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Re: EMS and fist aid working together

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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 1 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 2 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 3 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 4 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 5 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.

               
               
              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
              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 6 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.




                Yahoo! Groups Links

                <*> To visit your group on the web, go to:
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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 7 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 8 of 24 , Dec 4, 2006
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                    "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 9 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 10 of 24 , Dec 4, 2006
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                        --- 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 11 of 24 , Dec 6, 2006
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                          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 12 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.




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                            Click Here To Receive My New Creations In Your Inbox!
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                          • 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 13 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.




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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 14 of 24 , Dec 6, 2006
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                                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:
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                                Click Here To Receive My New Creations In Your Inbox!
                                Letter Made: January 6, 2005
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                                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 15 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.




                                  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

                                  <*> To change settings online 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



                                  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

                                • 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 16 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.




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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 17 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
                                      >Font Used: Harrington
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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 18 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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