consciousness or delay the onset of suspension syndrome? Has any research addressed this?How helpful it would be if something as low-tech as shouted instructions to flex one's legs could widen the survival window!
Author Bill Raynovich responds:We did not include a specific recommendation in the article as the recommendations are currently split on this. One suggestion is for the suspended person to vigorously kick the legs to actively move blood back up to central circulation, and the other is a caution not to kick the legs as that only hastens the pooling of the blood. The absolute recommendation is to keep the leg muscles working. Contracting the leg muscles will buy time.
Takes All Kinds
I think the conclusion [in "Of EMS, By EMS, for EMS," September] that "EMS education should be provided by EMS" could not be more wrong.The perfect medic program would include trauma assessment and treatment from ED docs and trauma surgeons, neurology exams from neurologists and peds exam from peds criticalists, followed by instruction from a streetwise medic to put it all together. Docs have a degree of expertise that can be transmitted to medics. It would be shortsighted to discount this.JEMS
Evan P. Weinstein, NREMT-P, MD&, FAAEM