Administration and Leadership, Cardiac & Resuscitation, News, Training

Featuring From Trailblazing EMT-P Headed for Cambodia & Teaching Teens Continuous Compressions

Issue 12 and Volume 33.

Trailblazing EMT-P Headed for Cambodia In 1994, a speeding vehicle struck Paramedic James Garcia as he worked a highway crash scene in Lexington County, S.C., breaking his arm and leg. When the S.C. Highway Patrol let the driver off the hook but faulted the paramedic for being on a dark road wearing a dark uniform, Garcia took action. He found that South Carolina gave first responders no rights to be on a roadway—let alone require drivers to move over to protect them.

Garcia convinced state legislators to pass a “move-over” law in 1996 and then to strengthen it several years later. The U.S. Department of Transportation and other federal agencies adopted his stronger version as a model for such state legislation. We gave Garcia a Thumbs Up for this work in September 2002.

Now, having made his mark on EMS safety in the U.S., James and his wife Cara, an RN, are off to make a difference in another country.

When they visited Cambodia—one of the world’s poorest countries—on vacation in April, the Garcias saw babies dying in the streets. They also saved a dehydrated elderly woman’s life with Gatorade, multivitamins and Ensure.

“All the things we take for granted—schools, health care, government services, immunizations, ambulances and fire departments—simply don’t exist [in Cambodia],” the Garcias note.

They’re returning to Cambodia in January with their 9- and 11-year-old daughters for a two-year stay. They plan to set up a free clinic in the Phnom Penh area and train a Cambodian staff to make the clinic permanent. They’ll provide first aid, minor trauma care, routine immunizations, infection treatment and control, and disease-prevention education. James says he expects to see anything from cobra bites to typhoid to land-mine trauma.

“There’s an emotional component to what we’re doing, but we have to do it intelligently,” he says.

The Garcias aren’t rich and have no corporate backing—although they’ve been writing grant proposals day and night. They’re simply a middle-class, working couple who couldn’t ignore the misery and despair they saw.

They welcome donations via their Web site, And their home in Cambodia will have two extra rooms for volunteers willing to help for two days or two months.

Teaching Teens Continuous Compressions
What would it be like to have an entire generation of citizens comfortable doing chest compressions if they saw someone collapse? Arizona is working on it.

In October, the Arizona Department of Health Services “Save Hearts in Arizona Registry and Education” (SHARE) program launched “Your Hands—Their Heart.”

All 1,800 of the state’s public and private middle and high schools got a kit to train some 100,000 students in continuous chest compressions, the type of CPR the American Heart Association now promotes for bystanders. The kit includes a nine-minute video, a plastic sheet with a torso outline, a PocketCPR training device (from Bio-Detek Inc., a division of ZOLL) and associated documents. (For a brief description of the Pocket CPR, read “Hot Products” in June 2007 JEMS .)

After watching the video, students practice compressions using the plastic sheet, spread on a firm pillow, and the training device.

SHARE Director Lani Clark says the program created all 1,800 kits for less than $100,000 from Arizona’s Health Crisis Fund. A Tucson business produced the video, and Bio-Deteck gave SHARE a price break on the PocketCPR devices. (Information about the program and the training video are at

Arizona EMS Medical Director Ben Bobrow, MD, says, “Arizona is the only state that tracks bystander CPR rates,” and has found that sudden cardiac arrest (SCA) survival rates triple when bystander CPR is administered. Arizona has some 5,000 SCA cases annually, so this could save a lot of people. A big Thumbs Up for “Your Hands—Their Heart,” an innovative program with lifelong, life-saving potential.

Investigation Afoot for Florida Paramedic
When firefighter-paramedic Cindy Economou took a patient’s severed leg to train her cadaver dog, the St. Lucie County (Fla.) Fire District was forced to clarify its policy regarding transportation of severed limbs and Economou was all but forced to resign. The former firefighter of the year and several colleagues are currently under investigation for the Sept. 19 incident, in which Economou put the foot in double biohazard bags and brought it back to the station, where coworkers photographed it on personal cell phones before she took it home and stored it in her freezer. It’s the fire district’s policy to take dismembered body parts to the hospital with the patient if there’s any chance of reattachment; however, it’s unclear why that protocol wasn’t followed. For the full story, visit