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#180765 - 08/29/09 01:18 PM Re: Not trained, what should be in my urban FAK? [Re: paramedicpete]
jcurphy Offline
Newbie

Registered: 03/27/08
Posts: 48
Loc: Iowa City, IA
Originally Posted By: paramedicpete
Quote:
Yeah that's a tendency quite a few professionals have with mass casualty situations (I've fallen victim to that myself), once they start treating one patient they'll get "hung up" on that patient.


I think that is primarily due to having it drilled into us that once you establish contact with a victim/patient leaving them is abandonment. In a MCI, aside from the emotional enormity of encountering such an incident, it can take great willpower to override that sense of duty to a particular individual and move on to the next victim/patient.

Pete


Supposedly physicians are terrible at triage, for the same reason. It just takes a different mindset, doing the most good for the most people.

Just to hammer a point made earlier, NEVER do more than you are trained to do, regardless of good samaritan laws, you can easily do more harm than good. The only time you should ever consider removing someone from an automobile after an accident is if you believe they are more likely to sustain a life threatening injury by remaining in the vehicle - i.e. the vehicle is on fire - otherwise do what you can to support life with them in place.

First Aid Kit should contain only products that you are confident in using. If you don't know what it is and how to use it, it shouldn't be in there. Stick with the absolute basics of ABCs, as mentioned earlier.

Airway - held-tilt chin-lift or jaw thrust maneuver - no equipment for layperson is needed - you will NOT being doing a cricoidotomy! - although, I often wonder about suction... very useful, but suction devices are bulky.
Breathing - pocket valve mask, anyone trained in CPR should carry one of these or equivalent
Circulation - bandages in varying size (2x2s, 4x4s, abdominal pads), tape, gauze, trauma shears, cohesive bandages (ACE wrap), tin foil (for occlusive dressings), tourniquet -> only if bleeding cannot be controlled with direct pressure, elevation and use of pressure points!

EDIT: forgot to mention PPE!! I carry 2 pairs of nitrile gloves, a couple face masks (droplet precaution only), and safety glasses.

Never give meds unless they have a prescription for it, and are carrying it, just too risky.

That being said, I do carry a bottle of Benadryl, tylenol, chewable aspirin, and a tube of glutose for low blood sugars. Some people also carry activated charcoal for overdoses, but it's messy, tastes disgusting and people often vomit it back up regardless.


Edited by jcurphy (08/29/09 01:25 PM)

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#180768 - 08/29/09 02:03 PM Re: Not trained, what should be in my urban FAK? [Re: jcurphy]
MoBOB Offline
Veteran

Registered: 09/17/07
Posts: 1219
Loc: here
Originally Posted By: jcurphy


EDIT: forgot to mention PPE!! I carry 2 pairs of nitrile gloves, a couple face masks (droplet precaution only), and safety glasses.


Are the face masks regular N95s?
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"Its not a matter of being ready as it is being prepared" -- B. E. J. Taylor

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#180809 - 08/30/09 02:20 AM Re: Not trained, what should be in my urban FAK? [Re: NightHiker]
raven Offline
Stranger

Registered: 05/12/09
Posts: 11
Loc: FL
the greatest kit in the world is useless if you don't know how to use it. the red cross has frist aid class almost ever where I've lost court how many time I've take it and still lean some thing new ever time I take it agian , after that they are some great books the one I like the best is Medical for the Outdoors by Paul S. Auerbach, M.D 4 edition .the best kit I can think of is the one you make up your self . I have a few kits my self the ong I like the best is the M-3 medic bag it's about the size of A lady's pocketbook hold a lot of stuff you'll save your self some money and buy the bag emetiy and fill it up as you go or need thing . good luck


Edited by raven (08/30/09 02:23 AM)

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#180819 - 08/30/09 10:25 AM Re: Not trained, what should be in my urban FAK? [Re: raven]
KG2V Offline

Veteran

Registered: 08/19/03
Posts: 1371
Loc: Queens, New York City
OK folks - someone decided to notify me as a moderator over the lasts posts bad spelling.

I will notedit/block a post over bad spelling (unless the bosses tell me I should)

Charlie
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73 de KG2V
You are what you do when it counts - The Masso
Homepage: http://www.thegallos.com
Blog: http://kg2v.blogspot.com

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#180821 - 08/30/09 11:51 AM Re: Not trained, what should be in my urban FAK? [Re: KG2V]
scafool Offline
Pooh-Bah

Registered: 12/18/08
Posts: 1534
Loc: Muskoka
Yup, Raven has terrible spelling.
What Raven said in the post makes sense though.
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May set off to explore without any sense of direction or how to return.

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#180823 - 08/30/09 12:09 PM Re: Not trained, what should be in my urban FAK? [Re: MoBOB]
jcurphy Offline
Newbie

Registered: 03/27/08
Posts: 48
Loc: Iowa City, IA
Originally Posted By: MoBOB
Originally Posted By: jcurphy


EDIT: forgot to mention PPE!! I carry 2 pairs of nitrile gloves, a couple face masks (droplet precaution only), and safety glasses.


Are the face masks regular N95s?


No. True airborne protection (surgical N95s) are supposed to be fitted and airflow tested - at least in hospitals... I often wonder how effective they are if they are not? So, the masks I carry will not protect me from TB (airborne), but it will offer protection against bugs like the flu and meningitis (both are droplet). I guess it wouldn't hurt at all to carry N95s, since I'm sure they protect against droplet transmitted diseases, and may afford additional protection against airborne disease, regardless of whether or not they have been fitted.

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#180877 - 08/31/09 02:34 AM Re: Not trained, what should be in my urban FAK? [Re: jcurphy]
MoBOB Offline
Veteran

Registered: 09/17/07
Posts: 1219
Loc: here
So, what are you using as face protection?
_________________________
"Its not a matter of being ready as it is being prepared" -- B. E. J. Taylor

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#180899 - 08/31/09 12:30 PM Re: Not trained, what should be in my urban FAK? [Re: jcurphy]
paramedicpete Offline
Pooh-Bah

Registered: 04/09/02
Posts: 1920
Loc: Frederick, Maryland
Quote:
Just to hammer a point made earlier, NEVER do more than you are trained to do, regardless of good samaritan laws, you can easily do more harm than good. The only time you should ever consider removing someone from an automobile after an accident is if you believe they are more likely to sustain a life threatening injury by remaining in the vehicle - i.e. the vehicle is on fire - otherwise do what you can to support life with them in place.



I would say yes and no. I would agree totally, that if a victim is breathing and no life threatening conditions exist such as fire or a leaking fuel tank, you should wait for Emergency Services. However, if a patient is not breathing, has no pulse and the need for CPR has been established, you should as carefully as possible, maintaining some time of C-spine control, get them out of the vehicle ASAP. Remember the adage “life over limb”; if CPR is required leaving them in place is only going to result in death. Effective CPR cannot be readily performed while they are in the vehicle.


Pete

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#181029 - 09/01/09 12:30 PM Re: Not trained, what should be in my urban FAK? [Re: MoBOB]
jhritz Offline
Stranger

Registered: 06/25/08
Posts: 8
One other consideration is any personal emergency medical needs that you have. I picked this principle up from the military IFAK where each soldier carries a compression bandage, tourniquet, quikclot, etc. on the front of their uniform in case they are hit.

If you are diabetic, have angina, are allergic to bee stings, etc, those items that treat your unique health risks should be in your personal first aid kit. We're not talking chapstick and sunblock. Glucose tabs, nitro, epipens, rescue inhalers should be in your kit so that someone can help you.

You should also consider the sort of work you do and what active risks you take. If you sit in an office, that presents different medical issues than if you are an arborist or go on frequent hikes.

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#181034 - 09/01/09 01:00 PM Re: Not trained, what should be in my urban FAK? [Re: paramedicpete]
scafool Offline
Pooh-Bah

Registered: 12/18/08
Posts: 1534
Loc: Muskoka
Originally Posted By: paramedicpete
However, if a patient is not breathing, has no pulse and the need for CPR has been established, you should as carefully as possible, maintaining some time of C-spine control, get them out of the vehicle ASAP. Remember the adage “life over limb”; if CPR is required leaving them in place is only going to result in death. Effective CPR cannot be readily performed while they are in the vehicle.


Pete

I would add to Pete's comment.
If they are not breathing or beating then they are already dead and you can not kill an already dead person.
CPR needs them on a solid surface to work, and it needs to happen right away to have even a slight hope of working.
In multiple victim scenes the triage system tells you to not even start on them until you have attended to life threatening injuries affecting other victims who are breathing and beating.
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May set off to explore without any sense of direction or how to return.

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