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103RE: [E-Chir] Re: EMS and fist aid working together

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  • Benetti,Sandy [Ontario]
    Dec 6 11:18 AM
      Hey maybe we can go "medieval" on them and resort to leaches and maggots (noting that still are both used in modern medicine and that in some cases maggots work better and cleaning up a nasty wound than  a lot of modern antibiotics).
      Seonag :)
      -----Original Message-----
      From: E-Chir@yahoogroups.com [mailto:E-Chir@yahoogroups.com] On Behalf Of James D Sena
      Sent: December 6, 2006 2:08 PM
      To: E-Chir@yahoogroups.com
      Subject: Re: [E-Chir] Re: EMS and fist aid working together

         The further dumbing down of CPR.  We had that in my ARC CPR class when I renewed this year.  The given reason was "In an emergency most people can't remember how to check for a pulse, or even find their own".

        I disagree with it, and I won't stop checking for a pulse myself.  Then again my original training was not "lay person".  For the first 10 years I had a CPR card it was either "CPR for the Professional Rescuer" or "CPR for Health Care Providers".  It is a much more educational program than "Standard CPR with AED".

        And don't even get me started on the dumbing down of AEDs either.

      Lord Brendan ap Llewelyn

        Ninka wrote:
      The new Heart and Stroke guidelines (which govern St. John's, Red Cross and all other first aid training providers) no longer teach pulse checks to the lay provider. In fact, there is no longer a check for signs of circulation of any type. If you have to breathe for a patient, then you immediately start CPR. These new standards came into effect in either September or October of this year.

      ----- Original Message ----
      From: "Benetti,Sandy [Ontario]" <sandy.benetti@...>
      To: E-Chir@yahoogroups.com
      Sent: Wednesday, December 6, 2006 8:53:16 AM
      Subject: RE: [E-Chir] Re: EMS and fist aid working together

      Who is "we" St. John's, Red Cross, someone else? Any one with CPR training gets taught how to take a pulse.  I don't know if it's mandatory, but at Pennsic they asked for copies of my CPR certs as well as my first aid ones.
      -----Original Message-----
      From: E-Chir@yahoogroups. com [mailto:E-Chir@ yahoogroups. com] On Behalf Of MaryCatharine
      Sent: December 6, 2006 8:20 AM
      To: E-Chir@yahoogroups. com
      Subject: RE: [E-Chir] Re: EMS and fist aid working together

      With the new modalities, we no longer teach the
      "lay person" to take a "pulse", anywhere, period...
      We are to only teaching/recerting EMS to "take pulses "...
      Have fun with this one,
      ...."Of course he has a knife. He always has knives.
      We all have knives.  It's 1183 and we're all barbarians."

      Katharine Hepburn (1907 - 2003) As: Eleanor of  Aquitaine.
      The Lion in Winter. 1968
      -------Original Message----- --
      Date: 12/05/06 14:11:42
      Subject: RE: [E-Chir] Re: EMS and fist aid working together

      All good points, however as a first responder you still don't need the BP cuff. You can take a carotid pulse and a distal pulse. If you do them at the same time, they should both have the same rate and rhythm. If they don't there's a problem. If you can find one and not the other, there's a problem.  These are the 2 major pulse points most first aiders use.  Finding a podieital pulse is tricky and finding a femoral pulse is usually only done as a drastic measure.  Both carotid and distal pulse tell you a rough approximation of the systolic pulse.
      So, taking vitals yes. Change in pulse or a difference between carotid and distal pulse for rate rhythm or strength tell you if your patient is stable, improving, deteriorating and are (along with pupil response and respiration rate, skin colour and condition and level of consciousness) are all things you can relay to EMS. They don't require a BP cuff or stethoscope. I'm with the ski patrol, I know this.
      -----Original Message-----
      From: E-Chir@yahoogroups. com [mailto:E-Chir@ yahoogroups. com] On Behalf Of KIM MCAULEY
      Sent: December 4, 2006 10:21 AM
      To: E-Chir@yahoogroups. com
      Subject: Re: [E-Chir] Re: EMS and fist aid working together

      You are very correct in all those assessments Streonwald. However, as a person who has to call 911 more than most, I can tell you that St. John does suggest that taking a full set of vitals is a good thing. Including BP. However, and this is in big red letters, you do this only when you have done everything else on the list of things to do and while still waiting for EMS to arrive, cause you called them right at the beginning. Taking vitals sure beats twiddling your thumbs?
      In the case of BP, there are certain things that a *changing* blood pressure can tell EMS and the hospital. If you can, get the baseline vitals so they have more information to work with.
      Curious? Google Cushing's Triad for more information. ::grins:: Who wants to do a report for the class on it?

      I agree.  As a Ski Patroller of 18 years experience (including over
      ten years as an instructor), I have never needed, nor taken a BP
      reading.  If I don't find a pulse anywhere distal to an injury - it's
      a load and go.  If I don't find a peripheral pulse - it's a load and
      go.  If I find an abnormal (ie. unexpected) rate, or strength, or an
      unusual rhythm in any pulse - it's probably load and go.  A BP cuff,
      or a stethoscope won't help me decide.

      Basically, any unusual circulatory function requires care that I can't
      provide (ie. beyond blankets, O2, monitor, transport) and my patient
      needs to go to the hospital, ASAP.

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