Responding to Medical Emergencies
Based on the Safety Member Certification training module "Mass Trauma Emergencies"
From the Bible
There is ... a time to heal ... (Ecclesiastes 3:1,3).
He healeth the broken in heart, and bindeth up their wounds (Psalm 147:3).
And [the Samaritan] went to him, and bound up his wounds, pouring in oil and wine, and set him on his own beast, and brought him to an inn, and took care of him (Luke 10:34).
Is there no balm in Gilead; is there no physician there (Jeremiah 8:22).
And Isaiah said, “Take a lump of figs.” And they took and laid it on the boil, and he recovered (2 Kings 20:7).
The scene on the TV screen is the deck of a ship engaged in a naval battle. A sailor is wounded. The seaman next to him calls out, "Medic! Medic!" A medical corpsman comes to treat the wounded man.
Frankly, it does not always happen just the way it does in a movie script, but this scene does illustrate a fact: lives can be saved by people trained and equipped to respond to wounds, accidental injuries, health issues, and other medical emergencies.
In the News
Hockessin, Delaware, late October, 2022 - A woman, age 84, attending church with her husband, felt ill. She got up and headed for the door to the foyer. The ushers noticed her difficulty and tried to assist her when she collapsed. She lost consciousness, and the ushers recognized it as cardiac arrest. They were trained in CPR, so they kept her alive until EMTs arrived and took over. Five months later, she met with the men who saved her life to thank them.
Edwardsville, Wisconsin, December 2, 2018 - A woman who was carrying a baby went down the stairs of a church to the children's department for a program. She fell down the stairs and was injured. Almost two years later, she filed a negligence lawsuit against the church claiming the stairs were too steep and the steps not wide enough front-to-back. The news story makes no mention of what emergency treatment she received at the church.
Chesapeake, Virginia, September 2017 - A woman speaking at a Woman's Day service began to repeat herself and stuttered. Then she became unsteady and collapsed. It was a ruptured aneurysm. The pastor and others rushed to help, while 911 was called. As they prayed, EMTs came and took her to the hospital. The aneurysm was clamped shut in surgery, stopping the hemorrhage. A second one was clamped about a year later. The quick response saved her life and spared her from disability.
Romney, West Virginia, May 25, 2023 - The Romney First United Methodist Church hosted a Stop the Bleed class held by the Hampshire County Sheriff's office and the Hampshire County Emergency Services Agency. May 25 was National Stop the Bleed Day.
Idaho Springs, Colorado, April 14, 2023 - The clerk at a gas station began to waver. Someone took his hand before he went blank. The county EMS responded and treated him for anaphylactic shock (a whole-body allergic reaction). Apparently it was triggered by a food allergy. The EMTs intubated him so he could breathe while the epinephrine began to work.
Videocast and Show Notes
This topic is covered in a Sheepdog Church Security Academy videocast (the audio is in a Church Security Roll Call podcast). Kris draws on his experience in the military, law enforcement, and church security. Beneath the video window is a link to the Show Notes (an article summary). This link will be for this article's show notes until the next weekly article is posted.
Our free download for this week is "Equipped for Success: Recommended Essential Equipment." Several of the items are for medical response. Click *HERE* to get this resource,
Treating the Ill and Injured
Some churches have a Safety Team and a Medical Response Team, while others have the same team fill both roles. At the very least, we need someone there who can respond to a medical emergency. They should see the need for a medical response, be equipped for medical response, and be trained for medical response
See the Need for a Medical Response
Whether you have one team or two, if all members recognize the signs of medical emergencies, they can at least call for a response. Ideally, everyone should be able to be a first responder to at least buy the time for a better-trained medic to arrive (as in the first news story).
The first step is to be alert. See what is going on around you and know when something is not right. Do we know the signs of a heart attack or stroke, of heat stress or hypothermia, of choking, or of anaphylaxis? Do we know when someone is injured enough to need immediate help and whether a firearm or knife wound is life-threatening?
Signs of a Heart Attack
The American Heart Association has issued a one-page infographic PDF, "Common Heart Attack Warning Signs" which can be printed and posted or distributed so team members and others can recognize the possibility of a heart attack. The signs are:
- Chest discomfort or pain
- Nausea, feeling lightheaded, or vomiting
- Pain in the jaw, neck, or back
- Angina: pain or discomfort in shoulder and/or arm
- Shortness of breath
Signs of a Stroke
When a person is having a stroke, much of the permanent damage can be avoided through quick treatment. There are treatments which can keep affected brain tissue from dying. According to the CDC,
"The stroke treatments that work best are available only if the stroke is recognized and diagnosed within 3 hours of the first symptoms. Stroke patients may not be eligible for these if they don't arrive at the hospital in time."
The CDC recommends F.A.S.T. action to identify a stroke and get help:
F—Face: Ask the person to smile. Does one side of the face droop?
A—Arms: Ask the person to raise both arms. Does one arm drift downward?
S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
T—Time: If you see any of these signs, call 9-1-1 right away.
The signs of a ruptured aneurism (as in the news story from Chesapeake) are similar to those for a stroke, because it affects the same organ, the brain.
Signs of Heat Stress or Hypothermia
The Mayo Clinic posts symptoms of hypothermia.
- Cool, moist skin with goose bumps when in the heat
- Heavy sweating
- Faintness, Dizziness, Fatigue
- Weak, rapid pulse
- Low blood pressure upon standing
- Muscle cramps, Nausea, Headache
- Slurred speech or mumbling
- Slow, shallow breathing
- Weak pulse
- Clumsiness or lack of coordination
- Drowsiness or very low energy
- Confusion or memory loss
- Loss of consciousness
- Bright red, cold skin (in infants)
Signs of Choking
It is easy to choke. Just get something caught in your windpipe (trachea). I personally know this. During my parents' 50th wedding anniversary celebration, I choked on a "gold" foil leaf in the frosting of a piece of cake. Fortunately, I was able to go to the restroom, reach into my throat with my fingers, and pull it out. Not all chokings are that easy to take care of. Most times, the person choking needs help. The object is too far down and cannot be grabbed. To know they need help, we must recognize the signs of choking.
Healthline says a person who is choking
- Cannot speak
- Cannot cough
- Cannot make noise
- Cannot breathe
If there is already a lack of oxygen, the lips, skin, or nails may have a bluish tint.
Signs of Anaphylactic Shock
Anaphylactic shock (anaphylaxis) is an allergic reaction which affects most of the body, especially one or more vital organs, such as the brain, the heart, or the lungs. Symptoms come on rapidly. According to Healthline, the signs of anaphylaxis are:
- abdominal pain
- anxiety, confusion, and/or nausea
- coughing, wheezing, or trouble breathing
- rash and/or itchy skin
- slurred speech and/or facial swelling
- low pulse
- difficulty swallowing and/or swelling in mouth and throat
Healthline goes on to say that a person experiencing anaphylaxis should be taken to the emergency room immediately. The most-used first response is an injection of epinephrine (a.k.a. adrenaline). However, it is not for everyone. For instance, in those with heart disease it could trigger a heart attack. There are other adverse conditions. The ER is equipped to deal with complications.
Be Equipped for Medical Response
This is divided between equipment and supplies for the whole team and personal medical response items. Three items a Safety Team or Medical Team member may have are disposable medical gloves, CPR masks, and tourniquets. A individual team member can carry a pair of nitrile glove, a CPR mask, and one tourniquet, enough for the first person they treat in an emergency.
The church should have wall mounted first aid cabinets in key locations so anyone who knows First Aid can respond.
Sheepdog Church Security (SDCS) has an affiliate relationship with Mountain Man Medical (M3). SDCS worked with M3 in developing an individual First Aid kit (Sheepdog IFAK) and a kit for the team to use in a mass casualty event (Mass Casualty Trauma Kit). A few of the many items in the Mass Casualty Trauma Kit are:
- "Israeli Style" High-Pressure Dressing
- Nitrile Gloves
- Compact Twin Pack Chest Seals
- Combat Medical NPAs
- Hemostatic Dressing
- CPR Face Shields
There are also a few medical response items on the SDCS Amazon store (Recommended Equipment for Safety Ministries). Among them are Rapid Care First Aid Cabinet, Philips HeartStart Home AED, Ergodyne Large Mass Trauma Duffel Bag, CAT Combat Application Tourniquet, and Nasopharygngeal airway tubes (NPAs).
Be Trained for Medical Response
"Mass Trauma Emergencies" is a Safety Member Certification training module (class) which focuses on treating multiple injuries in a mass trauma event, such as a bus accident, a tornado, a local disaster, or an active killer incident. However, in-person training is better for some other medical emergencies.
The American Red Cross and several fire departments offer First Aid courses. They and the American Heart Association also provide training in cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use. Training in the Heimlich Maneuver to relieve choking is also readily available.
All church safety team members are urged to get this training. It should also be available for anyone else in the church, especially teachers, youth directors, activity leaders, ushers, and greeters. Anyone might be the first responder during a medical emergency.
Be ready to respond to medical emergencies in the church. Know the signs, be equipped, and be trained.
Since training is a key to an effective emergency response, all Church Safety Teams are urged to get each member trained and certified through the Safety Member Certification program. The training module "Mass Trauma Emergencies" is one of the eight classes.
The three training formats are church-hosed classes (Team Certification), self-paced online instruction (Individual Certification), and live Zoom classes (Online Events). The 2022-2023 season for Online Events is over, but a new season begins this Fall. Students can enroll now, and the enrollment is good for a year. Choose the format that is best for you and for the team. Team Certification has the advantage of training the entire team at once. Online Events is open to both individuals and teams.
There are also benefits for alumni: online groups and consultation with Kris at Office Hours.
Safety ministries are also encouraged to enroll members in other medical response training, especially First Aid, CPR, and AED. Take Stop the Bleed training if it is held in your area.
Articles linked to in references 10-15 can be read to learn more about medical emergencies which may arise in church or at church events.
The article on deck for next week is "2020 Glorious Church of God in Christ Shooting" (Lesson Learned).
- Kris Moloney, "Mass Trauma Emergencies," Safety Member Certification, Sheepdog Church Security, © 2020 [https://sheepdog-church-security.thinkific.com/].
- Alyana Gomez, "Woman reunites with first responders who saved her life after she collapsed at church," 6ABC (WPVI TV), March 21, 2023 [https://6abc.com/woman-rescued-cpr-training-saved-after-church-st-marys-of-the-assumption/12987047/].
- Marian Johns, "Woman alleges dangerous staircase caused her fall at Edwardsville church," Madison - St. Clair Record, November 30, 2020 [https://madisonrecord.com/stories/566547069-woman-alleges-dangerous-staircase-caused-her-fall-at-edwardsville-church].
- American Heart Association News staff, "Standing at a church pulpit, a blood vessel burst in her brain," American Heart Association, May 1, 2020 [https://www.heart.org/en/news/2020/05/01/standing-at-a-church-pulpit-a-blood-vessel-burst-in-her-brain].
- Review Staff, "Stop the Bleed class scheduled for May 25," Hampshire Review, May 10, 2023 [https://www.hampshirereview.com/news/article_387dac02-ef49-11ed-9ca3-23eb516cd015.html].
- Dave Bloom, "EMS Saves Man Suffering Anaphylaxis from Shellfish Exposure with Intubation," Snack Safely, April 28, 2023 [https://snacksafely.com/2023/04/ems-saves-man-suffering-anaphylaxis-from-shellfish-exposure-with-intubation/].
- Kris Moloney, Sheepdog Church Security Academy, YouTube [https://www.youtube.com/channel/UCTrrcSlOn6zG1ySOHYzQkdQ].
- Kris Moloney, Church Security Roll Call, SoundCloud [https://soundcloud.com/churchsecurityrollcall].
- Kris Moloney, "Equipped for Success: Recommended Essential Equipment," Sheepdog Church Security, © 2018 [https://sheepdog-church-security.ck.page/8ad20a0b70].
- American Heart Association staff, "Common Heart Attack Warning Signs," American Heart Association, © 2021 [https://www.heart.org/-/media/Files/Health-Topics/Heart-Attack/Heart-Attack-warning-signs-infographic.pdf].
- CDC Staff, "Stroke Signs and Symptoms," National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention, Last Reviewed: May 4, 2022 [https://www.cdc.gov/stroke/signs_symptoms.htm].
- Mayo Clinic Staff, "Heat Exhaustion: Symptoms & causes," Mayo Clinic, Last updated March 3, 2023 [https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250].
- Mayo Clinic Staff, "Hypothermia: Symptoms & causes," Mayo Clinic, Last updated March 31, 2020 [https://www.mayoclinic.org/diseases-conditions/hypothermia/symptoms-causes/syc-20352682].
- April Kahn, Medically reviewed by Andrew Gonzalez, "What You Should Know About Choking," Healthline, Last medically reviewed on September 4, 2019 [https://www.healthline.com/health/choking-adult-or-child-over-1-year].
Adrienne Santos-Longhurst and Stephanie Watson, medically reviewed by Cynthia Taylor Chavoustie, copy edited by Steve Barry, "Anaphylaxis: Recognizing The Signs of Anaphylaxis," Healthline, Updated on April 6, 2020 [https://www.healthline.com/health/allergies/severe-reactions-anaphylaxis-emergency-room#administering-epinephrine].