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

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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 1 of 24 , Dec 4, 2006
      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 2 of 24 , Dec 4, 2006
        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 3 of 24 , Dec 4, 2006
          Been away, updating courses...
           
          Well said Steve!
           
          Molto Buono,
           
          MariaKatharina/MaryCatharine
           
           
          -------Original Message-------
           
          Date: 12/4/2006 10:12:29 AM
          Subject: [E-Chir] Re: EMS and fist aid working together
           

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

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

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

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

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

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

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

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

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

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

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

            Lord Brendan ap Llewelyn






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

             
            ----- Original Message ----
            From: "Benetti,Sandy [Ontario]" <sandy.benetti@ ec.gc.ca>
            To: E-Chir@yahoogroups. com
            Sent: Monday, December 4, 2006 10:58:23 AM
            Subject: RE: [E-Chir] Re: EMS and fist aid working together

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



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


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

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




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          • Streonwold Wulfesbana (mka Steve Benetti)
            ... cuff? And spell it correctly? sphygmomanometer ... and the one I use on myself at home is digital, bulletproof, and way more accurate than anybody needs.
            Message 5 of 24 , Dec 4, 2006
              --- 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 6 of 24 , Dec 4, 2006
                "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 7 of 24 , Dec 4, 2006
                  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 8 of 24 , Dec 4, 2006
                    --- 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 9 of 24 , Dec 6, 2006
                      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:
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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 10 of 24 , Dec 6, 2006
                        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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                      • 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 11 of 24 , Dec 6, 2006
                          The new Heart and Stroke guidelines (which govern St. John's, Red Cross and all other first aid training providers) no longer teach pulse checks to the lay provider. In fact, there is no longer a check for signs of circulation of any type. If you have to breathe for a patient, then you immediately start CPR. These new standards came into effect in either September or October of this year.
                           
                          Xristina


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

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

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

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

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



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


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

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




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                        • Benetti,Sandy [Ontario]
                          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 12 of 24 , Dec 6, 2006
                            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

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                          • 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 13 of 24 , Dec 6, 2006
                                 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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                              <*> To visit your group on the web, go to:
                                  http://groups. yahoo.com/ group/E-Chir/

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



                              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 14 of 24 , Dec 6, 2006
                                Message
                                Hey maybe we can go "medieval" on them and resort to leaches and maggots (noting that still are both used in modern medicine and that in some cases maggots work better and cleaning up a nasty wound than  a lot of modern antibiotics).
                                 
                                Seonag :)
                                -----Original Message-----
                                From: E-Chir@yahoogroups.com [mailto:E-Chir@yahoogroups.com] On Behalf Of James D Sena
                                Sent: December 6, 2006 2:08 PM
                                To: E-Chir@yahoogroups.com
                                Subject: Re: [E-Chir] Re: EMS and fist aid working together

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

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

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

                                Lord Brendan ap Llewelyn



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


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

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

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

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

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



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


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

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




                                Yahoo! Groups Links

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

                                <*> Your email settings:
                                    Individual Email | Traditional

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                                Letter Made: January 6, 2005
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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 15 of 24 , Dec 6, 2006
                                  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
                                  >For Personal Use Only! No Copyright Infringement Intended
                                  >
                                  >
                                  >
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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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                                  >
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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 16 of 24 , Dec 6, 2006
                                    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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                                    Letter Made: January 6, 2005
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