I don’t get the fuss about any of this tbh (road marching generally and this specific issue within it).
HQAC note comes out to say don’t do first aid that isn’t recommended in first aid provider book, including potentially invasive medical procedures you’re not qualified or trained to do.
Same note also says we shouldn’t push young people to do something they’re physically struggling with and could be damaging to them by recommending or supplying them with painkillers and creating social pressure to complete something.
I actually think that’s all very sensible and should be something we have as routine.
As an aside I’ve never understood the cult following this activity can sometimes generate, and I know from other areas of the organisation that individuals within it can adapt a finish-at-all-costs mentality that is downright dangerous.
It doesn’t help that the manuals are not actually designed for many of the adventurous activities as undertake. We’re using a First Aid syllabus designed for office work as a catch all.
Our first aid manual says never reset a dislocated shoulder. My White Water rescue books say that in some circumstances you may have no choice but to do exactly that.
First, are you saying that no activity has ‘cliques’? I have never seen road marching as a cult, I have seen shooting and other activities described exactly the same way.
I have never seen any finish at all costs and have always worked to cadets capacity, and if they reach it, then on the minibus they go. Anyone that supplies cadet walkers need to be stomped on, I’ve never seen it in my experience though. Nobody is ‘qualified’ to lance blisters as there is no such course, but basic hygene measures can make it safe.
No, that’s literally the opposite of what I said. I said from the other areas of the organisation I know it exists, and is no different in this one.
Uhh yeah, exactly my point. Why would this ever be acceptable? Would you start digging round in someone’s finger with a needle to get a splinter out too? Lancing blisters hasn’t been an acceptable first aid option for a very long time, so long I forget when it changed over. The fact people are still doing it, despite this, is worrying.
But it’s corps policy. The problem here is that this kind of action, ie draining via needle, has been taught from our policy to our Road Marching Team Leaders.
This isn’t rogue CFAV. Carrying of hyperdermic needles is specifically mentioned in the road marching policy.
General advice. Whenever treating blisters on the feet (at a rest area or at the end of the day), allow a little time for the feet to cool down, blisters should be drained using a STERILISED needle. Do NOT use the same needle on more than one person. After swabbing the area clean with surgical spirit or other antiseptic, gentle pressure should be applied to one end of the blister with a thumb so that it ‘balloons’ and stands proud of the healthy skin. The needle should then be laid along the skin and pushed sideways into the blisters. This avoids the possibility of puncturing healthy tissue and causing pain. When the fluid has been emptied, ensure there is a small hole in the outer skin to allow any excess fluid to drain away. The affected area should then be covered with a clean sterile dressing and taped into place.
That is HQAC approved road marching policy.
The safety notice makes it sound like this is some people going rouge.
Road marching has long had different approaches from many of our other activities, which I’ve always struggled to reconcile. Blister.treament is one. Another is the mainly road based routes that would never be acceptable for DofE/AT events, from a safety perspective.
Perhaps these discrepancies are now being looked at and the risks considered in a way that’s consistent with other activities?
It will shock no one that I’m not an expert on RM policy, but my reading the safety alert I thought this was very much people doing their own thing and harking back to the old days.
The optics on this are not good.
Especially as if I was new and referring to policy next week it would tell me to go against the safety alert I don’t know exists.
Unfortunately, this isn’t new or unique. ACP 1358 says CIs shouldn’t wear uniform in any circumstances, but FC, RM, and UAS / RPAS policies say they must wear PCS in certain circumstances: with or without headdress, depending on which policy.
Various policies need to be re-written to incorporate IBNs and other notices, and to be brought into alignment with each other.
Now im going to remove the emotion here with my PoV.
I will caveat it with i agree with the policy and ill explain why below, but i dont agree with the fact the SoP on how to operate with blisters going forward hasnt been communicated. Also there are further impacts here than just RM that havent been thought about, such as AT, DofE , Drill etc
But the reason i agree with the safety alert, specifically the needles part is:
If I by some horrendous mistake had a child, who joined the RAFAC and liked Road Marching. I would not be entirely confortable with a volunteer piercing my childs skin with a needle.
Piercing a blister, even though minor is a medical procedure, I would only trust a trained medical professional to do that. Now I hear you all scream but its taught on the RMTL course!!! Yeah thats a made up cottage industry course in the RAFAC. It isnt assured and goverened by any medical body so doesnt fly with me. I also dont trust that its not being done in a clean sterlie environment. I would put money on there being examples of it being done at the side of the road or in the back of the minibus, infact ive been told by RM cultaholics this happens.
So i dont think the majortiy of people in this organisation are in the eyes of the law trained appropriatly to reduce blisters and protect cadets and CFAVs from further injury when it comes to this level of treatment. Id even go as far as saying i dont think it should be expected of RM Directing Staff/First Aid Staff.
Any form of medical practitioner acting outside of their scope of practice, or outside of suitable training to undertake the task unless it is in an emergency may find if it all goes wrong at the wrong end of a charge of professional misconduct. To act they would also need indemnity insurance against being sued.
This matter also came up in the RIAT incidents about professional responsibilities and actions.
It sounds like the whole lot needs to be rewritten.
I agree with Alex though, I don’t think we should really be sticking needles in people feet. But I’m no medic, nor am I a road marcher. So I’d be happy to see evidence that this is in fact best practise and can be done safely.
Why? Nothing in that contradicts what this alert says. The alert says we, as staff, should not promote the idea of getting cadets to medicate themselves just to take part. Your screenshot is saying if they do it themselves and choose that, then fine but let us know.
The alert is just for those people who are aching, sore and pained who go to staff and say “I can’t continue”, and staff who say “oh go on, just take some paracetamol and don’t let the team down”.
Stop the promotion or administration of pain relief medication for the purpose of enabling participants to “push through” injuries or discomfort.
The slide says:
You will experience the need to lessen the pain …
Medication should be a help to get over the finish line
Surely, the slide itself (and therefore the mandated delivery of it by staff) is promoting the administration of pain relief for the purposes “pushing through” discomfort.
