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#133162 - 05/18/08 12:59 AM Re: Airways? [Re: MDinana]
Art_in_FL Offline
Pooh-Bah

Registered: 09/01/07
Posts: 2432
Packing a dedicated airway may be inadvisable, suggesting to untrained people that they give it a try, and an opportunity for liability.

But you could pack a scalpel and you could chose other pieces with an eye toward their being used as field expedient airways. The old-style Bic pens were handy for this. Unscrew the pen-tip and the plug on the other end and you have a tube that is a handy size for the job. The Uniball Gel Grip pen is similarly configured.

This might give you a last-chance device if it comes down to it without anyone drawing the conclusion that your advocating anyone untrained try anything.

IMHO it is good practice to select equipment that is adaptable for multiple jobs. Both of these pens are also usable as a winding stick for a tourniquet if you lack anything better.

I don't know about the Uniball but I used to participate in demonstrations where a common Bic pen was gripped in a fist, backed with a handkerchief, and driven through a piece of half-inch plywood in a punching motion. Invariably the pen still wrote after this abuse.

Select the right writing tool and you open the window for lots of other uses.

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#133163 - 05/18/08 01:33 AM Re: Airways? [Re: Paragon]
bsmith Offline
day hiker
Addict

Registered: 02/15/07
Posts: 589
Loc: ventura county, ca

i agree - beyond the scope of a boy scout who can't even carry a fixed-blade knife.

just for clarification, i don't carry a crico kit. but i do carry a sharp, pointy knife, as well as a #11 scalpel, and an empty bic pen barrel. and i wouldn't hesitate to use them on me, you or anyone who needs them. never done one, never seen one done, have read about them, seen illustrations, know the anatomy and physiology, and wouldn't hesitate to give it a try in the most dire circumstances.
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#133169 - 05/18/08 03:01 AM Re: Airways? [Re: bsmith]
haertig Offline
Pooh-Bah

Registered: 03/13/05
Posts: 2322
Loc: Colorado
I guess I disagree with the majority here - that you should leave things out of your first aid kit unless everyone who could possibly find the kit is certified in the use of every item (which is silly, because you don't get certified in the use of most things you find in a FA kit, oral airways included).

An oral airway is used:
(1) when the patient can't control their own airway
(2) the patient is unconscious

People die from (1). There are different ways to control a compromised airway, but sometimes the best and easiest way is an oral airway. Depends on the situation. Positioning is easiest, but some injuries and/or transport situations do not allow you to reposition the patient.

All that being said, I don't carry oral airways when I go hiking. They are too bulky. I do carry them in my large kit that goes in the car.

If I were hiking and had real need to control a compromised airway when I might normally use an oral, I'd pull a safety pin out of my PSK, pull the tongue up, and pierce it like a "T" with the safety pin, and sit it on the lips for support. That sounds drastic but if you really have a compromised airway and can't be there to maintain it 100% of the time yourself, you have to do what you have to do. About that time I'd be kicking myself for not having an oral airway because piercing a tongue would be more prone to later complications (nerve damage and infection). But maintaining an airway comes first.

You'd have to check the local laws about oral airways. I'd be surprised if you find them mentioned, but it they are you should abide by that. Also, the scouts should be shown how to use the airways. I don't think 13 is too young myself, but you'd have to assess their maturity. 13 year old scouts aren't going to be running around without adult supervision anyway. The adults should carry the FA kits.

I understand and respect that others disagree with me on this.

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#133186 - 05/18/08 01:38 PM Re: Airways? [Re: haertig]
Lono Offline
Old Hand

Registered: 10/19/06
Posts: 1013
Loc: Pacific NW, USA
I think the Boy Scouts of America and their team of attorneys disagree with you haertig, and even without the lawyers watching I wouldn't pack an oral airway in a Troop FAK ever. Two or more epipens + several doses of bendadryl for allergic reactions will reestablish the most common compromised airway. The likelihood is vanishingly remote for a patrol encountering (and recognizing the proper treatment for) a different compromised airway (such as from a fall and spinal injury) that can't be reestablished by traditional means. The act of training a troop to insert an oral airway itself carries definite risk and liabilities - if you were on the jury following a death, would you find it prudent to have taught oral airways to 13 year olds? Its commonly held that putting anything except your finger into a Scouts throat to swipe debris is an invasive and potentially injuring treatment.

I usually ask, what would I want Scouts to know to treat me if I fell. Generally I want them to stablize the scene, stay calm, stay within their training, apply basic first aid, and get help for anything they can't handle. I would be damn proud if they could stay cool, organize and treat me as we practiced. However, if I fell, suffered a spinal injury, and had a compromised airway, if the patrol couldn't rescue breath for me long enough to get help, then I guess I've had it, and no amount of oral airways plus kids willing to apply it is likely to change that. It would not be pretty for sure, but neither is a botched airway and the idea that some Scout has to live with that for the rest of his life. Part of preparing a Troop for outings is going over the Worst Case, and telling them now that while most times we can work together and get a victim to safety, sometimes we can't, and that will be the hardest thing to experience. Its been part of every training I've received too - sometimes circumstances run against you in the woods.

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#133207 - 05/18/08 07:18 PM Re: Airways? [Re: bsmith]
climberslacker Offline
Youth of the Nation
Addict

Registered: 09/02/07
Posts: 603
Quote:
Originally Posted By: bsmith

[quote]That said, I realize the likelyhood of me ever needing any of these items is extremely remote (and clearly beyond my CPR/AED/WFASRM certification) although I can think of very few things that would be worse than watching helplessly as a close friend or loved one suffocates due to a traumatic injury.

something tells me you are older than the asker (13yrs). and that you have more experience than him too (CPR/AED/WFASRM certification).


Well I am CPR-AED and First aid trianed, and am going and getting re-certified in a few days probably, but I have no idea what WFASRM is, maybe wilderness first aid SRM??

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#133222 - 05/18/08 10:24 PM Re: Airways? [Re: climberslacker]
ki4buc Offline
Old Hand

Registered: 11/10/03
Posts: 710
Loc: Augusta, GA
Originally Posted By: climberslacker


Well I am CPR-AED and First aid trianed, and am going and getting re-certified in a few days probably, but I have no idea what WFASRM is, maybe wilderness first aid SRM??




I am with the crowd that says not to include them.

You and your troop are Lay Responders. Your job is to try and keep oxygen flowing to the brain until the First Responders arrive. If something prevents you from doing this (obstructed airway, physical exhaustion, etc. ), there is nothing more you can do.

Establishing an airway represents a Trauma Level Event (1 - RED). The patient is already in rough shape, and in most states requires immediate transport to the nearest Trauma Center. The odds are already stacked against this patient because of what ever happened to them (i.e. severe allergic reactions, car accident, etc.). Simply providing the airway without other care probably will not provide any measurable increase in survival.

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#133226 - 05/18/08 11:56 PM Re: Airways? [Re: climberslacker]
climberslacker Offline
Youth of the Nation
Addict

Registered: 09/02/07
Posts: 603
Originally Posted By: climberslacker
Ok thanks, I will probably not include it



I did say this on the first page, I am already sold on not including them!

Thanks for all of the replies!!
_________________________
http://jacesadventures.blogspot.com/
- - - - - - - - - - - - - - - - - - - -
impossible is just the beginning

though i seek perfection, i wear my scars with pride

Have you seen the arrow?


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#133233 - 05/19/08 12:54 AM Re: Airways? [Re: climberslacker]
Paragon Offline
Enthusiast

Registered: 10/21/07
Posts: 231
Loc: Greensboro, NC
Originally Posted By: climberslacker
Well I am CPR-AED and First aid trianed, and am going and getting re-certified in a few days probably, but I have no idea what WFASRM is, maybe wilderness first aid SRM??

Wilderness First Aid, Safety and Risk Management.

WFASRM is essentially a traditional Red Cross WFA certification course, with some additional training related to extended care of the patient due to the length of time required to reach advanced medical care.

The BSA council that I'm involved with requires all adult leaders to be certified in standard first aid, CPR/AED, and WFASRM prior to involvement in any BSA National High Adventure program.

Jim
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My EDC and FAK


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#133244 - 05/19/08 02:50 AM Re: Airways? [Re: Paragon]
TrailDemon Offline
Newbie

Registered: 03/14/08
Posts: 43
Loc: BC, CANADA
Learn and MASTER the basic first aid skills first, then learn the advanced ones.

As an Industrial First Aid Officer for over ten years, i recommend taking a Red Cross Basic course first. I think the basic class is 1 day.
If you really want to get serious, then look at Wilderness First Aid(this is what we have here in canada).
However, i think the WFA course has an age limit of 16.

I recommend under NO circumstances that you try Airway insertion yourself(without proper training), as you may cause more damage to your patient. Because air is so precious, you really wouldn't want to mess anything up. Here in canada, the good semaratin act only covers you if you try to help someone with propper training and skills, NOT what you might have seen on TV or may have learned from an unauthorized person/teacher.

A skill you really have to master is propper usage of a pocket mask. It may look easy, but like any other skill, it takes practice to master it.

My congradulations to you and your thirst for the knowledge to help people.

good luck,

peace
al
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"Roads? Who the Hell needs Roads!?"

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#133245 - 05/19/08 03:23 AM Re: Airways? [Re: TrailDemon]
climberslacker Offline
Youth of the Nation
Addict

Registered: 09/02/07
Posts: 603
yes, in US teh good samerictan act only covers what you are certified in. I need to get my first aid re-cert and cpr re-cert (first aid is expired, I have till july for CPR) But I am probably going to get it over with this week...I will ask the instructor waht level of certification covers OPAs and/or NPAs...I will keep you all updated...

of topic I know, but maybe a first aid section on the forum?
_________________________
http://jacesadventures.blogspot.com/
- - - - - - - - - - - - - - - - - - - -
impossible is just the beginning

though i seek perfection, i wear my scars with pride

Have you seen the arrow?


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