In the interests of fairness though, I should say that I have known cadets be charged by a horse at Cosford.
In the interests of fairness, I’ve known cadets be nearly drowned at Cosford…
Ahh, cosford is the one event I pack EVERYTHING for - full gary to factor 50 
Sorry I was late - I’ve read the above, I think I’m up to date - but forgive me if I miss anything…
Forgive me for preaching to the choir - but thanks to ND, I have a compulsion to try to cover everything!
(Forewarned is forearmed - I’ve typed a lot… RSI in both thumbs - even had to stop and get a cup of tea halfway)
First up - Blister busting:
From when I got involved back in 2018, this subject has gone back and forth as to whether or not to do it.
At the time - I believe the orders were “blisters could only be lanced by the med team at Cosford / Nijmegen”.
All other blisters were to be covered / padded with a clean dressing - and the individual assisted, if necessary to the nearest rest point & med team - provided they were comfortable enough to proceed.
AFAIA - CFAVs have never been “qualified” to lance a blister - because it is beyond the scope of the training course materials underwritten by SJA.
Therefore - no qualification, no indemnity.
In theory - a cadet would be encouraged to continue, until either they asked to withdraw, or the instructing staff intervened and pulled them.
ACROMATI, sought to formalise a lot of different sets of instructions & procedures - (and with the utmost respect to the authors - MOST documents require review, revisions and updates - but this was a great starting point).
Allowing an individual to carry on walking with a blister, brings various risks -
Risk of greater injury: simply an even bigger blister
Referred pain by compensating
Inappropriate use / misuse of analgesia
And the worst of all - infection! What happens if, or rather when the blister bursts? Sweaty socks / damp conditions / second hand boots & insoles - all present serious hazards now that the skin has been broken.
The counter argument to not lancing blisters was to minimise the risk of infection, by draining the blister; dressing & padding the wound, then monitoring the individual regularly snd inspecting the blister when appropriate - and referring to the medics if necessary.
As ever - all this is great, when you have the full support team at Heumensoord and the Mil Team Rest Areas.
But - what about during training?
A video & support materials were produced - and used to demonstrate how to safely drain a blister - but to the best of my knowledge, very few RMTLs ever got supervised as a part of their training.
Let’s be honest, it is not rocket science - BUT - there are multiple hazards from risk of using needles that are out of date; to poor hygiene in the field; nervous / shaky CFAV or patient; previously undiagnosed allergy to latex / dressings etc - to the obvious “accidental” stabbing / pricking.
When you consider how risk averse HQAC are to everything… it’s little wonder that they’ve taken the step to say “no blister-busting, by non-medics”.
So - instead… theoretically, individuals are to be permitted to carry on, should they feel capable; after having inspected and assessed the blister - padding the blister - and hoping for the best… then deal with the aftermath later.
The likelihood is either the individual will get to a point that they withdraw, either voluntarily or told to; or the blister gets so bad, that it pops by itself - then clean & dress the (much larger) injury - and allow the individual to carry on - with a more painful wound!
With all the attention on RM and Nijmegen as an activity - and the slashed number of cadets & staff that go to Nijmegen now, you’d think HQAC would want to do everything to increase the chances of success for those individuals…?
Could someone please clarify whether the same orders regarding blisters are being applied to DofE…?
What about to individuals participating in exceptional overseas, adventurous activities such as Op Mountain Storm?
What about blisters arising during ceremonial & drill competitions / marching band events etc…?
What about simply a blister on an overseas camp…?
Regardless of the activity, the issue is dealing with blisters…
The RIGHT solution is to review the level of training being provided and making sure it is ACTUALLY APPROPRIATE & FIT FOR PURPOSE - and that it is thoroughly assessed and therefore indemnified.
It would be great if someone could clarify whether the current Corps Medical Officer is actually a qualified medic with a broad professional experience in paediatric medicine as well as advanced physio therapy - as opposed to an individual with a “Medical Trainer” background…
Someone who “goes by the book” can only go by the book - if the book is irrelevant or inappropriate, then the level of training will be too…
Ultimately - the training for staff needs to cover ALL reasonable eventualities.
But because of cost cutting measures - it’s cheaper to say “we don’t train you to do that - so therefore you mustn’t do it”.
Not exactly “Venture Adventure” is it?
As for pain management…
Paracetamol, ibuprofen and many other meds can’t be purchased by under 16s - so they have to be provided by their parents / guardians… straightforward enough…
When was the last time, you insisted on an inventory of meds provided for each cadet…?
How would you ascertain IF a cadet HAD taken an overdose… whether accidental or otherwise?
What about awareness of possible side effects…?
I agree entirely that staff cannot provide meds - or “leave them lying around, where someone might be able to pick them up…” but, when planning for a camp, or overseas activity such as Nijmegen / IACE, do you provide a shopping list…?
Paracetamol, ibuprofen, laxatives, Ex-lax, antihistamines, travel-sickness, Bach Rescue Remedy, Rennies / Settlers…?
The corps policy on medical disclosure is already imperfect… an organisation simply CANNOT INSIST on being informed of any and all routine, prescribed medications - this IS THE LAW! To do so is a breach of privacy.
On the off chance that someone is still reading this - draw comfort that my thumbs now have cramp - and that the reason why life is such a pain now, is because people before us made serious errors of judgement, which is why HQAC don’t trust CFAVs to be “sensible”.
Going back and forth on the same arguments is nothing more than confusing and a waste of time.
Get the procedure right - THEN deliver the order…
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Agree that there’s a case that our FA training for these activities is insufficient. A glorified FAAW that is worth less than FAAW.
As a cadet, on just about any activity (considering the mention of DofE above) I was perfectly willing to self-treat all manner of things to keep going. That would have included a couple paracetamol or ibuprofen, or even popping, draining, cleaning, and wrapping a blister.
If any of the treatments I wanted to do were binnable offences, I wouldn’t have told anyone.
From a risk perspective, I think there’s greater risk in not providing a level of training to CFAV sufficient to make these things not binnable.
At these higher levels, the cadets we’re dealing with are the most determined and most passionate about what they’re doing, and for many of them they’d have to lose a leg before gracefully accepting a withdrawal.
…but I’m the guy that’s played goalkeeper with a freshly broken hand and whose idea of breaking in brand new boots is a fieldcraft weekend on rough terrain. I am the embodiment of “worst recipient of my own advice” and the corporeal form of “I wrote the risk assessment, if you get hurt, I’m responsible; if I get hurt, I’m responsible, and I’d rather answer to my mum than yours”. This isn’t new, it’s not a CFAV “press-on-itis” thing. I was the same as a cadet. I played football, cricket, and rugby, and knew what I could and couldn’t push through or stick a (metaphorical or literal) plaster on for the sake of “a few more miles” or “one more day”. Or if I didn’t know, I was willing to test and find out.
I know, even if HQAC don’t, that we have cadets in our number that will happily pop a kneecap back into place like it’s just another day ending in “y”. They will do these things with or without our knowledge and care.
I’m worried about the “without” part.