Just a quick note:

I'm in the middle of the 4 day HSE First Aid at work course at the moment.

If anyone who normally holds a cert hasn't done a course in the last 2 years get updated soon.

SO much has changed I'm having to re-learn almost everything.

DaveA

Ok.

Got through, got a good pass but there's a couple of things I have concerns about.

i) I've just been taught NOT to check for a pulse in the neck in the first instance, just check for 'Signs of Life' eg: Skin Colour & Temperature, pupil reaction etc.

ii) On a choking victim who's unconcious on the floor it used to be, sit arcross the victims waist and push up and into the diaphragm (sort of the same push as the Heimlich Manouver but from the front). This has now changed to Chest compressions (as in CPR).

These worry me as I'm aware that compression on a beating heart has a high incidence of inducing Cardiac Arrythmia.

I know that the circualatory system shuts down but the Carotid pulse should surely be the point check for whether the hearts working.

Any ideas anyone?

DaveA

Dave,

I was a FAW Trainer for as number of years until recently-ish.

The rational behind the pulse I believe is too many people were missing finding one where it was present and ignoring other obvious signs of circulation. Also it can be difficult to find in a poorly casualty when the first aider is under pressure. As a trainer I saw countless students who couldn't find one on their (very much alive) partners having just been shown, with support and coaching at the time, so no chance on a dark rainy night in three years time!

Regarding choking casualty, well firstly many people used to forget the encouarge casualty to cough, back slaps then finally heimlich and go straight for heimlich and rupture all sorts of things. However like a lot of things in first aid, it is a trade off against the priorities. Eg turning an unconscious casualty into the recovery position may possibly advance any spinal injury. However leaving them on their back, they are far more likely to choke or aspirate fluids and die! So quite often in critical life saving first aid you have to do something which may cause some damage, but for the greater good. I would rather be alive with something that can be treated, than intact but dead!

Hope this helps!

Z

After a few greatful souls in the US sued for broken ribs when they were resusitated, people started stepping over bodies in the street. The result was that the law changed to recognise 2 things:

1)If you are trained to give assistance you have an obligation to do so - you cannot walk on by unless someone better qualified has taken charge of the situation

2) You cannot be worse off than DEAD! Therefore if you break someones ribs giving CPR they should shut up & be greatful!

Been a while since I updated my M.F.I - is the recovery position ever used anymore in accidents? I thought this had joined "tongue holding" and other such techniques on the "not anymore" pile?

You are not legally bound to give assistance. (In Germany, for example you have to take an emergency aid course to get I driving licence and you are legally bound to stop and assist at an accident, I think). However I know I couldn't walk by and still sleep. Having said that, I did fail to attempt resuscitation on one occasion as half the casualty's head was missing.

You are covered by your employer when giving acting as a First Aider in the workplace. Outside it is a different matter. It is possible to buy insurance to cover yourself if you choose to do so. St John's for example market this.

Provided you are acting in the caualty's best interests within the scope of your training (eg you don't whip out a penknife and biro tube to do a trache because you saw it on tv, or improvise a defib from a lampost Mr Bean style) you are unlikely to be successfully sued. (As Dylan says on the prnciple of you're not dead so be grateful!)

Some technique changes come about because it simplifies or standardises things and makes it more likely that a first aider will be able to recall and the technique and effectively apply it. Some changes are through research and monitoring of outcomes.

Yes, the Recovery Position is still used, as the European Resuscitation Council research shows it to be in the casualty's best interest.

Z