And yet a second TQ isn’t in the kit, but they kept that…
It is such a nonsense.
Really we should be knocking on St John’s door demanding all these be included in AFA, then demanding kit we need.
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Yep. I called that out during the course and didn’t get a decent response.
They used to do a +F forestry bolt on that covered dealing with cat bleeds and major trauma. I think that integrated into AFA would be fantastic!
I have a couple of thoughts, here.
Firstly, I’m pretty sure the control of catastrophic haemorrhage being taught (including the CABC or equivalent approach) was a recommendation from the Manchester arena enquiry. Whilst I appreciate coronial recommendations sometimes have a hard time being translated to practical life, this one always struck me as an eminently sensible idea and one that all first aid providers (such as SJA) should be scrambling to get on board with. Our young people should be empowered to deal with life threatening bleeds wherever they see them, and I would advocate them being included at EFA level - it truly is an essential skill.
Secondly, the SARAH act (Good Samaritan law) will protect people acting to save a life within the scope of their training, whether or not the relevant “parent” organisation is the one who gave them that specific bit of training. The only thing you must not do is make the casualty’s condition worse.
So, if you have what you believe to be a life threatening bleed and you have no other way of controlling it, by all means chuck a TQ on if you know how! Just please make sure you write the time on it - it really is important! (And, if you can, draw a big red T on the casualty’s forehead)
(Keep in mind a stepwise approach to bleed control - a TQ applied when not needed/when there is a suitable alternative could be argued as making things worse…)
It initially entered the conversation following 7/7, then lessons learned in the military mainly from Afghanistan brought it even further forward in mainstream medical and first aid circles.
I did my first cat bleed bolt on in 2017.
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I’ve been reading through all the comments above and find myself shaking my head more than ever.
The level of appropriateness of First Aid training is reasonably sound - until you look at what is actually covered / not covered - or worse yet, frowned upon - “you’ll risk getting into a lot of trouble for that”.
Frankly, EFA is about the only suitable / balanced course - in terms of content, delivery method and intended audience.
Young people; highly nervous; limited attention; unlikely to be called on to use their new skills - unless in a genuine emergency.
But - AFA has never struck me as being much better, when you consider it is intended as a standard for CFAVs.
Either way, it feels like the level of training has moved on very little from when I did my First Aid badge in the Cubs, when I was about 9…. more than 40 years ago!
I’ve had multiple people tell me it’s because of working within the constraints of what SJA will teach - and therefore what RAFAC are indemnified / insured upon.
I can understand HQAC getting nervous about using Haemostat products that are beyond their use-by date… leading to yet more ongoing replacement costs - risk of incorrect use etc.
Likewise - everyone warns against having a TQ - “you’ll definitely get into a lot of trouble if you’ve got one of those…”. - well, a LOT less trouble than the casualty that needs one - and the best you can do is whip a belt off.
Another objection I’ve heard repeatedly, is the risk of a TQ being mis-used - ie, used for a minor bleed…
But surely the same argument could be made for any manner of treatment…
Catastrophic bleed is a real threat, in a wide variety of scenarios. Most adults, let alone cadets would struggle to apply enough pressure to such a wound.
Lastly - I have been a long time advocate that all activity leading staff (at least!) should complete the FAAW qual.
Not only would it afford greater skills for the individual; it would enhance the protection for all staff and cadets; it would be a genuinely useful qualification for all holders!
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With appropriate training, then the use of a TQ in the correct manner and situation is life-saving, Who are these people warning against?
If it is used inappropriately, first responders when they take over the care of the casualty will either loosen or remove the TQ, but I suspect that they will leave it in place until the casualty is in A and E with a resuscitation/trauma team.
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I wasn’t much more impressed with FAAW, which is the SCC standard two day course. (The SCC are much more sparing in their deployment of FAAW, they have to pay for every course so it’s reserved for staff who need it, like me, for my PaddleUK quals)
I can’t say I learnt anything on FAAW that I didn’t know already from AFA with the TQ bolt on I did 4 years ago, and FAAW needed 6 hours of e-learning on top of the two days course.
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In all honesty, I don’t think FAAW is that relevant for a lot of what we do - it seemed very office-focused when I was there (although in an ideal world the course would be tailored slightly for individual workplaces.)
I’d be interested to know how much actual review there is of incidents occurring within the RAFAC, to adjust the course based on what participants are likely to face within the organisation?
(I do still think there should also be a bit about what cadets and staff are likely to face outside of the org too - but I think that should be at EFA/YFA level)
There is no adjusting the course based on our needs!!
As for review, every incident and accident should lead to a report (SOR?) which would include first aid actions taken. Then more serious incidents may have a full investigation. For example there was a bad MTB accident this year that led to a full DAIB review.
I really think as an organisation we should be delivering FREC-style courses, especially for those doing outdoor/remote/RTL stuff.
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Thinking about this a bit more, one of our core aims is to “provide training which will be useful in the Services and civilian life.”
So this shouldn’t just be about what is useful for us as CFAV to deliver activities, but also how CFAV and cadets take what they have learned to apply it in the civilian world. So delivering cat bleed training to all would be very useful for reacting to events that may unfold within our local communities.
A decent forestry IFAK containing TQ, Celox, chest seals and trauma bandages can be had for <£100. If we delivered a course on how to use this stuff, and encouraged individuals to carry this sort of thing in their car, it would have a wide-reaching positive impact. As well as the obvious positive of us as CFAV being able to react within a cadet environment, too.
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Only need to look at yesterday to see how this sort of skill can come in handy.
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I completely agree. I think a week long course leading to professional qualification is exactly what gold level courses are for, and sounds ideal for a FREC 3.
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If an incident occurs under the RAFAC purview, and there are serious injuries or even deaths, what post incident debriefing is available to staff or cadets from the organisation.
Having been through a major incident of a fire underneath an intensive care unit and patient evacuation, with the staff inhaling noxious gases, the first thing management did the next day was to have all involved staff see a Consultant chest physician and a psychologist the next day.
Consider how many emergency services personel have psychological injuries post a major incident, then cadets and CFAV subject to smaller but just as intense incidents, what help is available?
Explicitly told, in front of staff and cadets alike by AFA instructors and other senior FA staff.
The only concession offered - “[IF you are qualified elsewhere, by another agency to use a TQ, then you can upload your qualification from THAT organisation and it will be recognised, but you will be responsible for maintaining the currency of the qualification. RAFAC First Aid Training is underwritten by SJA - and as the use of a TQ is not covered - you are not insured to use one]”.
As ever - the position of “cover your ass” being paramount.
Realistically, no citizen requires an in date qualification for first aid, tourniquets included or not.
The idea of being insured is nonsense. The MOD would surely be laughed out of court if they tried to deny a payout because someone unsuccessfully attempted aid just because the technique wasn’t provided to the aider by the MOD.
Naturally, as an organisation, our people need to be trained to a minimum standard, but within the organisation or not, if you take action in the belief that is correct and helpful and is not actively, inadvertently harmful, then you’re probably going to be ok.
While I’m not condoning getting out the Gerber to shove a pen stem in someone’s esophagus, for the most part if what feels sensible to a vaguely educated person doesn’t save someone or prolong them enough for proper medical treatment then they probably weren’t going to be saved by any Bloggs with a certificate. You can’t do any more harm than dead for someone that is already dead or dying.
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True, I had a mate doing CPR on stabbing victim, guy was clearly dead, paramedics showed up and were bit “meh” helicopter wasn’t coming (it was elsewhere) passer-by presented as a basics trained doctor, offered to “have a go if someone’s got a knife”. Quick confabulation with the Paramedics and decision was “well he can’t make anything worse”.
Didn’t make a difference to guy had been stabbed in the heart and no one was criticised for trying using non-issue on his day off.
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MANY moons ago, I remember watching a training video that was focusing on trying to remove apprehension and fear, when it comes to first aid… if the casualty is not stable - uncontrollably bleeding, not breathing, choking or in imminent other danger - then doing “nothing”, is certainly worse than doing “something”… and as mentioned above - “you’re not going to make matters worse!
Part of the problem to me, is the seemingly endemic attitude of “do everything to cover your rear, because HQAC won’t support you, if things go wrong.”
How true that is in practice is another conversation.
It also doesn’t help, the piecemeal way in that procedures are updated - and worse yet, where they contradict other orders.
I know it’s not a democracy, but why not encourage Corps, Region and Wing SMEs and COs to complete a survey of whether they feel the existing first aid training is adequate for their needs - and where lacking, give details of what they would like to see included…?
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There is another side to this aswell… let’s do a statistical analysis of what first aid is actually used and then tailor our requirements to that.
Lots of wet paper towels and ‘there there’ on most camps I’ve been to over the last 20+ years.
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Which isn’t exactly taught anywhere 
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Exactly, it’s daft. I struggle with that type of first aid but thankfully we have lots of people who are very good at it in the org.
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