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

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  • Kim
    ... Kaellyn ... From: dabernan@aol.com To: E-Chir@yahoogroups.com Sent: Thursday, November 30, 2006 6:10 PM Subject: Re: [E-Chir] EMS and fist aid working
    Message 1 of 24 , Nov 30, 2006
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      ::sighs:: because everyone insists on overanalyzing things.
       
      Kaellyn
       
      ----- Original Message -----
      Sent: Thursday, November 30, 2006 6:10 PM
      Subject: Re: [E-Chir] EMS and fist aid working together

      Hey all,
       
      So basicly we should handle it the same way We do here at the fire department....
       
      I'm 1st responder to a 911 call, My basic job is to stabilize and treat to my ability, and if the emergency is beyond my training ....it is to call or wait for "higher care personell"
       
       
      why does it sound so much more complicated then that?
       
       
       
      Drake of Timberwolfe/Godwesel
    • Streonwold Wulfesbana (mka Steve Benetti)
      ... That s for sure. Even our triage is easy once you figure it out: a) Can I treat it here? (ie. walking wounded, can survive without treatment) b) Do I need
      Message 2 of 24 , Nov 30, 2006
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        --- In E-Chir@yahoogroups.com, "Kim" <viscountessk@...> wrote:
        >
        > ::sighs:: because everyone insists on overanalyzing things.

        That's for sure.
        Even our triage is easy once you figure it out:

        a) Can I treat it here? (ie. walking wounded, can survive without
        treatment)
        b) Do I need help? (ie. life threatened, but salvageable)
        c) Is it beyond help? (self- evident)

        Anything requiring more than a band-aid is b) or c) and I don't really
        need to distinguish between b) and c) because, from my point of view I
        need 911 (or EMS) for both. Unless I have multiple casualties, in
        which case, I help b) first.
      • S. Rabinovitch
        Er..mostly due to USA lawsuit-happiness? TSivia ... From: E-Chir@yahoogroups.com [mailto:E-Chir@yahoogroups.com]On Behalf Of dabernan@aol.com Sent:
        Message 3 of 24 , Nov 30, 2006
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          Er..mostly due to USA lawsuit-happiness? <Grin>
          TSivia
          -----Original Message-----
          From: E-Chir@yahoogroups.com [mailto:E-Chir@yahoogroups.com]On Behalf Of dabernan@...
          Sent: Thursday, November 30, 2006 6:10 PM
          To: E-Chir@yahoogroups.com
          Subject: Re: [E-Chir] EMS and fist aid working together

          Hey all,
           
          So basicly we should handle it the same way We do here at the fire department....
           
          I'm 1st responder to a 911 call, My basic job is to stabilize and treat to my ability, and if the emergency is beyond my training ....it is to call or wait for "higher care personell"
           
           
          why does it sound so much more complicated then that?
           
           
           
          Drake of Timberwolfe/Godwesel
        • Bethoc (Lesley)
          (late entering the converstation...) Why is it so difficult? dabernan@aol.com wrote: I m 1st responder to a 911 call, My basic job is to stabilize and treat to
          Message 4 of 24 , Dec 3, 2006
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            (late entering the converstation...)
             
            Why is it so difficult?

            dabernan@... wrote:
            I'm 1st responder to a 911 call, My basic job is to stabilize and treat to my ability, and if the emergency is beyond my training ....it is to call or wait for "higher care personell"
             
             
            why does it sound so much more complicated then that?
             
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            because
            1) not all first aid responders can control their "eagerness". A little bit of knowledge is a dangerous thing in the right person. Meaning that some folks think "I can handle it" regardless of whether or not they actually can.
            2) legal legal legal... especially States side.
            3) in an effort to feel vindication for the Chiurgeonate, I think people responded very emotionally, without respecting the privacy of both the persons they were serving (the public) and the persons involved (they deserve their privacy too). In the medical industry, privacy is a BIG issue. And unfortunately some folks took that as inappropriately withholding information.
            4) misunderstanding of responsibilities (which also speaks to point #1).... for example, the Chirugeons *can* do a BP... the question is, as a first aid responder, why do you need to? If the BP is too low, the person faints, if it's too high, there's nothing you can do about it anyways as a first responder and it requires medical intervention (which would only happen at very high BP, at that). But, a couple of the first aid responders I spoke to about it were offended that I should suggest that they not wear their stethoscope and/or not to a BP (besides, in a real emergency, you just need a periferal pulse check and that will tell you a systolic BP....a measurement may just be wasting time)
            5) and yes, there is/was lots of over analysis. It seemed very hard for folks to just let things go and get on with it... especially as they seemed to think that they couldn't "help out" as civilians. I was torn into by two of our American Chiurgeons about who covers the insurance on their CPR/FA card.
             
            anyways, I'm not trying to be inflammatory. I saw a lot of things which opened my eyes to the "life of litigation", and I saw how emotional people were (both in and outside of the chiurgeonate). I had my own concerns about some of the EMS stuff, but then I also had my own concerns about some of the Chirugeonate stuff.
             
            It's not the kind of environment that either group can handle independently, and when you have an organisation and an event such as this, (both of which are their own entity) that's why it's not so easy.
             
            my two cents
            Beth{o'}c


            solis sacerdotibus. Ave atque vale.


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          • Streonwold Wulfesbana (mka Steve Benetti)
            ... people responded very emotionally, without respecting the privacy of both the persons they were serving (the public) and the persons involved (they deserve
            Message 5 of 24 , Dec 4, 2006
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              --- In E-Chir@yahoogroups.com, "Bethoc \(Lesley\)" <bethoc12thc@...>
              wrote:

              > 3) in an effort to feel vindication for the Chiurgeonate, I think
              people responded very emotionally, without respecting the privacy of
              both the persons they were serving (the public) and the persons
              involved (they deserve their privacy too). In the medical industry,
              privacy is a BIG issue. And unfortunately some folks took that as
              inappropriately withholding information.

              People did respond very emotionally. They were hurt, felt threatened,
              and kept, largely in the dark. For right or wrong, that's natural.
              An earlier statement by the BOD, to the Chirurgeonate, outlining some
              of the "problems" and detailing their direction forward would have
              helped defuse this. The BOD could have even given details of the
              "incidents" without violating any person's, cokmpany's, or
              organization's privacy, or impinging upon anybody's civil rights.

              An earlier release of information would have resulted in the
              Chirurgeons discussing the realities of the situation, rather than the
              emotionally charged suppositions.

              > 4) misunderstanding of responsibilities (which also speaks to
              point #1).... for example, the Chirugeons *can* do a BP... the
              question is, as a first aid responder, why do you need to?


              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.
            • KIM MCAULEY
              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
              Message 6 of 24 , Dec 4, 2006
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                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?
                 
                Kaellyn
                 
                 
                 
                >>>>>>>>>>>>


                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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              • Benetti,Sandy [Ontario]
                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
                Message 7 of 24 , Dec 4, 2006
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                  Message
                  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.
                   
                  Seonag
                  -----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?
                   
                  Kaellyn
                   
                   
                   
                  >>>>>>>>>>>>


                  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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                • KIM MCAULEY
                  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
                  Message 8 of 24 , 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?
                     
                    Kaellyn
                     

                     
                    ----- 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.
                     
                    Seonag
                    -----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?
                     
                    Kaellyn
                     
                     
                     
                    >>>>>>>>>>>>


                    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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                  • MaryCatharine
                    Been away, updating courses... Well said Steve! Molto Buono, MariaKatharina/MaryCatharine ... From: Streonwold Wulfesbana (mka Steve Benetti) Date: 12/4/2006
                    Message 9 of 24 , Dec 4, 2006
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                      Been away, updating courses...
                       
                      Well said Steve!
                       
                      Molto Buono,
                       
                      MariaKatharina/MaryCatharine
                       
                       
                      -------Original Message-------
                       
                      Date: 12/4/2006 10:12:29 AM
                      Subject: [E-Chir] Re: EMS and fist aid working together
                       

                      --- In E-Chir@yahoogroups. com, "Bethoc \(Lesley\)" <bethoc12thc@ ...>
                      wrote:

                      > 3) in an effort to feel vindication for the Chiurgeonate, I think
                      people responded very emotionally, without respecting the privacy of
                      both the persons they were serving (the public) and the persons
                      involved (they deserve their privacy too). In the medical industry,
                      privacy is a BIG issue. And unfortunately some folks took that as
                      inappropriately withholding information.

                      People did respond very emotionally. They were hurt, felt threatened,
                      and kept, largely in the dark. For right or wrong, that's natural.
                      An earlier statement by the BOD, to the Chirurgeonate, outlining some
                      of the "problems" and detailing their direction forward would have
                      helped defuse this. The BOD could have even given details of the
                      "incidents" without violating any person's, cokmpany's, or
                      organization' s privacy, or impinging upon anybody's civil rights.

                      An earlier release of information would have resulted in the
                      Chirurgeons discussing the realities of the situation, rather than the
                      emotionally charged suppositions.

                      > 4) misunderstanding of responsibilities (which also speaks to
                      point #1).... for example, the Chirugeons *can* do a BP... the
                      question is, as a first aid responder, why do you need to?

                      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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                      Letter Made: January 6, 2005
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                    • James D Sena
                      Sphygmograph IIRC. It s an interesting tool. Probably on of the better uses is to appear to a loved one that you are doing something while you wait for EMS.
                      Message 10 of 24 , Dec 4, 2006
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                        Sphygmograph IIRC.

                          It's an interesting tool.  Probably on of the better uses is to appear to a loved one that you are doing something while you wait for EMS.  (Provided there isn't something better you SHOULD be doing of course!)  And as stated elsewhere, EMS doesn't mind usually having a baseline from before they got there.  At least the EMS teams I've dealt with!

                          Unfortunately taking blood pressures is becoming a lost art.  Too many places are taking BPs only with the automated roll around machines, and people are forgetting skills they knew.

                        My Kingdom Chirurgeon, Mir, has a kit I love.  It's like a modular system, all in one bag.  Just wish I could find it at an affordable price.

                        Lord Brendan ap Llewelyn






                        KIM MCAULEY wrote:
                        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?
                         
                        Kaellyn
                         

                         
                        ----- Original Message ----
                        From: "Benetti,Sandy [Ontario]" <sandy.benetti@ ec.gc.ca>
                        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.
                         
                        Seonag
                        -----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?
                         
                        Kaellyn
                         
                         
                         
                        >>>>>>>>>>>>


                        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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                      • Streonwold Wulfesbana (mka Steve Benetti)
                        ... cuff? And spell it correctly? sphygmomanometer ... and the one I use on myself at home is digital, bulletproof, and way more accurate than anybody needs.
                        Message 11 of 24 , Dec 4, 2006
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                          --- In E-Chir@yahoogroups.com, KIM MCAULEY <viscountessk@...> wrote:

                          > Ok, be honest and don't Google... who can say the real name of a BP
                          cuff? And spell it correctly?

                          sphygmomanometer

                          ... and the one I use on myself at home is digital, bulletproof, and
                          way more accurate than anybody needs.

                          But, in 18 years with the Patrol, I've never, ever been trained in the
                          use of a sphygmo, and probably never will. We consider it useful for
                          advanced diagnosis, which is beyond the scope of the care we provide.
                          Vitals are:
                          Airway (patent, partially obstructed, noisy, obstructed, etc)
                          Breathing (regular, irregular, ragged, etc.)
                          Pulse (2 locations present/absent, count, strength, condition, etc.)
                          Level of Consciousness (Glasgow scale)
                          Skin (colour, condition, temperature, etc.)
                          Pupil Response (equal/unequal dilation/response, etc.)

                          Changes in these co-indicate changes in BP (and other things).

                          Our training is directed at cold weather applications, where the
                          rubber of a cuff may become brittle, crack, be unreliable. The above
                          stuff is reliable no matter the temperature.
                        • S. Rabinovitch
                          sphygnomometer TSivia (who always wows them in doctors offices with that) Ok, be honest and don t Google... who can say the real name of a BP cuff? And
                          Message 12 of 24 , Dec 4, 2006
                          • 0 Attachment
                            "sphygnomometer"
                            TSivia (who always wows them in doctors' offices with that)
                             
                             

                            Ok, be honest and don't Google... who can say the real name of a BP cuff? And spell it correctly?
                            Kaellyn
                            .

                          • Kim
                            Really? Care to share the make and model? Kaellyn ... From: Streonwold Wulfesbana (mka Steve Benetti) To:
                            Message 13 of 24 , Dec 4, 2006
                            • 0 Attachment
                              Really? Care to share the make and model?

                              Kaellyn

                              ----- Original Message -----
                              From: "Streonwold Wulfesbana (mka Steve Benetti)" <streonwold@...>
                              To: <E-Chir@yahoogroups.com>
                              Sent: Monday, December 04, 2006 12:51 PM
                              Subject: [E-Chir] Re: EMS and fist aid working together


                              > --- In E-Chir@yahoogroups.com, KIM MCAULEY <viscountessk@...> wrote:
                              >
                              >> Ok, be honest and don't Google... who can say the real name of a BP
                              > cuff? And spell it correctly?
                              >
                              > sphygmomanometer
                              >
                              > ... and the one I use on myself at home is digital, bulletproof, and
                              > way more accurate than anybody needs.
                              >
                              > But, in 18 years with the Patrol, I've never, ever been trained in the
                              > use of a sphygmo, and probably never will. We consider it useful for
                              > advanced diagnosis, which is beyond the scope of the care we provide.
                              > Vitals are:
                              > Airway (patent, partially obstructed, noisy, obstructed, etc)
                              > Breathing (regular, irregular, ragged, etc.)
                              > Pulse (2 locations present/absent, count, strength, condition, etc.)
                              > Level of Consciousness (Glasgow scale)
                              > Skin (colour, condition, temperature, etc.)
                              > Pupil Response (equal/unequal dilation/response, etc.)
                              >
                              > Changes in these co-indicate changes in BP (and other things).
                              >
                              > Our training is directed at cold weather applications, where the
                              > rubber of a cuff may become brittle, crack, be unreliable. The above
                              > stuff is reliable no matter the temperature.
                              >
                              >
                              >
                              >
                              > Yahoo! Groups Links
                              >
                              >
                              >
                            • Streonwold Wulfesbana (mka Steve Benetti)
                              ... Sure, it s a LifeSource UA-704VL Manual model. It s small, cheap and only takes 1 AA battery. BP Accuracy is claimed to be plus or minus 3 mm Hg or 2%
                              Message 14 of 24 , Dec 4, 2006
                              • 0 Attachment
                                --- In E-Chir@yahoogroups.com, "Kim" <viscountessk@...> wrote:
                                >
                                > Really? Care to share the make and model?
                                >

                                Sure, it's a LifeSource UA-704VL Manual model.

                                It's small, cheap and only takes 1 AA battery.

                                BP Accuracy is claimed to be plus or minus 3 mm Hg or 2% whichever is
                                greater.
                                Pulse Accuracy is claimed to be plus or minus 5%

                                Drawback: can't be used in extreme cold/heat. It's operating range
                                is 50F to 104F, <85% humidity

                                It's from A & D Medical in Milpitas, California, but I bought it at
                                Shoppers Drug Mart.
                              • MaryCatharine
                                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 ...
                                Message 15 of 24 , Dec 6, 2006
                                • 0 Attachment
                                  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,
                                   
                                   
                                  MaryCatharine
                                  ...."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.
                                   
                                  Seonag
                                  -----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?
                                   
                                  Kaellyn
                                   
                                   
                                   
                                  >>>>>>>>>>>>


                                  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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                                • Benetti,Sandy [Ontario]
                                  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
                                  Message 16 of 24 , Dec 6, 2006
                                  • 0 Attachment
                                    Message
                                    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.
                                     
                                    S.
                                    -----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,
                                     
                                     
                                    MaryCatharine
                                    ...."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.
                                     
                                    Seonag
                                    -----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?
                                     
                                    Kaellyn
                                     
                                     
                                     
                                    >>>>>>>>>>>>


                                    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.




                                    Yahoo! Groups Links

                                    <*> To visit your group on the web, go to:
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                                    Click Here To Receive My New Creations In Your Inbox!
                                    Letter Made: January 6, 2005
                                    Font Used: Harrington
                                    For Personal Use Only! No Copyright Infringement Intended

                                  • Ninka
                                    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
                                    Message 17 of 24 , Dec 6, 2006
                                    • 0 Attachment
                                      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.
                                       
                                      Xristina


                                      ----- 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.
                                       
                                      S.
                                      -----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,
                                       
                                       
                                      MaryCatharine
                                      ...."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.
                                       
                                      Seonag
                                      -----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?
                                       
                                      Kaellyn
                                       
                                       
                                       
                                      >>>>>>>>>>>>


                                      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.




                                      Yahoo! Groups Links

                                      <*> To visit your group on the web, go to:
                                          http://groups. yahoo.com/ group/E-Chir/

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                                      Click Here To Receive My New Creations In Your Inbox!
                                      Letter Made: January 6, 2005
                                      Font Used: Harrington
                                      For Personal Use Only! No Copyright Infringement Intended


                                    • Benetti,Sandy [Ontario]
                                      Thanks for the update. So, what about the first aid side (St. Johns and Red Cross) do they not teach that any more either? Seonag ... From:
                                      Message 18 of 24 , Dec 6, 2006
                                      • 0 Attachment
                                        Message
                                        Thanks for the update.  So, what about the first aid side (St. Johns and Red Cross) do they not teach that any more either?
                                         
                                        Seonag
                                        -----Original Message-----
                                        From: E-Chir@yahoogroups.com [mailto:E-Chir@yahoogroups.com] On Behalf Of Ninka
                                        Sent: December 6, 2006 1:26 PM
                                        To: E-Chir@yahoogroups.com
                                        Subject: Re: [E-Chir] Re: EMS and fist aid working together

                                        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.
                                         
                                        Xristina


                                        ----- 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.
                                         
                                        S.
                                        -----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,
                                         
                                         
                                        MaryCatharine
                                        ...."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.
                                         
                                        Seonag
                                        -----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?
                                         
                                        Kaellyn
                                         
                                         
                                         
                                        >>>>>>>>>>>>


                                        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.




                                        Yahoo! Groups Links

                                        <*> To visit your group on the web, go to:
                                            http://groups. yahoo.com/ group/E-Chir/

                                        <*> Your email settings:
                                            Individual Email | Traditional

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                                            http://groups. yahoo.com/ group/E-Chir/ join
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                                        Click Here To Receive My New Creations In Your Inbox!
                                        Letter Made: January 6, 2005
                                        Font Used: Harrington
                                        For Personal Use Only! No Copyright Infringement Intended


                                      • James D Sena
                                        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
                                        Message 19 of 24 , Dec 6, 2006
                                        • 0 Attachment
                                             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.
                                           
                                          Xristina


                                          ----- 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.
                                           
                                          S.
                                          -----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,
                                           
                                           
                                          MaryCatharine
                                          ...."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.
                                           
                                          Seonag
                                          -----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?
                                           
                                          Kaellyn
                                           
                                           
                                           
                                          >>>>>>>>>>>>


                                          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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                                        • Benetti,Sandy [Ontario]
                                          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
                                          Message 20 of 24 , Dec 6, 2006
                                          • 0 Attachment
                                            Message
                                            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.
                                             
                                            Xristina


                                            ----- 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.
                                             
                                            S.
                                            -----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,
                                             
                                             
                                            MaryCatharine
                                            ...."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.
                                             
                                            Seonag
                                            -----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?
                                             
                                            Kaellyn
                                             
                                             
                                             
                                            >>>>>>>>>>>>


                                            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.




                                            Yahoo! Groups Links

                                            <*> To visit your group on the web, go to:
                                                http://groups. yahoo.com/ group/E-Chir/

                                            <*> Your email settings:
                                                Individual Email | Traditional

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                                                E-Chir-unsubscribe@ yahoogroups. com

                                            <*> Your use of Yahoo! Groups is subject to:
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                                            Click Here To Receive My New Creations In Your Inbox!
                                            Letter Made: January 6, 2005
                                            Font Used: Harrington
                                            For Personal Use Only! No Copyright Infringement Intended



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                                          • J Corso
                                            While leeches and maggots are used - it must be remembered that maggots eat dead flesh only - if infected - antibiotics are still used - I myself have applied
                                            Message 21 of 24 , Dec 6, 2006
                                            • 0 Attachment
                                              While leeches and maggots are used - it must be remembered that maggots eat
                                              dead flesh only - if infected - antibiotics are still used - I myself have
                                              applied leeches and maggots to flesh in my work! Not really nice to do - but
                                              it was cool in a clinical way - the leech story isnt really gross and i can
                                              share if wanted but the maggot story is a little graphic - still willing to
                                              share but email firect and i will save the group the grossness!! LOL
                                              Giovanni Ferraius (aka John)


                                              >From: "Benetti,Sandy [Ontario]" <sandy.benetti@...>
                                              >Reply-To: E-Chir@yahoogroups.com
                                              >To: <E-Chir@yahoogroups.com>
                                              >Subject: RE: [E-Chir] Re: EMS and fist aid working together
                                              >Date: Wed, 6 Dec 2006 14:18:31 -0500
                                              >
                                              >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.
                                              >
                                              > Xristina
                                              >
                                              >
                                              > ----- Original Message ----
                                              > From: "Benetti,Sandy [Ontario]" <sandy.benetti@...>
                                              ><mailto: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.
                                              >
                                              > S.
                                              >
                                              > -----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,
                                              >
                                              >
                                              >MaryCatharine
                                              >...."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----- --
                                              >
                                              >From: Benetti,Sandy [Ontario] <mailto:sandy.benetti@...>
                                              >Date: 12/05/06 14:11:42
                                              >To: E-Chir@yahoogroups. com <mailto:E-Chir@yahoogroups.com>
                                              >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.
                                              >
                                              >Seonag
                                              >-----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?
                                              >
                                              >Kaellyn
                                              >
                                              >
                                              >
                                              > >>>>>>>>>>>>
                                              >
                                              >
                                              >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.
                                              >
                                              >
                                              >
                                              >
                                              >Yahoo! Groups Links
                                              >
                                              >
                                              > (Yahoo! ID required)
                                              >
                                              >
                                              >
                                              >
                                              >
                                              >
                                              >
                                              >
                                              > <http://www.sleepingangel.com/>
                                              >Click Here <http://groups.yahoo.com/group/princess_silvia_incredimail/>
                                              >To Receive My New Creations In Your Inbox!
                                              >Letter Made: January 6, 2005
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                                              >
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                                              >
                                              > No virus found in this incoming message.
                                              > Checked by AVG Free Edition.
                                              > Version: 7.5.430 / Virus Database: 268.15.6/568 -
                                              >Release Date: 12/4/2006 3:20 PM
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                                            • MaryCatharine
                                              That was the whole point... The we IS everyone... It is not the new Heart and Stroke guidelines . It is the new guidelines for cardiopulmonary resuscitation
                                              Message 22 of 24 , Dec 6, 2006
                                              • 0 Attachment
                                                That was the whole point...
                                                The "we" IS everyone...
                                                 
                                                It is not the "new Heart and Stroke guidelines".
                                                 
                                                It is the new guidelines for cardiopulmonary resuscitation (CPR) and first aid were released recently by ILCOR, the International Liaison Committee on Resuscitation, in 2006, who are  the body that reviews CPR and first aid every five years.
                                                 
                                                ( This is why everyone from Red Cross, to St. John's, and beyond update the modalities, every five years...)
                                                 
                                                The most important thing for Canadians to know right now is that the CPR they've been trained to perform is not “wrong.” The new guidelines reflect current scientific research and are a natural evolution of CPR since its introduction to the general public over 20 years ago.  The new recommended guidelines are focussed on simplifying CPR even further, making it even easier to learn.
                                                 
                                                I teach how to take the carotid, brachial pulse, radial pulse, and femoral pulses...
                                                I do not have to, but I do.
                                                 
                                                I could show the Abdominal aorta,  (Very thin individuals may be able to note a slight pulsation beneath the stomach when lying down in a relaxed position. This pulsation is caused by the abdominal aorta, the continuation of the aorta from the heart. At the level of the umbilicus (belly button), the aorta splits into the left and right common iliac arteries which deliver blood to the legs.)
                                                Or the Popliteal artery, (This artery lies behind the knee. Bend your knee slightly and feel in the soft area behind the knee.)
                                                 
                                                I do not normally teach this to lay people because it confuses them, especially if it their first time learning First-Aid & CPR/AED.  I have been instructing for 17 years.
                                                 
                                                Yours in health and safety,
                                                 
                                                MariaKatharina
                                                ...."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: 12/6/2006 2:12:14 PM
                                                Subject: RE: [E-Chir] Re: EMS and fist aid working together
                                                 

                                                Thanks for the update.  So, what about the first aid side (St. Johns and Red Cross) do they not teach that any more either?
                                                 
                                                Seonag
                                                -----Original Message-----
                                                From: E-Chir@yahoogroups. com [mailto:E-Chir@ yahoogroups. com] On Behalf Of Ninka
                                                Sent: December 6, 2006 1:26 PM
                                                To: E-Chir@yahoogroups. com
                                                Subject: Re: [E-Chir] Re: EMS and fist aid working together

                                                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.
                                                 
                                                Xristina


                                                ----- Original Message ----
                                                From: "Benetti,Sandy [Ontario]" <sandy.benetti@ ec.gc.ca>
                                                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.
                                                 
                                                S.
                                                -----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,
                                                 
                                                 
                                                MaryCatharine
                                                ...."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.
                                                 
                                                Seonag
                                                -----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?
                                                 
                                                Kaellyn
                                                 
                                                 
                                                 
                                                >>>>>>>>>>>>


                                                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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