Training to be certified in First Aid/CPR/AED ?'s

[daedalus]

A bit to the extreme, is'nt it? I don't recall reading anywhere where anyone claimed to be superhuman or to save the world. As I recall it was about assisting those in need, and whether or not it should be done. It just would'nt be a complete day without taking a shot at another member(s).

Why can't someone make an arguement without some form belittlement? Sasha made a very good point along with some very sobering examples which are very thought provoking. An excellent way to make a meaningful point.

Not that extreme. What about the right for your wife to have her husband around? Kids?

You can get killed when you stop to help, you can get sued when you stop to help, you can get fired, etc.

 

[Melclin]

Not that extreme. What about the right for your wife to have her husband around? Kids?

You can get killed when you stop to help, you can get sued when you stop to help, you can get fired, etc.

Well of course you can evaluate each individual situation for dangers and if its unacceptable then so be it. But its a bit much to sit their on your cynical chair saying, I don't help people off duty because I might die.

I don't understand these arguments where the older guys seem so keen to crush any sense of idealism out of students. Just because you don't immediately scoff at the idea of helping a mate out, doesn't make you some kind of idealistic, superhero wannabe, nut whose out to try and save the world with a BVM. It is possible to be positive and realistic at the same time.

 

[JPINFV]

Just because you don't immediately scoff at the idea of helping a mate out, doesn't make you some kind of idealistic, superhero wannabe, nut whose out to try and save the world with a BVM. It is possible to be positive and realistic at the same time.

Yea, but at least in my experience, the odds are against it. There simply are too many nuts out there who thinks that their wacker pack is going to save the world and are willing to put down way too much money for a scanner just for the opportunity to jump calls. I've seen it here and I've seen it in real life.

 

[Flight-LP]

Why can't someone make an arguement without some form belittlement? Sasha made a very good point along with some very sobering examples which are very thought provoking. An excellent way to make a meaningful point.

I did, you chose not to acknowledge or listen.................

Sorry, but you are a student with no practical knowledge or experience in this field. There are very sound reasons, that you will learn with time, as to why different folks do different things. I come from an area that does not have a duty to act. Therefore, no I am not under any obligation to assist. We also have a well organized, paid, ALS service that runs 24/7 with solid FD 1st response. My assistance is not needed. Bad things happen to good people, but one of the first concepts that you need to impregnate into your head is that the emergency is not yours, it is the patients. You can call it what you wish, but the second you place the emotional belief that "you have to save the day always" into your response, you have lost effective control of yourself and the ability to use critical thinking. You have to stay unbiased. You will learn this with experience.

We can all appreciate where you coming from and it does give me a warm fuzzy feeling knowing there are people that care, but you have to keep it in check. Sometimes that means not getting involved.

Sasha said it best; "what if it's YOUR life that can't be replaced?"

It happens.................

 

[Shishkabob]

Please cite journal articles that show the efficacy of spinal immbolization in regards ot the prevention of secondary spinal injury.

Come on man, you know it's impossible to prove that something didn't happen because of spinal precautions.


Better safe than sorry--- the cliche holds true.


But, if you disagree, by all means when you're in an MVC, refuse a C-collar and a long board / KED. Walk yourself to the rig.

 

[JPINFV]

Out-of-hospital Spinal Immobilization: Its Effect on Neurologic Injury

ABSTRACT

Objective: To examine the effect of emergency immobilization on neurologic outcome of patients who have blunt traumatic spinal injuries.

Methods: A 5-year retrospective chart review was carried out at 2 university hospitals. All patients with acute blunt traumatic spinal or spinal cord injuries transported directly from the injury site to the hospital were entered. None of the 120 patients seen at the University of Malaya had spinal immobilization during transport, whereas all 334 patients seen at the University of New Mexico did. The 2 hospitals were comparable in physician training and clinical resources. Neurologic injuries were assigned to 2 categories, disabling or not disabling, by 2 physicians acting independently and blinded to the hospital of origin. Data were analyzed using multivariate logistic regression, with hospital location, patient age, gender, anatomic level of injury, and injury mechanism serving as explanatory variables.

Results: There was less neurologic disability in the unimmobilized Malaysian patients (OR 2.03; 95% CI 1.03–3.99; p = 0.04). This corresponds to a <2% chance that immobilization has any beneficial effect. Results were similar when the analysis was limited to patients with cervical injuries (OR 1.52; 95% CI 0.64–3.62; p = 0.34).

Conclusion: Out-of-hospital immobilization has little or no effect on neurologic outcome in patients with blunt spinal injuries.

It is very possible to show that an intervention causes an effect, such as lower secondary injury.


and yea, if I'm in an MVC there's a very good chance that I'm going to refuse voodoo practices. Thanks, but the ability to breath and not get skin breakdown is much more important than making providers feel good that they are 'doing something.'

 

[Melclin]

There are very sound reasons, that you will learn with time, as to why different folks do different things. I come from an area that does not have a duty to act. Therefore, no I am not under any obligation to assist. We also have a well organized, paid, ALS service that runs 24/7 with solid FD 1st response. My assistance is not needed. Bad things happen to good people, but one of the first concepts that you need to impregnate into your head is that the emergency is not yours, it is the patients. You can call it what you wish, but the second you place the emotional belief that "you have to save the day always" into your response, you have lost effective control of yourself and the ability to use critical thinking. You have to stay unbiased. You will learn this with experience.

Yeah I absolutely agree. I get the whole the emergency is not yours things and its really important. I just don't see why its necessary to jump down the throats of people who express the slightest interest in helping people out if they come across an injured person, calling them whackers and talking about dying by road sides.

While we're on the topic of the importance of staying detached and unbias, those of you that stand proudly on their experience should remind yourselves of the dangers of putting personal experience on a pedestal. There's a reason anecdotal accounts don't rank highly on the hierarchy of scientific evidence. I'm not saying experience is useless or anything silly like that. It's just that, other than often being wrong, as far as statistical significance goes, it has a tendency to make you bias on the side of bitterness. My point is that us students are not the only bias ones. As usual there's probably a healthy middle ground between your wisdom and our idealism, but I don't see how we can get there if you guys are just ganna bite peoples heads off every time they wanna keep some band aids in the car.

 

[EDAC]

I did, you chose not to acknowledge or listen.................

Sorry, but you are a student with no practical knowledge or experience in this field. There are very sound reasons, that you will learn with time, as to why different folks do different things. I come from an area that does not have a duty to act. Therefore, no I am not under any obligation to assist. We also have a well organized, paid, ALS service that runs 24/7 with solid FD 1st response. My assistance is not needed. Bad things happen to good people, but one of the first concepts that you need to impregnate into your head is that the emergency is not yours, it is the patients. You can call it what you wish, but the second you place the emotional belief that "you have to save the day always" into your response, you have lost effective control of yourself and the ability to use critical thinking. You have to stay unbiased. You will learn this with experience.

We can all appreciate where you coming from and it does give me a warm fuzzy feeling knowing there are people that care, but you have to keep it in check. Sometimes that means not getting involved.

Sasha said it best; "what if it's YOUR life that can't be replaced?"

It happens.................

Actually my comment was in response to the Superman comment. I actually did take the time to read and take in what you had to say. I can only come from one side of things, since that is the only side of things I have seen, up to this point. I do appreciate all the input and advice that is given here, as well as the critsizms. Believe it or not I am here to learn, I constantly have a book in my face or am online trying to educate myself. The other times I am in school or taking classes through home study. I believe the combined knowledge here is the best I have found anywhere else, it does not mean I will not look other places for information as well.

I have always been the type of person who has tried to help others, if you are pushing your car, I will pull over and help you push, if you are hungry I will give you food, I can't remember the last time i walked by a Salvation Army bell ringer and did not toss in whatever change I have in my pocket. Toys for tots, the list goes on, it is just something I do. Perhaps I need to re-evaluate my stance on the subject at hand here, although I still feel the need to help, maybe it is not always in the best interest. I can look at both sides and see the points being made.
So yes thank you, I do read the posts, I do try to understand the information being given, sometimes I need to take the time to evaluate and apply to my situation.
Trust me, I have no desire to save the world, or be superman, we have those people in Washington DC, who think they can do so. I just want to make the right choice and be able to live with it, good or bad.

 

[ffemt8978]

Out-of-hospital Spinal Immobilization: Its Effect on Neurologic Injury




It is very possible to show that an intervention causes an effect, such as lower secondary injury.


and yea, if I'm in an MVC there's a very good chance that I'm going to refuse voodoo practices. Thanks, but the ability to breath and not get skin breakdown is much more important than making providers feel good that they are 'doing something.'

Link, please....

 

[Shishkabob]

Let me rephrase---


If you choose to do spinal precautions (Hint precaution, not immobilization) you can't prove one way or another that something would have happened had you chosen to NOT do the precautions.

You can't prove that if you chose not to do SP, they would have been paralyzed. You can't prove that you saved them from paralysis either.


Again, better safe than sorry, but if you want to risk paralysis, even if the alternative might only give a 1% chance at no paralysis, that's on you.

 

[Melclin]

Link, please....

http://www.ncbi.nlm.nih.gov/pubmed/9523928

It's a poor study design in my opinion, barely statistically relevant, small experimental group, to many extraneous variables.

Also Malaysian (1) and Mexican (2) EMS are rubbish it would seem (happy to be proven wrong by someone whose been there). You can hardly generalise finding made in those pre-hospital environments to ours. Hardly call spinal immobilization voodoo on those grounds.

Again, better safe than sorry, but if you want to risk paralysis, even if the alternative might only give a 1% chance at no paralysis, that's on you.

Well said. Even if it is true that its 1%, you'll easy see 100 spinals in your career. Collar + board them just in case I reckon.

1. http://www.sciencedirect.com.ezprox...d=542840&md5=506170d47001b804c2466f1f569735ab

2.http://pdm.medicine.wisc.edu/21-2 PDFs/peralta.pdf

 

[LAS46]

I will say this until you have a EMT-Basic license in your pocket do even bother with this bag. Most everything in that bag is out of your scope of practice as a First Aider with CPR & AED Training. Also if you have never been trained in C-Spine care then dont attempt it you could do more damage if they have a underlying injury.

I hate to say this but getting this bag may just make you look more like a Supper Trooper than someone who is truly able to help.

Just my 2 cents.

 

[guardian528]

I see no harm in having some supplies with you, but i do agree that this bag is overkill. Also, I think that for me, stopping to help is more based on the circumstances. Yes, I have a large desire to help people. I don't really agree with whoever said, "i don't do it unless i get paid" or something similar to that, if I see someone in need I would like to help. However, that statement has limitations. If see an accident on the freeway, will I stop? Nope. My cell phone does a perfectly good job of alerting the right people, and stopping on the freeway is one of the most dangerous things you can do as pointed out by Sasha's links and countless other stories. With that said, if I see something on a side street or at a campground near where I work, sure, I'd love to help them out if they need it.

 

[JPINFV]

http://www.ncbi.nlm.nih.gov/pubmed/9523928

It's a poor study design in my opinion, barely statistically relevant, small experimental group, to many extraneous variables.

Also Malaysian (1) and Mexican (2) EMS are rubbish it would seem (happy to be proven wrong by someone whose been there). You can hardly generalise finding made in those pre-hospital environments to ours. Hardly call spinal immobilization voodoo on those grounds.

...and there's no evidence that spinal movement restriction reduces secondary injury anyways. As far as 'barely statistically significant' I'd hardly call the low end of the odds ratio's 95% confidence interval at 1.03 (no effect at all would be at 1 with increased injury being below 1) to be insignificant.

As far as study design, I'd like to see someone get a research protocol to completely remove spinal restriction for a prospective study through public comments and IRB given the current complete vacuum of research results regarding spinal immobilization.

Linus, it's much easier to show that an intervention has an effect than has no effect.