How do you know whether it has a pulse? It's an elephant, so they have arteries in analogous places to humans?
I'm that note I also wondered whether I'd be confident enough to detect a missing pulse in someone. I was showing my kids the other day and it wasn't so easy to find theirs. Not sure what my error rate would be on real cases.
Dig your fingers deep into your neck from the front, to the side of your throat, not just limply touching the surface.
That aside, as others saying you do CPR when they're not breathing, not when there's no pulse. (Otherwise would you check for a pulse every few compressions and stop them but continue breaths?)
In a real crisis situation your error rate is 100%. This is the same for trained professionals as well as complete laymen, when you're in a life or death situation your own pulse shoots up sufficiently so that you won't be able to tell whether it's your own pulse or theirs. Pulse is irrelevant, if they're not breathing or unresponsive, you start CPR.
Poor animal was alive and conscious under the “CPR”, at least I assume this watching the baby elephant opening and closing its mouth and moving its tongue.
That is true for adults as well. When I did a first aid course the instructor said something like 30-40% of people who receive CPR will have fractured ribs as you need to put a lot of pressure on the chest to do it properly.
"If you haven't heard a crack you are not pumping hard enough" was the rule he went by although they are mostly talking about the sternum but if you hear/feel a rib crack you don't stop. You keep on pumping until a paramedic arrives if you can. A few minutes doing CPR on someone is exhausting. I did 5 minutes on the dummy and after I felt like I was going to pass out.
Did a first aid certification 15 years ago in France.
At the end of the course, they told us that based on French law, it is your legal duty if you have the certification to perform first aid when the situation requires it. That is, once you have the certification, if you do not perform a somewhat correct first aid procedure in case of need, you could be charged for "non assistance à personne en danger" (disregarding assistance to endangered person).
It dreads me to this day that I could have to perform such procedure and not remember it.
French law will only put you in trouble if you voluntarily do absolutely nothing. For instance not calling an ambulance when you could have. When the action taken is judged "insufficient" (like not trying to stop heavy bleeding) there is a consideration for your medical knowledge. You'll never be in trouble for not performing everything correctly, especially after 15 years. First responders appreciate someone who has some better understanding of the situation so don't hesitate!
I've been in this situation recently: I had first aid certification in 2004 and then a bad situation happened.
Ancient "training" kicked-in and I took charge of the situation with some mistakes due to adrenaline and having to manage panicked people around me.
You should do a refresher course because some of the recommended procedures have changed over the years. I think everyone should take a regular first aid course, it is strange to me how many people I know have never had one.
When I was taught, for use on humans, broken ribs were expected and without them 'you're probably not pushing hard enough'. Worst that could happen is one punctures a lung, but they're going to need medical attention if you get a pulse back anyway, that can be dealt with.
It should be clear - in an ideal scenario you'd have direct access to massage (or shock) the heart, chest compressions are approximating that through flesh, skin, and bone... The ribs' job is to protect the heart from the sort of thing you're trying to do!
> Despite having dealt with dozens of road traffic accidents involving humans, Mana said the elephant was the only victim he had managed to revive while performing Cardiopulmonary resuscitation (CPR)
Sadly Thai roads are incredibly dangerous for all living creatures. The number of annual road deaths are second only to Liberia, a failed state.
Beautiful country and people but a "sabai sabai" attitude mixed with drunken driving and a strand of fatalism makes for treacherous journeys. For a guide to Thai culture disguised as a guide to Thai driving, this is worth a read: https://www.chiangmailocator.com/wiki-traffic-rules-in-thail...
You're suggesting Thai people loose their sabai-sabai "attitude" but doing so can not come without major cultural changes since it's rooted in philisophical traits. What you're suggesting is that, essentially, Thai people stop being Thai people.
Every culture "improves" and moves on. Usually it's only after a huge trauma, once a civilisation is on the brinks of collapse.
French used to believes kings were chosen by gods themselves. Then they realized they're just humans, and there's no reason for noblemen to own lands simply by being born.
They didn't stop being "french", they just added another flavor.
Precisely. So Thai culture, as we know it, would have to evolve into something else. And that's a job for the Thai people, not someone on an internet forum pointing at one aspect of it and saying that this is wrong and should be dropped.
I agree fully but the linked-to "driving guide" is a bit more problematic than that.
I stopped at the sentence for example: "According to international traffic rules, you have to check your mirrors and do a shoulder check when you change lanes, make a turn or in other circumstances, but because Thai people are inherently lazy, most of them fail to do that consistently."
I don't find accusing a group of people of being "inherently lazy" at all helpful. Firstly I don't believe it to be true - even if it could be measured - but worse it suggests that the failure is innate and incurable.
You're kind of right. I don't believe Thai's fail to check their blind spot because of laziness. It's ignorance.
Not long after my then gf, now wife and I came to Thailand, we went somewhere with her mother. I had a Intl. drivers permit and she asked if I wanted to drive, so fuck it why not. Within a few minutes, she asked my gf "why is he turning his had, can't he see in the mirrors?".
She is a retired school teacher, and she had zero clue about the concept of a blind spot in a car. I can count the number of times I've seen her wear a seat belt, on my fingers (in 8 years).
I'm pretty sure s/he's just suggesting that Thai people find at least a single fuck to give about road safety. I'd probably just say safety in general, but road safety is a good start.
After ~8 years here, I tend to believe it's not so much "sabai sabai" as "mai pen rai" that is a contributing factor.
A relaxed attitude doesn't mean you ignore pretty basic concepts like.. I dunno. Stop signs. Red lights. Driving on the correct side of the road. Using a car seat for an infant. Cooking food properly.
Mai pen rai attitude is visible everywhere you look in Thai society.
Should I turn off the breaker before futzing with this outlet? Mai pen rai.
Should I use the tongs to grab some (raw) chicken out of a pile at the supermarket/cash-and-carry, or should I just stick my hands in there? Mai pen rai, who needs tongs?
Should I wear a helmet when I ride my motor scooter? Mai pen rai. How about after I'm hit by someone, and end up in a coma in hospital? Mai pen rai.
> The elephants soon returned when the mother heard her baby calling out, Mana said.
Luckily not soon enough for the elephants to go berserk on the rescuers! I wonder if the elephants would realize that people were trying to help the baby amidst the chaos.
TBH when I saw the video my first reaction was that what these folks are doing is VERY dangerous. Elephant moms, like many other K optimized moms, are extremely protective of their babies. And it has been reported that they around the corpses of their deceased loved ones:
> I have heard of animals staying beside the bodies of dead friends for three days and nights, refusing to move.
> Despite having dealt with dozens of road traffic accidents involving humans, Mana said the elephant was the only victim he had managed to revive while performing Cardiopulmonary resuscitation (CPR).
Wow that’s crazy, I’ve revived my daughter probably 20 times with CPR. 99% of the time we just do the breaths, haven’t had to break a rib yet, so I guess it’s more PR than COR. You get pretty good at giving breaths when your two year old needs it or she’ll die I suppose. You just do what you have to do and blow through all the spit and human fluids to get air where it needs to go.
Despite knowing what to do and it being almost muscle memory at this point, it’s always harrowing to try to bring someone back, and my adrenaline still pumps with a big sigh of relief when her eyes flutter open and she starts crying.
I responded to another comment here about why she needs breaths. Basically she has a complication from a spinal defect that causes breath holding, which some kids hold their breath but a normal kid will just pass out and start breathing again. For her, she needs breaths (usually with an oxygenated bag and mask that we keep at home) to get her to wake back up.
The first time we tried to give her breaths at home we had to call an ambulance and she went back to the NICU for another 6 months. She spent the first 9 months of her life there. She’s actually a pretty normal two year old now aside from not being able to walk, and the breath holding.
Honestly it’s pretty normal at this point for me and my wife so I’m fairly nonchalant about it. Her rate of breath holding has gone way down since we found medication that makes a huge difference. As she gets older it should happen less as her conscious brain becomes better at overriding her emotions. I do what I need to do and if I didn’t compartmentalize I wouldn’t be able to function day to day.
Didn’t really expect to get tone policed on Hacker News though.
FWIW, I thought the nonchalance was a good thing. As you say, there’s no point getting emotional about it online when it’s just a part of your life that needs to be dealt with.
20 times is too many. Focusing on the "probably:" my son had some significant health issues a couple years ago, and almost died twice. I remember every detail vividly, like it happened 5 minutes ago.
> 99% of the time we just do the breaths, haven’t had to break a rib yet
If you haven't had to break a rib yet, you just do breaths 100% of the time.
> You just do what you have to do and blow through all the spit
That's the sort of thing you say about strangers, not your kids who have peed and drooled on you countless times, not to mention drank your water and eaten 1/2 your sandwich.
My daughter has spina bifida with a condition called PEAC due to Chiari II malformation. She has a breath holding spell at least once a week, where she turns blue and needs to be resuscitated. It’s precipitated by her getting upset or scared, and she’ll hold her breath. Her brain doesn’t properly “reboot” when she passes out and she won’t breathe.
As for “blowing through the spit”, most of the time we have a bag and mask and she’s at home, so we’re able to administer breaths without having to use our mouths. My wife does this most of the time, as I work upstairs, and she’ll call me with the alarms we have set up in the house.
When she was born we were told she’d be dead before age one, so I don’t know, I’m somewhat detached from it? She’s two now and doing pretty well, all things considered, although the night nurse had to give her breaths yesterday morning for no discernible reason. Sometimes it just happens.
Maybe you’re right, maybe I wasn’t remembering vividly enough when I recall how a couple weeks ago she got upset and passed out in the back seat, as I frantically pulled over into a grocery store parking lot, trying not to get into an accident, then, looking back at her small body go rigid as she fought back the tears, trying not to hold her breath, realizing I was too late to soothe her, seeing her face turning blue, then pulling her little body out of her car seat trying not to hurt her since her muscles a locked up, and give her breaths in the dark, feeling her go limp as she passes out, getting worried after thirty seconds or so of her not coming back, telling Siri to call 911 and the countdown getting to 1 right as her little eyes flutter open as big as they can, terrified, canceling the 911 cal at the last second, then holding my dear sweet daughter that I love more than anything in the world as she cried, and I cried, and hugging her and telling her everything will be okay, that Daddy is here and won’t let anything happen to her. Then asking her if we should go home so she can rest but, bless her heart she still wanted to go grocery shopping because she loves doing that with her dad. Then she fell asleep on me sitting in the drivers seat, as I looked around for her glasses that I didn’t even remember flinging onto the floor when I plucked her from her seat, trying not to disturb her while I jostle around. Then maybe I misremember the part where I called my wife sobbing, asking her to come drive home with me because I’d made a mistake, it got too dark and I almost killed our kid by not being careful enough (again, I push her more than her mom does). My wife got there, held our darling girl who should be a toddler but can’t even crawl at a few months past 2, but we’re so proud of her for being able to kick her fat little legs, and we abandoned her car for the night and drove home together. So I didn’t get any groceries that day, unfortunately.
It’s pretty difficult to focus on work when you’re “called out” by some stranger on Hacker News who doubts the sincerity of your statements about your child’s disability in the internet. I detach from it because crying while recounting a story (as I am now) makes it difficult to be a software engineer. It makes it difficult to be anything useful. I have to compartmentalize the pain, the doubts, the worries, or I’d never be able to write another line of code. I hope I’ve provided enough evidence to satisfy your doubts, though.
She has myelomeningicele with a chiari II malformation, and PEAC due to the chiari. If you’d like some information I’ve provided some links below. If you were worried that I’m not doing CPR and just provided breaths, fair enough, but there are a thousand ways you could have phrased that which would have been less shitty.
1) Where does one check the pulse of an elephant to determine the need for CPR?
2) CPR for traumatic arrest? Nah.
3) Miraculous survival without blood transfusions or surgery? Nah.
61 comments
[ 3.4 ms ] story [ 109 ms ] threadKudos to these guys
Definitely smiled when the elephant gets up on its own feet again :)
I'm that note I also wondered whether I'd be confident enough to detect a missing pulse in someone. I was showing my kids the other day and it wasn't so easy to find theirs. Not sure what my error rate would be on real cases.
That aside, as others saying you do CPR when they're not breathing, not when there's no pulse. (Otherwise would you check for a pulse every few compressions and stop them but continue breaths?)
A proper CPR often fracture ribs at all ages.
Because a stopped heart is infinitely more serious and urgent than broken bones.
"If you haven't heard a crack you are not pumping hard enough" was the rule he went by although they are mostly talking about the sternum but if you hear/feel a rib crack you don't stop. You keep on pumping until a paramedic arrives if you can. A few minutes doing CPR on someone is exhausting. I did 5 minutes on the dummy and after I felt like I was going to pass out.
Thankfully I've never had to use it.
Did a first aid certification 15 years ago in France.
At the end of the course, they told us that based on French law, it is your legal duty if you have the certification to perform first aid when the situation requires it. That is, once you have the certification, if you do not perform a somewhat correct first aid procedure in case of need, you could be charged for "non assistance à personne en danger" (disregarding assistance to endangered person).
It dreads me to this day that I could have to perform such procedure and not remember it.
Luckily I never had to.
It was to compel French citizens to help injured German soldiers.
I've been in this situation recently: I had first aid certification in 2004 and then a bad situation happened. Ancient "training" kicked-in and I took charge of the situation with some mistakes due to adrenaline and having to manage panicked people around me.
probability of rib fracture increases with age.
sufficiently old and it approaches 100%.
babies are the most flexible, I don’t know if their ribs even can break, below a certain age.
edit: clarifying, I’ve never not broken ribs, but my youngest patient was middle age.
When I was taught, for use on humans, broken ribs were expected and without them 'you're probably not pushing hard enough'. Worst that could happen is one punctures a lung, but they're going to need medical attention if you get a pulse back anyway, that can be dealt with.
It should be clear - in an ideal scenario you'd have direct access to massage (or shock) the heart, chest compressions are approximating that through flesh, skin, and bone... The ribs' job is to protect the heart from the sort of thing you're trying to do!
Sadly Thai roads are incredibly dangerous for all living creatures. The number of annual road deaths are second only to Liberia, a failed state.
Beautiful country and people but a "sabai sabai" attitude mixed with drunken driving and a strand of fatalism makes for treacherous journeys. For a guide to Thai culture disguised as a guide to Thai driving, this is worth a read: https://www.chiangmailocator.com/wiki-traffic-rules-in-thail...
If not intentionally ignoring the harm you cause to others is ethnocentric then, yeah, I’m proudly ethnocentric.
French used to believes kings were chosen by gods themselves. Then they realized they're just humans, and there's no reason for noblemen to own lands simply by being born.
They didn't stop being "french", they just added another flavor.
I stopped at the sentence for example: "According to international traffic rules, you have to check your mirrors and do a shoulder check when you change lanes, make a turn or in other circumstances, but because Thai people are inherently lazy, most of them fail to do that consistently."
I don't find accusing a group of people of being "inherently lazy" at all helpful. Firstly I don't believe it to be true - even if it could be measured - but worse it suggests that the failure is innate and incurable.
Not long after my then gf, now wife and I came to Thailand, we went somewhere with her mother. I had a Intl. drivers permit and she asked if I wanted to drive, so fuck it why not. Within a few minutes, she asked my gf "why is he turning his had, can't he see in the mirrors?".
She is a retired school teacher, and she had zero clue about the concept of a blind spot in a car. I can count the number of times I've seen her wear a seat belt, on my fingers (in 8 years).
But the axiom of “I should avoid doing things that harm others” still stands. We should all (globally) work towards that goal.
A relaxed attitude doesn't mean you ignore pretty basic concepts like.. I dunno. Stop signs. Red lights. Driving on the correct side of the road. Using a car seat for an infant. Cooking food properly.
Mai pen rai attitude is visible everywhere you look in Thai society.
Should I turn off the breaker before futzing with this outlet? Mai pen rai.
Should I use the tongs to grab some (raw) chicken out of a pile at the supermarket/cash-and-carry, or should I just stick my hands in there? Mai pen rai, who needs tongs?
Should I wear a helmet when I ride my motor scooter? Mai pen rai. How about after I'm hit by someone, and end up in a coma in hospital? Mai pen rai.
Cameraman
"Tum [someone's name] go see the injured person."
"Hey, someone, wear a glove and continue the CPR" (presumably the person currently doing it will get fatigued)
cut
"What district are we at?" (someone replies: 8)
"Please look around as well"
cut to the elephant being lifted up
"Is it [the elephant] badly injured?"
to the elephant "Come on!"
"Bring it to the hospital for treatment"
cut to the elephant walking
"Ok the baby elephant seems strong and can start to walk on its own."
Luckily not soon enough for the elephants to go berserk on the rescuers! I wonder if the elephants would realize that people were trying to help the baby amidst the chaos.
> I have heard of animals staying beside the bodies of dead friends for three days and nights, refusing to move.
https://www.dailymail.co.uk/news/article-2270977/Elephants-r...
In combination this means: these people were in extreme danger. Glad that nothing happened.
Despite knowing what to do and it being almost muscle memory at this point, it’s always harrowing to try to bring someone back, and my adrenaline still pumps with a big sigh of relief when her eyes flutter open and she starts crying.
The first time we tried to give her breaths at home we had to call an ambulance and she went back to the NICU for another 6 months. She spent the first 9 months of her life there. She’s actually a pretty normal two year old now aside from not being able to walk, and the breath holding.
Honestly it’s pretty normal at this point for me and my wife so I’m fairly nonchalant about it. Her rate of breath holding has gone way down since we found medication that makes a huge difference. As she gets older it should happen less as her conscious brain becomes better at overriding her emotions. I do what I need to do and if I didn’t compartmentalize I wouldn’t be able to function day to day.
Didn’t really expect to get tone policed on Hacker News though.
https://www.researchgate.net/publication/314160379_Prolonged...
> probably 20 times
20 times is too many. Focusing on the "probably:" my son had some significant health issues a couple years ago, and almost died twice. I remember every detail vividly, like it happened 5 minutes ago.
> 99% of the time we just do the breaths, haven’t had to break a rib yet
If you haven't had to break a rib yet, you just do breaths 100% of the time.
> You just do what you have to do and blow through all the spit
That's the sort of thing you say about strangers, not your kids who have peed and drooled on you countless times, not to mention drank your water and eaten 1/2 your sandwich.
Etc.
As for “blowing through the spit”, most of the time we have a bag and mask and she’s at home, so we’re able to administer breaths without having to use our mouths. My wife does this most of the time, as I work upstairs, and she’ll call me with the alarms we have set up in the house.
When she was born we were told she’d be dead before age one, so I don’t know, I’m somewhat detached from it? She’s two now and doing pretty well, all things considered, although the night nurse had to give her breaths yesterday morning for no discernible reason. Sometimes it just happens.
Maybe you’re right, maybe I wasn’t remembering vividly enough when I recall how a couple weeks ago she got upset and passed out in the back seat, as I frantically pulled over into a grocery store parking lot, trying not to get into an accident, then, looking back at her small body go rigid as she fought back the tears, trying not to hold her breath, realizing I was too late to soothe her, seeing her face turning blue, then pulling her little body out of her car seat trying not to hurt her since her muscles a locked up, and give her breaths in the dark, feeling her go limp as she passes out, getting worried after thirty seconds or so of her not coming back, telling Siri to call 911 and the countdown getting to 1 right as her little eyes flutter open as big as they can, terrified, canceling the 911 cal at the last second, then holding my dear sweet daughter that I love more than anything in the world as she cried, and I cried, and hugging her and telling her everything will be okay, that Daddy is here and won’t let anything happen to her. Then asking her if we should go home so she can rest but, bless her heart she still wanted to go grocery shopping because she loves doing that with her dad. Then she fell asleep on me sitting in the drivers seat, as I looked around for her glasses that I didn’t even remember flinging onto the floor when I plucked her from her seat, trying not to disturb her while I jostle around. Then maybe I misremember the part where I called my wife sobbing, asking her to come drive home with me because I’d made a mistake, it got too dark and I almost killed our kid by not being careful enough (again, I push her more than her mom does). My wife got there, held our darling girl who should be a toddler but can’t even crawl at a few months past 2, but we’re so proud of her for being able to kick her fat little legs, and we abandoned her car for the night and drove home together. So I didn’t get any groceries that day, unfortunately.
It’s pretty difficult to focus on work when you’re “called out” by some stranger on Hacker News who doubts the sincerity of your statements about your child’s disability in the internet. I detach from it because crying while recounting a story (as I am now) makes it difficult to be a software engineer. It makes it difficult to be anything useful. I have to compartmentalize the pain, the doubts, the worries, or I’d never be able to write another line of code. I hope I’ve provided enough evidence to satisfy your doubts, though.
She has myelomeningicele with a chiari II malformation, and PEAC due to the chiari. If you’d like some information I’ve provided some links below. If you were worried that I’m not doing CPR and just provided breaths, fair enough, but there are a thousand ways you could have phrased that which would have been less shitty.