BelCanto comments

Posted in: Detainee dies after choking on food in Saitama police station cell See in context

I'm liking where this comment section is going!

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Posted in: Detainee dies after choking on food in Saitama police station cell See in context

The pen thing just doesn't work. Movies are not real life.

Next they had 10 people from different walks of life - lawyers, police officers and students - attempt to use the pens to perform a cricothyroidotomy on the bodies of 10 people who had died within the past two days.

Six of the participants punctured the neck too low and stabbed the thyroid gland. Three of the participants punctured the neck at the right spot.

Only one person was able to break the skin, ligaments and airway wall to establish airflow. For that person, it took more than 5 minutes, three attempts and “a lot of patience” and force. The person also caused damage to the neck and airway.

https://www.reuters.com/article/us-health-breathing-pen-idUSKCN0XP32Q

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Posted in: Detainee dies after choking on food in Saitama police station cell See in context

Yubaru  09:02 am JST

Oh and folks here do not assist not because of "it's not my job", it's because they can be held legally liable if they screw up. You assist someone who is bleeding or whatever, you make a mistake, they die or are incapacitated for whatever reason, YOU can be charged!

Simply not true, as long as you provide care that a reasonable person would consider appropriate - even if the outcome for the victim is poor. That's the law - Civil Code Article 698 and Penal Code Article 37 to be precise.

No layperson (excluding medical professionals) has ever been held criminally or civilly liable after providing emergency first aid in Japan. Not even once. 

Please, stop providing misinformation that might dissuade someone from doing the right thing.

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Posted in: Detainee dies after choking on food in Saitama police station cell See in context

Will Goode  09:28 am JST

It would be asking a lot of anyone to perform a tracheotomy on the spot, although we all know the technique of piercing the windpipe below the Adams Apple with a pen or something.

Hahahahahahaha. No. No, we don't all know it, and thank goodness. In Japan that's outside the reasonable standard of care from a bystander, and a great recipe for a criminal charge and a civil suit.

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Posted in: Woman injures pedestrian in suicide leap from building in Tokyo See in context

They need to start putting up those safety nets.

Please, explain the logistics behind that.

They've done this in Chinese factories where workers are sometimes tempted to commit suicide because of countless hours of work with little sleep. The nets are almost invisible so hopefully catch their fall.

So do this on every building of more than two stories in Japan? Suuure, we'll get right on that.

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Posted in: Mother, 6-year-old daughter killed in car crash See in context

ebisen  03:51 pm JST

K-Car, the death trap of the east... Would they be produced in other countries, Japan would have never allowed their import. But they're produced locally, and the Japanese auto lobby is very strong, and pays a lot of bribe money to the politicians...

Nope. Consumers demand them, but the auto makers would love to see kei cars go away. Low margins, separate R&D and production lines, no global potential to recover costs. Agree that they're death traps, but the bribe cliche is lazy and incorrect here.

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Posted in: 36-year-old father arrested for beating 8-year-old son to death See in context

Speed  10:57 am JST

I'm not against corporal punishment. But a parent needs to show restraint and know how much is too much.

Also, a lot of posters on here are speculating without a clue what it is that prompted this. You guys have no idea what the boy did or didn't do.

What could an 8 year old child do to provoke or justify a fatal beating?!

Please, build this idea out a little for us all. Or just delete it if you have any sense of shame.

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Posted in: Helicopter crashes in Gunma; 2 of 9 aboard confirmed dead See in context

There is something strange with Toho Air being in all these these accidents.

Not at all. Toho is a massive, massive heli services company. Helicopters are comparatively risky aircraft. Crashes are going to happen. Toho's accident history is unremarkable, considering the huge scale of their operations.

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Posted in: Tokyo riot police finally allowed to carry drinks on duty during summer See in context

Due to the nature of their work, however, the officers need to be ready to deal with potentially violent criminals, and thus they’re not allowed to carry their beverages in their hands like the Canadian officers were photographed doing.

Perhaps they can send the officers to my advanced tactics seminar, "Dropping: The Art of Quickly Releasing Objects From Your Hand."

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Posted in: Nurse arrested for abandoning dismembered body of mother along Shiga riverbed See in context

The overall crime rate might be low, but the murders are always so extremely sadistic

Unlike the kinder, gentler murders one finds in other countries. Good point.

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Posted in: 3 found dead in apparent murder-suicide in Niigata village See in context

He could've sold it and used the money to aid his wife and mother's health! 

Maybe, maybe not. Sekikawa is a farming village of a little over 5,000 people currently, experiencing steady depopulation like declining rural towns all over Japan. (Found the census data to confirm this.) You can only sell if you have a buyer, and there are quite possibly no buyers for farmland in Sekikawa.

I'm NOT disagreeing that this is tragic, and that his actions were terribly wrong. But for many thousands of older folks in rural Japan, there just aren't that many good options.

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Posted in: Miyagi man arrested for calling employment office 159 times in a row without saying a single word See in context

Seems like he's got a real hang-up to overcome.

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Posted in: Truck driver assaulted after being tailgated on Tomei Expressway See in context

Seems like a bad idea to get out of your vehicle in a case like this. Stay cool, record the plate number and wait for police to arrive.

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Posted in: Speculation swirls over postponement of Princess Mako's wedding See in context

If you ask me, by 2020, the Olympics will be yet again another reason for their wedding postponement. So they'll push it back even more until she falls in love with a royal relative of hers.

The only unmarried male in the imperial (not royal) family is 11 years old. Otherwise, incisive comment.

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Posted in: No. of Japanese tourists to Guam plunging on N Korea missile scare See in context

The threat by North Korea’s leader, Kim Jong-un, to create “an enveloping fire” around the tiny United States territory in the Western Pacific will bolster Guam tourism “tenfold,” Mr. Trump said in the recorded conversation with Gov. Eddie Calvo.

NYT 2017/8/12

So much winning!

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Posted in: Starbucks Japan asks customers to not use smartphones, laptops in its cafes for Dec 11 eco event See in context

So they're going to burn what are most likely petroleum derived candles, generating more pollutants per lumen than a lightbulb, to show how much they care about the environment. Why not just turn down the lights?

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Posted in: McDonald’s Japan brings back 'American' series See in context

Know what's actually on McD's menu in America? The Quarter Pounder with Cheese that McDonald's Japan should have never killed.

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Posted in: 2 dead as truck rear-ends minibus on highway See in context

Yes, you bet non of them were wearing the seatbelt. And why would they? The bus was parked, not moving when the accident occurred.

It was disabled on the expressway, genius.

Have people saying the bus shouldn't have "parked" there actually been on Japanese expressways? No one would stop on the expressway unless their vehicle was simply unable to move under its own power.

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Posted in: Woman dies from tick-borne disease after bitten by stray cat See in context

why in the world would you take a stray cat to a vet?

While we don't know in this particular case, it may have been to have it spayed or neutered. That's a thing people do, and perhaps you can reason out why. Try hard.

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Posted in: New coal power plants may block Japan's carbon emissions goal: environment minister See in context

Well done, anti-nuke crew.

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Posted in: Australia compromises on 'backpacker tax' See in context

While Japan levies 20% tax on all wages earned under working holiday visas here...

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Posted in: Nobel winner Oe: Japan should follow Germany, quit nuclear power See in context

Or... maybe we can be more like France, generating 75% of electricity from nuclear. Meanwhile, Japan is the 5th largest producer of CO2, and is backing off of climate change goals. Want to know something that is actually likely to "wipe out Japan's future," Mr. Oe?

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Posted in: 7-year-old boy chokes to death on plum pit in Sapporo See in context

I don't think there are a lot of people even reading this thread anymore, and even fewer on the fence about what lessons to draw from the article and related discussion. :) But...

Here's why the standard first aid procedures are the procedures: because they work better (i.e. save more lives) than any other course of action, for the greatest possible number of people, in the greatest possible number of cases.

This isn't even subject to debate. The best experts in the world review the evidence from real research into what works and what doesn't work - for both laypeople and medical personnel. They revise the internationally accepted resuscitation guidelines every 5 years based on the latest research. When you go learn basic first aid and CPR, you're learning procedures that directly reflect these evidence based guidelines. So you're learning what works best for regular people the greatest percentage of the time. End of story.

So if "procedure" says move straight to CPR (with airway check) for an unconscious choking victim, then heck yeah that's what I'm going to do. You should too. Not because you're unthoughtful or too hung up on procedure. Because it's proven to have the best chance of saving a life when performed by a lay rescuer. That's what procedures are about. That's the beauty of them.

First aid for regular people is being continually refined with two goals in mind 1) to be effective in the greatest possible number of cases, and 2) to be simple and understandable, thus more likely to be performed. It's not complicated. Explanations and rationales that seem complicated, and the people who provide them, should be viewed with skepticism.

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Posted in: 7-year-old boy chokes to death on plum pit in Sapporo See in context

Lowly, that's a bummer to hear they turned you down. I imagine it's a pretty Japanese organization, with all that implies. Maybe they did you a favor by turning you down. :) I considered joining the local volunteers as well, but then decided I could be more useful to society elsewhere.

Tons of foreigners have been through the fire department basic first aid courses, though, no problem. Call or drop by your local FD to find out when and where. Local FD websites almost universally suck. :)

Or, you can check out http://www.tokyo-bousai.or.jp/lecture/kyukyu/teate/teate01.html. Click the apply button to get a calendar. But this site doesn't list all local FD courses.

If you can understand Japanese, you're all set. You can request an English translation of the text in advance, but English courses are still rare, unfortunately.

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Posted in: 7-year-old boy chokes to death on plum pit in Sapporo See in context

Yabits, just a guess but you seem like you may have some medical / medic background, if you're comfortable with the idea of performing a tracheotomy. If so, fair play.

I just want to emphasize, and I hope you'll agree - this is NOT a procedure that one should consider doing without serious training. Sure, once you know how, it's not rocket science. But the page I linked, and the procedure, are not aimed at most people reading this thread.

If you're not a trained medic or the equivalent, you should not be contemplating this procedure. If you are not currently certified in basic first aid and CPR, you're many miles from needing to even think about this.

(Agree with everything in the latter part of your comment, too, BTW. Cheers!)

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Posted in: 7-year-old boy chokes to death on plum pit in Sapporo See in context

Japanese news is reporting that the school staff used a freakin' vacuum cleaner to try to suck the plum pit from this poor boy's throat. There is no 100% guarantee, but research (not opinion) makes clear this boy would have had an extremely high likelihood of being saved if the school staff had provided the standard choking response you learn in any basic first aid course.

Want to do something about this tragic death? Take a basic first aid / CPR course and retrain every year. If you have a kid in school here, demand that your board of education provide the same training for all staff. These are things that will actually make a difference. Anything else is the domain of medical professionals at best, or fantasists at worst, and doesn't concern this article or us laypeople.

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Posted in: 7-year-old boy chokes to death on plum pit in Sapporo See in context

Lowly, your first step is getting certified in basic CPR and first aid. :)

Then retrain at least every year, no matter how long your card says it's good for. In numerous studies, even pros show deterioration of basic technique after just a few months.

Do that, and then you can start thinking about what's next. :)

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Posted in: 7-year-old boy chokes to death on plum pit in Sapporo See in context

Lowly, here's a great page detailing emergency tracheotomy. (http://www.anatomyatlases.org/firstaid/Choking.shtml)

Note that the scenario has a thoroughly trained Marine corpsman performing the procedure. It's not trivial, and is simply never going to be appropriate for laypeople, like the school staff who were in charge of the Sapporo victim.

Get this: FNN's Japanese coverage of this accident says that school staff called 119 and tried using a vacuum cleaner to remove the plum pit. My whole point is that this kid almost certainly would have lived if the staff had learned and performed the standard basic first aid response for choking. Let's work on getting folks trained in the basics rather than go on and on about dubious cowboy "solutions".

Frungy JUN. 30, 2013 - 02:33AM JST:

BelCanto raised an interesting issue in terms of legal implications. Japan has a "Good Samaritan Law" that actually requires you to render assistance, and protects you from legal liability if things go badly. In fact Japan's law is phrased in such a way that you have a duty to rescue/assist and can be criminally charged if you do NOT take all reasonable steps and it results in death or injury.

OK, you're just making things up. Gobsmackingly absolutely false, despite the impressively rich detail and authoritative tone. Or can you provide a citation?

From the Tokyo Emergency First Aid Association (the folks who teach the Japanese fire department courses):

We do not have a law like this [the GS Law] in Japan. However those who have taken action for lifesaving with good intentions are supposed that [sic] they are not held liable. In fact, no citizen has ever been convicted as the result of his or her actions.

Wikipedia has a quite interesting discussion of the legal landscape, if you read Japanese. (http://ja.wikipedia.org/wiki/%E5%96%84%E3%81%8D%E3%82%B5%E3%83%9E%E3%83%AA%E3%82%A2%E4%BA%BA%E3%81%AE%E6%B3%95) It's not actually as simple as the Tokyo Emergency First Aid Assoc. puts it.

[I'm not a legal expert and am simply summarizing the Wikipedia discussion below.]

In a nutshell there is a civil law (article 698) that applies specifically to the business sphere, and absolves one of responsibility for acting urgently on another's behalf, provided the actor has no obligation to act (e.g. is not an employee who does already have that obligation), as long as one acts with good intentions and as long as one makes no serious errors.

The argument exists that in common law, the above civil code is a defacto Good Samaritan Law, but this legal opinion is still debated. Additionally, there is a possibility that a rescuer could have the burden of proving that no serious errors were made. (Doctors may be held to have an obligation to act, further complicating application of the above law.)

Criminal code article 37 spells out when punishment may be suspended for breaking the law in the course of responding to an emergency. The key point is that your actions must not result in damage greater than the damage you were seeking to avoid. And again, this only applies to people who do not have a professional obligation to act, such as doctors.

Despite the fact that to date rescuers have not been held responsible for acting (and I'm personally confident they will not be held responsible in the future), there is not solid legal precedent for absolution of responsibility, only the absence of a record of being held responsible. Thus, there is a push for passage of a proper Good Samaritan Law, to replace the current patchwork of laws and opinion.

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Posted in: 7-year-old boy chokes to death on plum pit in Sapporo See in context

Lowly, I'm glad you made it!

You raise a good point about bystander reluctance, which is a real factor not only in Japan. Good training is one factor in reducing hesitation. Especially when most people (on this thread and on the street) aren't trained in even the basics of first aid, extended discussion of field tracheotomies seems a bit silly. If you're an ex-corpsman or a medical professional, great, but that's not most of us.

This study (http://www.ncbi.nlm.nih.gov/pubmed/17169872?dopt=Abstract) found an 86.5% success rate for the Heimlich maneuver alone. Another paper by the UK Resuscitation Council notes that in half of cases a combination of techniques will be required to dislodge the object, which implies that rotation of back blows and Heimlich is going to push that success rate even higher. (So your dad's blameless response aside, it's no surprise that the knife wasn't needed.)

So after we achieve a society in which most people are trained in basic first aid and ready to save a life in the vast majority of situations, then great, let's start advocating for improvised surgery by laypeople.

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Posted in: 7-year-old boy chokes to death on plum pit in Sapporo See in context

CPR is your best hope for dislodging a stubborn foreign object at that point, as per the Mayo Clinic guidelines.

Best hope? So, here's the question: What do you do when CPR doesn't dislodge the object? What are the options left in those critical minutes, and how long should it take to make the decision?

As a seasoned instructor (major city ER, backcountry rescuer) of mine liked to put it, "At that point, you're having a bad day." Meaning, sometimes you don't have any really good choices, and sometimes things just aren't going to turn out for the best.

I'm a layperson - not a doctor, nurse, or EMT. As such, there are legal and ethical limits to what I can do, even in a life or death situation. My best bet is to follow the protocols I've learned and been certified for to the best of my ability, until advanced care arrives and takes over.

If I have an unconscious choking victim and I can't dislodge the object by sweeping the airway or CPR, well, it's a bad day. Regardless, I'm not going to grab my Bic pen and do an improvised tracheotomy, say. That's outside my training, and outside the definition of "reasonable assistance" that would protect me from liability for the outcome of my actions. For me, it would be the wrong choice. It would likewise be grossly negligent for me to suggest it when teaching a standard CPR course for laypeople.

If you're trained in battlefield medicine or are a medical professional, you might decide differently. If that's you, you know who you are. But that's not the vast, vast majority of people, and it's not a realistic, legal, or ethical option for them.

The standard first aid and resuscitation protocols are the protocols precisely because they're going to be the most effective in the most situations for the most people. They're not perfect, and they're no guarantee of a favorable outcome. We can only act to the best of our ability and training, and hope it's a good day.

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