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90Re: [E-Chir] Re: EMS and fist aid working together

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    Dec 4, 2006
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      You are also absolutely correct. We are also taught to do an initial pulse check at both the carotid and distal points and record the information, and also any changes if it is redone. And all those other things you discuss are also very very good information, most are a lot more important than a BP reading.
      Inside joke, how do you tell a Standard first aider from an Advanced? The Advanced will automatically reach for the 2 pulse points together instead of just one ::grins::
      However, we shouldn't dismiss the value of taking an initial blood pressure, if your training includes it and the situation permits it. Some first aid training includes it, some doesn't. SCA policy, last I heard, says that you may/should take it if you are trained. This is not to say that everyone should immediately run out and learn to use one. But if it is included in your training and you have the time, by all means do it.
      Ok, be honest and don't Google... who can say the real name of a BP cuff? And spell it correctly?

      ----- Original Message ----
      From: "Benetti,Sandy [Ontario]" <sandy.benetti@...>
      To: E-Chir@yahoogroups.com
      Sent: Monday, December 4, 2006 10:58:23 AM
      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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