Hartmanns solution and canulars

[Scuba Pete]

heh, yeah I know what you mean. It's a bit of a minefield I have to say, so many grey areas these days.

It's good we have so many knowledgeable people here, that can give advice and help.

I don't want to get into trouble, I would never put anyone in danger. You can do your best and nothing more.

It's surprising how little GP's, and many other doctors know about diving related injury. I had to learn a lot about diving physiology etc to be come a rescue diver and master scuba diver.

There is a doctor in Glasgow we go to see once a year. He is a specialist in diving medicine. We have to get a medical once a year if we want to teach/work with students.

The best people to call are the coastguard, as we dive at the coast we are covered by them. They send a chopper and fly you to a recompression chamber. I have never had to call them yet, and I am thankful.

Forgive my spelling, its too late on a fri.

Pete

 

[stotRE]

Wow

I turn away for a day and world war three breaks out :BlueTeamE

I might need to give you all some hartmanns if you all carry on like this

To tie up this thread i wanted to know where i could buy the stuff because i want to cover my backside as i feel that things arn't looking too rosie in the world these days.

Im building up a supply just incase as you never know whats around the corner and the way that the NHS is looking at the minute i would rather have the means to help my loved ones,better than they become another statistic of underfunding or over spending.

My law is its better to be tried by twelve than carried by six.

Also i don't claim to be a paramedic,i leave that job to the members of this great forum who are the real mcoy and also the men and women of our over stretched,under paid and under appreciated emergency services who deserve better.

I will be booking myself and my wife on a good training course and i'd appreciate a few suggestions (something abit more than ABCD please)

May Odins love make your suggestions happy ones please (i.e. play nice!)

 

[pibbleb]

Dude!

See what you started! :twak:

Can I suggest speaking with Wayne as he runs first aid courses, I'm not sure at what levels but probably worth having a chat.

Perhaps Doc can come up with something as well.

Pib

 

[Phil562]

Firstly may I thank Stu for starting this thread

It has been one of the most interesting since I found BCUK.

I have seen casualties both on and off the battle field and my one wish in life is that I never see another, however, we all are members of a community that may one day be called upon to aid somebody in some form of distress.

To those amongst us that have no form of FA / medical training please consider it as important as that new piece of Gucci kit.

To me my first aid training ( although carried out in the military )is the most imporatnt training I have ever undertaken.

Those with FA / medical training -be very aware of your limitations, however, please do not be afraid to dive in and help somebody in distress - because that somebody may be me

 

[bogflogger]

If you want Serious Wilderness/Outdoor First Aid training, this is the place to go:

http://www.pawprintmedical.com/index.html

These people train MRT, Outdoor Activity Instructors, Airport Fire Service Crews and Expedition/Trek Medics.

 

[stoddy]

Bruv


I will never let you stick a canula in my arm.....you would agree if you knew him



he his built like a brick toilet house, and as sausages for fingers


I would rather die, than be punctured by you

 

[Jackdaw]

Thanks for the apology Martyn. Well made points as ever and my only gripe was the generalised comment (numpty's).

I too would never carry out any first aid procedure that I haven't been taught, and certainly wouldn't run the risk of using equipment or techniques that I wasn't fully confident on.

Let's face it, most of us will do a 2 to 4 day First Aid at Work course and then not touch a Resuci Annie for the next 3 years.

My most important piece of kit I carry apart from me brain and knife, is my first aid kit. A slightly adapted Life Systems Mountain Kit. When I am in foriegn countries, I often have my Life Systems Sterile Set as a precaution against dirty needles should I need to be sorted out by a back street quack. I hate needles, especially dirty ones, so always offer a nice clean one if I have it.

To me, Bushcraft, including survival is about not relying on anything but yourself. I went on a Bushcraft Course recently to see what other people were teaching and there wasn't even a discussion on hygiene. Keeping clean in the field is about as important as you get. Get a slight scratch in the jungle and the next thing you know it's infected. Don't clean you hands during food preparation, then you're going to sit on a toilet for the next few days. All very mudane, but in the wrong situation, life threatening. Keeping clean means you can stay out in the field longer, thus enhancing your chances of survival in the field. A first aid kit supplements this by enabling you to treat little nasties in order to ensure they don't turn into big nasties and then make something fall off.

I bagsy Martyn for my first aid cover in the future!

 

[Martyn]

I bagsy Martyn for my first aid cover in the future!

Ahhh, well there's the thing mate. What I do isnt first aid and I dont have any first aid training at all, apart from a very long since expired RNLI certificate (I should do something about that). You'd be much better off getting cover from someone who's trained for it. I am ALS trained, but that's for in hospital situations, I dont think it's considered "first aid" as such.

 

[nickg]

I have to say that i think that several people on this thread seem a little complacent about the response level and speed for ambulance services in this country.

Now I am not knocking the NHS or its staff in ANY way.

But when the recent bombings happened the london services were FULLY absorbed, The services from the counties surrounding london were moved in to cover he shortfall. It was a surperb piece of logistic manouver and very effectively executed IMHO.

BUT there were areas that were less well covered that they were normally.

My point (and i think stotRE's as well) is WHAT IF?

In London they take the availability of mobile comms for granted. In Scotland and Wales they accept that there are large areas where comms are patchy/non existant. At times like New Years Eve, Christmas Day, The cup Final!! the networks are gridded out, you simply cannot get a signal, Anybody who just assumes that they will be able to get a call out in an emergency is making bad assumptions.

A motorcycle crash in a lonely lane, a tree fall resulting in a crushed limb, these kind of incidents can demand serious procedures in very short time. Your mobile is not working, a three mile jog across country to a house with a phone, MAY mean that the support simply CANNOT get there as quickly as you need them to.

A great many of the comments that I read here are more concerned with the social implications of the action than the medical ones.

Right or wrong I (personally) would sooner live in prison with an assault charge that live as a free man knowing that I could have saved someones (my daughters?) life but did nothing.
If you have something and know how to use it there is nothing forcing your actions but your own conscience. If you have nothing then you cannot use it no matter what the situation.
A girl friend of mine once bought a car, I advised her to buy a tool kit, she said that she could not use it if she did, I said that someone else could help her if she had it. The principle is no different.
StotRE follow you conscience and sleep easy

Apologies for the rant - I know that everybody expresses thier opinion here with the very best intentions.

Nick

 

[Stuart]

just out of interest

who is actually going to carry around bags of I.V. solutions?

if your not carrying them around but keeping them for some sort of emergancy are you actually going to keep replacing them when they pass there use date?

you may have been trained in how to set up an infusion, but do you have the training and experience required to know what you should be putting in for the particular circumstance, how much, how fast, contravening factors etc ?

forgetting the complications with the actual fluids for a moment, how many times have you actually put a cannula into a real person? it takes quite a bit of practice to get it right especially under pressure (I have only done it twice and I was pretty lame at it under calm conditions)

I have undergone training in the placement of an cannula and the set up of a drip as part of my expedition medicine course with the royal geographical society, but I certainly wont be carrying around a drip set and fluids, I undertook this training so that in extreme circumstances on expeditions outside Europe when medical help was possibly days away, I could assist an expedition doctor or set up an infusion whilst being instructed by experienced medical staff over radio or satphone with the required solution, infusion rates etc.

other than under that very narrow set of circumstances I wouldn’t even contemplate sticking someone, sure I can set up the infusion, but then what?
I don’t really know what solution I should be using for the huge number for different circumstances that might require fluids, I don’t know the formulas required to calculate the speed and quantity required and even if I did the chances that i would have access to the quantities and ideal types of fluids required are infinitesimally small.

if you are a medical professional on a large expedition operating far from medical assistance with the facilities available for transporting large quantities of medical equipment then you will probably choose to have a selection of fluids.

if you are an expedition medical officer with advanced medical training working with communications available to medical personnel at a base camp who will assist, you might possibly choose to carry one or two litres of the most versatile fluids to use under their direction.

other than those two circumstances (not entering the realms of the military) it is, in my opinion likely to be counter productive to attempt to carry or use I.V fluids

I did my advanced medicine course because it helps with my job prospects and provide myself with the knowledge look after myself and my companions a little better, not because I imagined that after the course I would be carrying litres of fluids, nasogastric tubes and suturing equipment with the intent to use them.

yes we learnt how to use them, but learning to use them and sticking your fellow student a few times does not mean you have the experience to do it in the field.

I do sometimes carry a giving set minus the fluids, but that is for medical Professionals in hospital/ambulance to use on me, should I feel uncomfortable about the hygiene standards of the facility in which I have found myself though what is likley to been my own reckless behaviour


sorry for that long post, just my thoughts and queries on the subject

 

[george]

I have undergone training in the placement of an cannula and the set up of a drip as part of my expedition medicine course with the royal geographical society, but I certainly wont be carrying around a drip set and fluids, I undertook this training so that in extreme circumstances on expeditions outside Europe when medical help was possibly days away, I could assist an expedition doctor or set up an infusion whilst being instructed by experienced medical staff over radio or satphone with the required solution, infusion rates etc.

I've done a similar if not the same course - if anything it made me realise just how little I know.

I could cope (I think) if I were being given instruction by a doc perhaps by satphone as Stuart suggests. Aside from that at most I know the names of the bits to hand to the Doc when they ask for them.

God forbid I'd ever be in the situation where I had the kit but no-one to instruct me on the finer details - I'd probably end up doing more harm than good if I tried to use it.

George

 

[den]

There have been Mountain Leaders who have been prosecuted for using something as innocuous as zinc- oxide plaster in Mountain Casualty situation

Can I ask where you sourced this information as any info or links would be greatly appreciated.
Cheers
Den

 

[bogflogger]

The incident related to a M.L. about five years ago, who used Zinc-Oxide plaster on a fairly minor abrasion that a Young person picked up on a Hill walk.

The Young person had a (previously unknown) allergy to Zinc-Oxide and developed a minor rash.

The M.L. was the Sued by the Y.P.'s parents, suspended from work by his Employer during an "A*** covering exercise" and initally charged with assault by the Police.

This was one of several cases where Qualified Mountain First Aiders have been prosecuted, for not adhering to accepted practice and/or Assault.

You can no longer use Zinc Oxide plaster (even though it adheres better than Micropore to cold/wet skin!) nor can you give ANY oral medicines, including Asprin, Paracetamol or anything else.

Neither can you apply Sunscreen or Calomine lotion to any Sunburnt Young People in your care.

This idiotic situation is more to do with "Compensation Culture" and Employers Liability, but it is real and it does affect anyone working in this field.

A final point, regarding administering First Aid beyond your actual Qualifications.

Nickg has said (post 49) that most of the comments in this thread "are more concerned with the 'Social Implications' of the action than the Medical ones."

To respond to this, these are not 'Social Implications' this is a matter of Criminal Law and Professional Competence.

If you are not Qualified (with a CURRENT and RECOGNIZED Qualification) then you are breaking the Law and deserve to be prosecuted for 'playing at Doctors.'

This is quite apart from the very real possibility of you causing more harm and complications for Qualified Medical Professionals to deal with.

 

[Martyn]

You can no longer use Zinc Oxide plaster (even though it adheres better than Micropore to cold/wet skin!).

Yeah, it's use has been widely depricated in hospital as well. While not actually banned yet, if we use it we are supposed to establish alergy status first. If we cant do that, we cant use it.

 

[Scuba Pete]

I find it funny a parent would be more concerned about a rash than the possability of an infected wound.

Pete

 

[bogflogger]

I think it was more a case of the parents "trying it on" to try and get some compensation.

As far as I know, they did not suceed, but this sort of C*** is unfortunately becoming normal practice and being second guessed by Solicitors, who have no practical experience in the outdoors (and with 20/20 hindsight from their nice comfortable offices) is something that is slowly but surely destroying Outdoor Education in this Country.

 

[stotRE]

I think it was more a case of the parents "trying it on" to try and get some compensation.

As far as I know, they did not suceed, but this sort of C*** is unfortunately becoming normal practice and being second guessed by Solicitors, who have no practical experience in the outdoors (and with 20/20 hindsight from their nice comfortable offices) is something that is slowly but surely destroying Outdoor Education in this Country.

Thats also why the Boy Scouts Movement is in decline because potential volunteers are scared of persecution if something goes astray.

Pretty sad really to think that our young are being converted into mindless robots in the name of health and safety.

Tommorrow i will be walking alone in Thetford forest without a safety harness,sat phone,IV sets,Air ambulances,hi viz vest,cotton wool,safety goggles,Lion tamer and i may do something completly reckless like boil up a hot brew without a anti-lip scald protector (i may even remove the cork from the end of my Mora )

Farewell my bushcrafting brethren..........i maybe gone for sometime

 

[Keith_Beef]

I'm quite used to seeing forms come home with the kids, about field trips, and specifically having to sign tot he effect that "I agree in advance to trip leaders carrying outany necessary first aid, and seeking urgent medical attention from competent authorities whenever necessary", and having to mark on the form any medication being taken, and any known allergies.

So far as I'm concerned, if my kids fall and get a nasty graze, I want it to be washed and covered. If a rash develops, I'm not going to scream "gimme the money", or try to get the trip leaders barred for life from working with kids.

Unfortunately, there are people like this around, and as a result there is more a*** covering going on than even twenty years ago.

When I got severe sunburn and sunstroke on a school camping trip, I was clarted in cream, given dioralyte, and taken the following day to hospital to get the blisters lanced. Nobody thought anything of it.


K.

 

[pibbleb]

I'd just like to say that for one I picked up on the legals side of the argument, as I know a little about it, leaving the medical question for the pro's.

But whilst focusing on the legals, and I think we all agree that as far as the law goes it's a big no no, we are ignoring some of the medical points and those revolve around whether this kind of intervention is necessary and it would seem to me that the giving of fluids is no longer done by first responders and is only done by primary carers in hospital when there is an idea of whats going on.

The other thing that has been discussed here, but perhaps again put in the shade by the legals, is how current is your training. This I suspect goes hand in hand with the point above and the question of qualifications. I agree that you do not need to have a bundle of qualifications to be good at something after all any first aid training I had expired along time ago, something I'm addressing but if you are diabetic, need injections I'm your man. My wife is diabetic and when she went through a bad patch of being poorly controlled I would frequently treat her Hypo's administer Glucagon injections, a replacement for giving Glugose fluids if I believe although I might be wrong about that, and take blood for blood sugar monitoring. However, despite having medically qualified parents, grand parents a wife training as a midwife and the above experience I know nothing! and what I do know is only kept up todate by my wife and her diabetic consultant. So I guess what I'm saying is that unless you move in the right circles is hard to keep up todate with the changes in the medical profession. As an example I probably haven't had to give my wife a jab for two possibly three years as she is now on an insulin pumb and the need for external intervention due to hypo is greatly minimised.

I'd initially joined in on this thread for two reasons. The first was a little silly but I'd taken to heart the use of the word 'numtys' but secondly because I was horrified that you can buy this stuff fairly easily.

This view, I have to say, has changed from one of horror to one of ooh what should I be buying. Someone on here posted saying they take needles and the like on foreign trips where the use of dirty medical equipment is common. This is the most sense I've heard in a long time and not something I've heard of before. So in this case I would probably take this advice and stock up.

From an end of the NHS/civilisation point of view I just wonder how helpful a couple of bags of fluid would be, certainly not a long term solution to your survival I'm guessing. Before I'm accused of being flippant, I certainly don't really mean to be, after all my family has an escape and evasion bag, which contains clothes, water and wifes spare medical stuff. But we have to face the realisation that this bag is only a short term answer to a question that could result in the wife not surviving. My wifes medical surplies for three months take up a huge amount of space and this does not include the other stuff required to keep her ticking over. I just wonder how many of us appreciate the volume of equipment needed to survive long term and in reality whether we have the funds and space to keep it all, and replace what goes out of date! After all the NHS is struggling with it!

All of the above is IMHO and I don't mean any offence. In addition this is not to under sell the legal question. I work for a commerical law firm which has a small litigation department which is ever growing and increasingly making a lot of money. This is thanks to the sue culture that we now live in. It would also seem from the usual corridor banter, that is common in offices, that an increasing number of these cases are medically related. This is obvisously directed at medical professionals and is very sad!

Pib

 

[nickg]

Nickg has said (post 49) that most of the comments in this thread "are more concerned with the 'Social Implications' of the action than the Medical ones."

To respond to this, these are not 'Social Implications' this is a matter of Criminal Law and Professional Competence.

If you are not Qualified (with a CURRENT and RECOGNIZED Qualification) then you are breaking the Law and deserve to be prosecuted for 'playing at Doctors.'

This is quite apart from the very real possibility of you causing more harm and complications for Qualified Medical Professionals to deal with.

Cmon Bogflogger, the very point of my post was that nobody was PLAYING doctor. I was exampling a real, difficult, urgent and life threatening situation that required a response. In those situations the requirement to act meaningfully may well override the civil or criminal repercussions you may face. Your own example shows that even if you have a CURRENT and RECOGNIZED Qualification and obey the rules you can still face police and civil recriminations, but you stll have to live with the consequences of NOT taking action and letting someone, unable to help themselves, suffer and possibly die as a result of your inaction.

My point is that it is not always sufficient, in my eyes, to simply say "I followed the rules". you have to follow your conscience as well.

The medical rules seem to change almost daily, as others here have said its a big deal just to keep abreast of them. What was permissable yesterday is proscribed today (rarely vice versa). Your conscience stays with you all your life and thats a long time.

I'm not putting my heart on my sleeve for this but during my army time I was put in a position like this and did nothing because I did not know what the right thing to do was. My actions were correct and irreproachable, but listen mate I still wake up at nights 25 years later and when I do i would gladly swop some jail time for peace of mind.

Follow your conscience - Please