Catastrophic bleeding is included as an optional extra in FAAW and the syllabus definitely includes CAT tourniquets.
At least our awarding organisation do it this way.
2 Likes
Is there any particular reason that St John charge 3 times as much for FAAW than other providers? Are they simply playing on brand recognition or do they offer more?
1 Like
If youâre lucky, you do it through a contact or CFAV at cost⌠If youâre even luckier you can even get that paid for.
1 Like
having completed my RAAW renewal this year i can indicate that torniquetes are now taught yet three years ago were a strict âno-noâ
Alot of time was spent on CPR and when we were invited to offer feedback i questioned this - apparently there is a minimum number of [b]hours[b] assigned to CPR - this frustrates me given heartstart is a course a couple of hours long and covers CPR within that time along side other scenarios.
I like Batfink have to agree that the FAAW/AFA is not relevant enough to me.
As a trekker, CPR isnât going to be âhighâ on the list of injuries or treatment i need to provide. There is little or no time spent on likely injuries that might occur during the AT I conduct and need a FA qual for, yet ironically despite needing it offers little advice/training/knowledge for the intended activity
Heartstart is designed to saturate the population with basic first aid knowledge to deal with the most critical situations, with the basic concept being that informed action is better than inaction.
Strenuous activity, interacting with people of a wide rage of age and physical welfare, with opportunities for drowning? It sounds like there is more chance of CRP scenarios than you appear to imagine, and for those scenarios to need longer, better CPR to be performed.
I do agree that FAAW (and much of AFA) is based on the principle of stabilising and getting an ambulance on site. High-risk workplaces have better kit and better-trained medics.
accepting the rest of your answerâŚ
âŚwhat is learnt in the second hour of CPR that wasnât covered in the first?
and to the same degree the third hour?
everytime our instructor decided it was time for a break we moved to the âAnniesâ and another cycle of CPR.
i am not saying it isnât relevant, but foot/ankle/leg injuries are more likely on a walk than someone struggling on strenuous activities, or drowning as such an injury can occur walking along the high street - so even more likely when âoff roadâ yet no/little time was allowed for it.
approaching from a likely risk point of view, i know far more people who have been on crutches due to a leg injury (ok for a variety of reasons, not necessary AT related) than I do those who have received CPR (Fyi = zero).
again I am not saying the skill isnât relevant, and the victim would be forever grateful if they survived, but the only persons i know who have conducted CPR in anger wear a green suit and drive round in a brightly coloured bus with a noisy siren. whereas i know of several occasions when persons have been out in âAT countryâ and suffered an injury which wasnât covered in my recent FA re-qual
More time in practice gives a better chance that the instructor can properly observe the CPR, correct issues with rate, depth, hand position, ventilations and so on. It can also involve CPR with multiple first aiders or the use of smart manikins to analyse performance. Good courses will also include AEDs.
I donât know how the class size affected the lesson, but more than 2 hours is stretching it. Iâm not sure where the âminimum timeâ you talk about is mandated or if it is an invention by your provider. I think he was padding!
Remember too that risk is not based solely on likelihood but also on severity.
1 Like
none of which i disagree with.
This was my third FAAW (second refresher) and at one point was active with Heartstart as an instructor so my familiarity with CPR is believe is good.
I would have benefitted more if it had been tailored to why i needed the course. ie for AT not simply to tick a box that I have a first aid qual.
I agree that severity enters risk, but on that premise why did the course not include stabbings and gunshot wounds??
They were introduced just under 3 years ago across the Summer/Autumn, I believe. Sounds like you just missed it last time out.
Accepted usage was revised and a fair amount of the âold thinkingâ was cast aside following A LOT of new information and dataâŚmostly out of warzones as Bob and I were discussing, but their usefulness was also seen in other scenarios.
Under the new thinking, they are much âeasierâ for a layperson to actually use safely/effectively compared to the old ways, and their efficacy has been better proven. Concerns over things like nerve damage and limb loss were proven incorrect (to a degree).
1 Like
that would explain why this was new to me this time around.
from what I recall it was a case of âpoisoned bloodâ (that which is cut off because of the Torniquetes) re-entering the bloodstream when the restriction is released could cause bigger problems.
As identified a lot has been learnt since and with the one handed operation far simpler to use correctly
1 Like
Torniquettes as well as limb entrapment is when you have a long period of no rminimal blood flow into and out of a limb causes blood cells to leach out ptasium into the blood serum (the yellow bit when a blood specimen is taken and left to stand as the cells separate out) so when the restriction of torniquette is released, the heart has large amount of potasium flushed into it, which can cause cardiac arrest.
This form of cardiac arrest maybe very difficult to treat but the effects of the pottasium can be ameliorated prior to the release by the use of drugs and fluids injected. This mangement is well documented and taught as part of the Advanced Life Support Course as mandated by the Resuscitaion Council.
In other words, by the time the tourniquet is released, the casualty is in a clinical care environment that has the ability to mitigate the complications.
In theory. But the alternative is to bleed outâŚ
1 Like
Correct in both cases, better a live patient who you can sort out in a suitable environment instead of somebody dying due to lack of activity. Torniquettes in the right circumstanes save lives. just a pity it has taken many deaths over the years to relearn a lesson. In the words of a Marine medic, old and grizzled, on the Michael Mosely documentry, he wshed heâd had them in Ulster to save lives.
1 Like
Just the one thing when applying a torniquette is to note the time of application, write it on the forehead if you have a pen or marker.
Thereâs a tag on on the windlass strap, and we were told one or the other (although if using a makeshift then you donât have a choice) but Iâm not passing on the opportunity to write on someoneâs face if I get the chance.
Less likely to get messy too.
Also wrapping the packet of a haemostatic dressing into the main wound dressing, lest you forget to hand it over.
3 Likes
One thing I really hated with ATC based first aid, and I did point it out with ALL the first aid I done with the corps especially with cadets present.
Even if you do all the CPR correct the person may still dieâŚ
I know itâs sad and not something we really want think about but the instructors constantly gave this impression, a few pumps to the chest and then the patient would stand up and walk into an ambulance. If someone needs to do it, and the person dies if they have been taught like this they will always harbour thought of âwhat ifâ, be honest it may not be as horrible in the end.
4 Likes
Iâm as unsanitised as I feel suitable for the group, but donât try to dress it up as a magic bullet.
1 Like
Having done CPR for real I know that all you are doing is buying the casualty time. An AED may buy them more time or even âbring them backâ but the majority of people think that chest compressions and rescue breaths will enable the casualty to cough, wake up and go about their daily lives.
Nothing - apart from the rare exception to this - is true.
An ex-WFAI(T) in my (former) Wg encountered a RTC many years ago where the driver had already died. I ended up counselling him because he felt that it was his lack of ability to bring the casualty back which he felt was his fault. It wasnât but he carried that responsibility with him for years and even now, I donât think heâs managed to absolve himself of it.
2 Likes
The vast majority of people requiring CPR will die, that is a fact, having been involved with many CPR situations even in the best equipped hospital facilities with drugs defibs and experienced people. The debrief afterwards is the most important usually allowing people to talk through the experience can ameliorate the guilt feelings, in particular to those who very rarely if ever have been in such a situation.
There again, a colleagueâs grandad had a cardiac arrest at home grandma and a neighbour started CPR and called 999, first responders were the local fire station who arrived and took over, defibed him and got him back. Time to defib was 7 minutes. Grandad now back home.
And a colleague who was a HEMS consultant had a call, tasked to a patient collapsed on a club bike ride who was in his 60s. On arrival it would appear a police firearms team had been passing at that moment, got their trauma kit out and placed an airway in and were giving oxygen via a bag and valve, commenced cardiac massage and defibed the patient a couple of times. They had a queue of people to do chest compressions changing every two minutes (chest compressions are exhausting to perform). HEMS team took patient to hospital.
YES it does work but there are more losses than successes that is the nature of the situation but it NEVER EVER precludes us from trying.
2 Likes
i recall one First Aid instructor indicating - they are already dead, you canât make their life any worse for them!
5 Likes