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Re: [E-Chir] Re: Pennsic XXXV griping

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  • Kim
    It just goes to show that sometimes we don t have all the information. Asking is the best way to find out, and if we can share without breaking
    Message 1 of 16 , Sep 13, 2006
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      It just goes to show that sometimes we don't have all the information. Asking is the best way to find out, and if we can share without breaking confidentiality, we all learn.
       
      Kaellyn
       
      ----- Original Message -----
      Sent: Wednesday, September 13, 2006 2:35 PM
      Subject: Re: [E-Chir] Re: Pennsic XXXV griping

      Thank you for clearing that up for me.
       
      Standing outside the tent seemed a different story altogether.
       
      Well done.
       
      Derfel

      ----- Original Message ----
      From: KIM MCAULEY <viscountessk@...>
      To: E-Chir@yahoogroups.com
      Sent: Wednesday, September 13, 2006 11:00:48 AM
      Subject: Re: [E-Chir] Re: Pennsic XXXV griping

      Actually I can speak to that situation as I was attending as a first aider. And I should mention Tancred gave me specific permission to speak to other chirurgeons, and he was discussing the incident publically, so we are not breaking any confidentiality here. But please keep this among ourselves.
       
      I escorted the first ambulance to Patient 1. When I arrived, he was being attended by at least one other chirurgeon. He refused care from EMS quite emphatically and repeatedly, in fact their presence was agitating him. I asked EMS to wait outside while he calmed down and was persuaded to allow their assistance.
       
      While they were waiting outside, Patient 2 became unresponsive. Having been refused at the first patient, they attended at the second and immediately called for a second EMS unit to attend Patient 1 when he was ready.
       
      My first aid training says that responsiveness is right up there with ABC and should be treated just as seriously, but your and their mileage may vary.
       
      Sometimes s***tuff just happens in great leaps and bounds. One deals with it the best they can.
       
      Kaellyn
       
       


       
      ----- Original Message ----
      We deal with some pretty minor stuff. Small broken bones, heat exhaustion, dehydration, and so on. Not to belittle those but overall, easy to deal with and if treated well not life threating. The most serious problem I saw was Baron Tancred at Pennsic. Here's a man in his 60's suffering an angina attack and while someone faints the EMTs left him to tend to her. Although I can see one of them going to check on her breathing, surely someone should have stayed with him. But they didn't. For almost a minute, Tancred was unattended. So much for training.
       

    • Kim
      MessageI ve discovered something very important over the years. Goodness knows that old age had to bring something besides grey hairs. Cultivate a reputation
      Message 2 of 16 , Sep 13, 2006
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        I've discovered something very important over the years. Goodness knows that old age had to bring something besides grey hairs.
         
        Cultivate a reputation for being a reasonable, "yes, sure, go on if you want, I've warned you" kind of person, then when you do recommend something like sitting out or seeking medical attention immediately, they're more likely to listen.
         
        Manipulating fighters and other ... nvm? Hey, I'm Collin's mom. I'm an expert!
         
        ;)
         
        Kaellyn
         
        ----- Original Message -----
        Sent: Wednesday, September 13, 2006 9:29 AM
        Subject: RE: [E-Chir] Re: Pennsic XXXV griping

        With respect to the situation with Tancred.  The EMTs may not be at fault.  It is entirely possible that the only information they had was "an individual with possible heart related issues". When they arrived, they were directed to a person laying on the street with breathing difficulties. It would be easy for them to assume that this was the person they were called to attend.  It was probably at that point that someone else pointed out that Tancred was the reason they were called not the person on the street. Hence a second ambulance arrived for Tancred.
         
        It may also be a triage situation. You have 2 casualties. The first is on the ground, conscious, with very apparent breathing difficulties. The second is sitting quietly, conscious and appears to be breathing normally. Which do you check first? The one with obvious breathing issues.
         
        Happily in this case there was a very fast response for the arrival of both ambulances, the person on the street was okay ( a close friend of Tancred's who reacted badly to Tancred's initial resistance to going in the ambulance) and Tancred, who was back on site the next day and attended the Ealdormere Bardic circle.
         
         
        As to the rest of your suggestions:
         
        I like the idea of having a more visible/obvious presence for first aid (even if it's just a sign at troll that says who the chirurgeon for the event is or where one can go for first aid issues)
         
        I'm not so sure about the "pulling someone from fighting" part.
        We can offer assistance, we can suggest that someone stop fighting if we think it's warranted due to the nature of the injury. We can't make them stop as you pointed out. The MIC can't make them stop either unless they present a danger to the other fighters. Oddly I don't believe there's anything that covers "danger to yourself" in this situation. One would hope, that if the injury were of a serious nature that no convincing would be necessary.
         
        This brings us to the "how do you determine it's serious"?  It's not always obvious.  If I may Derfel, let me use your situation as an example.  If you had come to me with the injury or if I had seen the incident which caused it and asked to check you over I would have suspected a sprain (at the very least)  and suggested you quit fighting for the day and if the pain persisted that you get it checked by a doctor in case it was more serious. I imagine a couple of people may have done that and you probably said, "hey it's no big deal it's just a minor sprain."  As it turned out, it was more serious than just a minor sprain.  So, where do you draw the line? How far do you go?  Do you talk to the MIC and say "this person has a bad sprain, I don't think they should fight anymore but they want to keep going, will you pull them from the fighting on the grounds that they could make it worse"?    Probably not. Do You try to scare the fighter into doing what you want by predicting dire things if they aggravate the injury? Probably not.  All you can do is encourage them to at least take a break because running around with even an minor sprain can aggravate the injury and prolong the time it takes to heal it. 
         
        It's a fine line between doing the best for the person you are trying to look after and being a "cowboy" and running roughshod over them when a bit of diplomacy and gentle persuasion is all that's needed.  It's not something you can regulate or make a manual for. Every situation is different.  Now if the fighter pulls himself out, it may be a good idea to go to the Chirurgeon and tell that person the reason so that the Chirurgeon can keep an eye on them or offer first aid.  Hopefully the fighter will consult the Chirurgeon before trying to resume fighting but if they don't, there isn't a lot we can do to prevent it. We're all adults and unless there is an obvious risk of danger to other people (again I'm not sure there's anything in the rules about being a danger to yourself) it would be very difficult to pull the person out against their wishes.
         
        Having said all of that, I have found that most of our fighters are pretty reasonable and they also have a pretty good idea of their limits. I have only had one or two occasions where I've suggested that the individual hang it up for the day. Once for heat related stuff and once for a knee pull.  Both times the fighter, went back in to try one more round and both times, they came out almost immediately following the first swing and said "nope your right, I need to stop now". It was getting the one with the knee to sit quietly and rest the knee that was the hard part.
         
        Seonag
         
      • Claude Gagne
        I m replying to 2 e-mails at once so bear with me please. 1. It just goes to show that sometimes we don t have all the information. Asking is the best way to
        Message 3 of 16 , Sep 13, 2006
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          I'm replying to 2 e-mails at once so bear with me please.
           
          1. It just goes to show that sometimes we don't have all the information. Asking is the best way to find out, and if we can share without breaking confidentiality, we all learn.
           
          Kaellyn
           Yes. And thanks again for the help. I'm never beyond admitting I was wrong.
           
          2. I've discovered something very important over the years. Goodness knows that old age had to bring something besides grey hairs.

           

          Kaellyn
          Do you mean that the grey hairs on my head serve as more than a reminder of all my mistakes. Ouch! That's quite a few.
           
          Looking forward to meeting you in person, I remain humbly yours.
           
          Derfel

           
          ----- Original Message ----
          From: Kim <viscountessk@...>
          To: E-Chir@yahoogroups.com
          Sent: Wednesday, September 13, 2006 5:09:40 PM
          Subject: Re: [E-Chir] Re: Pennsic XXXV griping

          I've discovered something very important over the years. Goodness knows that old age had to bring something besides grey hairs.
           
          Cultivate a reputation for being a reasonable, "yes, sure, go on if you want, I've warned you" kind of person, then when you do recommend something like sitting out or seeking medical attention immediately, they're more likely to listen.
           
          Manipulating fighters and other ... nvm? Hey, I'm Collin's mom. I'm an expert!
           
          ;)
           
          Kaellyn
           
          ----- Original Message -----
          Sent: Wednesday, September 13, 2006 9:29 AM
          Subject: RE: [E-Chir] Re: Pennsic XXXV griping

          With respect to the situation with Tancred.  The EMTs may not be at fault.  It is entirely possible that the only information they had was "an individual with possible heart related issues". When they arrived, they were directed to a person laying on the street with breathing difficulties. It would be easy for them to assume that this was the person they were called to attend.  It was probably at that point that someone else pointed out that Tancred was the reason they were called not the person on the street. Hence a second ambulance arrived for Tancred.
           
          It may also be a triage situation. You have 2 casualties. The first is on the ground, conscious, with very apparent breathing difficulties. The second is sitting quietly, conscious and appears to be breathing normally. Which do you check first? The one with obvious breathing issues.
           
          Happily in this case there was a very fast response for the arrival of both ambulances, the person on the street was okay ( a close friend of Tancred's who reacted badly to Tancred's initial resistance to going in the ambulance) and Tancred, who was back on site the next day and attended the Ealdormere Bardic circle.
           
           
          As to the rest of your suggestions:
           
          I like the idea of having a more visible/obvious presence for first aid (even if it's just a sign at troll that says who the chirurgeon for the event is or where one can go for first aid issues)
           
          I'm not so sure about the "pulling someone from fighting" part.
          We can offer assistance, we can suggest that someone stop fighting if we think it's warranted due to the nature of the injury. We can't make them stop as you pointed out. The MIC can't make them stop either unless they present a danger to the other fighters. Oddly I don't believe there's anything that covers "danger to yourself" in this situation. One would hope, that if the injury were of a serious nature that no convincing would be necessary.
           
          This brings us to the "how do you determine it's serious"?  It's not always obvious.  If I may Derfel, let me use your situation as an example.  If you had come to me with the injury or if I had seen the incident which caused it and asked to check you over I would have suspected a sprain (at the very least)  and suggested you quit fighting for the day and if the pain persisted that you get it checked by a doctor in case it was more serious. I imagine a couple of people may have done that and you probably said, "hey it's no big deal it's just a minor sprain."  As it turned out, it was more serious than just a minor sprain.  So, where do you draw the line? How far do you go?  Do you talk to the MIC and say "this person has a bad sprain, I don't think they should fight anymore but they want to keep going, will you pull them from the fighting on the grounds that they could make it worse"?    Probably not. Do You try to scare the fighter into doing what you want by predicting dire things if they aggravate the injury? Probably not.  All you can do is encourage them to at least take a break because running around with even an minor sprain can aggravate the injury and prolong the time it takes to heal it. 
           
          It's a fine line between doing the best for the person you are trying to look after and being a "cowboy" and running roughshod over them when a bit of diplomacy and gentle persuasion is all that's needed.  It's not something you can regulate or make a manual for. Every situation is different.  Now if the fighter pulls himself out, it may be a good idea to go to the Chirurgeon and tell that person the reason so that the Chirurgeon can keep an eye on them or offer first aid.  Hopefully the fighter will consult the Chirurgeon before trying to resume fighting but if they don't, there isn't a lot we can do to prevent it. We're all adults and unless there is an obvious risk of danger to other people (again I'm not sure there's anything in the rules about being a danger to yourself) it would be very difficult to pull the person out against their wishes.
           
          Having said all of that, I have found that most of our fighters are pretty reasonable and they also have a pretty good idea of their limits. I have only had one or two occasions where I've suggested that the individual hang it up for the day. Once for heat related stuff and once for a knee pull.  Both times the fighter, went back in to try one more round and both times, they came out almost immediately following the first swing and said "nope your right, I need to stop now". It was getting the one with the knee to sit quietly and rest the knee that was the hard part.
           
          Seonag
           

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