Hartmanns solution and canulars

[Martyn]

I'm not saying they are all perfect and clearly it's only the doctors and nurses that work at the hospitals and not the combat medics but it's not quite as black and white as you say Martyn

Bam, we were comparing combat medics and civillian first aiders.

The comparison between military doctors & nurses and civillian doctors & nurses never came into the discussion. They are both trained, and most importantly qualified to equal status. It's a moot point.

 

[bambodoggy]

Fair enough Martyn, my mis-understanding, it was a long thread and as so many abs were used and nurses were mentioned I must have got the wrong end of the stick

BF.....no I haven't but if you fancy a night out then I'm all up for some fun! lol

 

[rik_uk3]

Duty of care is based on English common law, the "reasonable man" syndrome, i.e. what would a "reasonable man" do in this circumstance.

Rule of thumb guide, if you start giving assistance, keep at it until the paramedics arrive, don't stop. If your not going to keep at it, then walk on by in the first place

Duty of care in hospitals is still very much a grey area, and changing all the time, its often difficult to be specific in certain conditions

 

[Hawk]

Does anybody know if its possible for individuals to buy hartmanns solution and canulars.

I want to make up my own first aid kit but im after more than just plasters and crepe bandages.

Before anybody asks, i know how to use this kit as i was taught by HM forces,its just looking like you have to be a doctor or NHS manager to buy this kit.(i can buy from the US so why not here?)

You can buy venflons in loads of places

try any of the followibg

www.999supplies.com
www.stjohnsupplies.co.uk
www.galls.co.uk
www.medekit.com/controller/Info/page/index/Welcome.html

Fluids can be bought through link below (But they are pricey)

You should pay about £7 for plasma substitutes and £3 for Saline or Glucose

http://shop.interhealth.org.uk/product.asp?urn=33af1334bdcd4a41b805dfec1fad47b8

 

[Hawk]

Hope you know what you're doing with it - I pour gallons of Hartmans into people on a daily basis and I promise you there's a heluva lot more to it than just putting the needle in and turning on the tap. Quick test, give me one example of when would you choose to infuse someone with dex/saline or 5% dex over n/saline? If you cant answer without using google, you shouldnt be going anywhere near a living person with a cannula.

I'm also wondering what you need it for. A litre of Hartmans wieghs a kilo, so it's doubtful it's going into a bergen. There isnt anywhere in the UK where you need this kind of kit. What you need is a cellphone to call someone who knows what they are doing. If it's an emergency, 1000's of miles from civilization and your victim is clearly dying, then go for it, knock yourself out. But in any western country, there is simply no need for this.

Interesting post, Why do you pour gallons of Hartmans into people on a daily basis. I thought the current best practice was too give a small fluid challenge until you get a radial pulse to prevent disolving clots.

Also I`ve worked with Medics that regularly use IVs for field rehydyration in the UK, so see no problem with keeping some yourself if your trained to use it. Especially if your into preparedness as well as Bushcraft.

 

[Martyn]

Interesting post, Why do you pour gallons of Hartmans into people on a daily basis. I thought the current best practice was too give a small fluid challenge until you get a radial pulse to prevent disolving clots.

Becaue they'd quickly be dead if I didnt. I work in a trauma intensive care unit with people who have been crushed in RTA's, ran over by trains, squashed by forklifts, mangled in industrial accidents, fallen off tall buildings and generally not in the best of health. They are the most sever injuries you can have and still be alive and often with the most severe hypovolemic and septic shock you can imagine. Even so, 70% of them still die. I think my personal record for blood transfusions is 26 units in one shift, not to mention in the region of 10 litres of Ringers and starch. Industrial doses of noradrenaline, dobutamine and vasopressin are normal. I never feel a pulse, I have no need to, because every patient has a cannulated radial, brachial or femoral artery, which is transduced into a space labs monitor. I get real time arterial pressure readings on my monitor. We're probably comming at the concept of "best practice" from slightly different points of view.

Also I`ve worked with Medics that regularly use IVs for field rehydyration in the UK, so see no problem with keeping some yourself if your trained to use it. Especially if your into preparedness as well as Bushcraft.

I think this has been covered extensively.

 

[Hawk]

Are you based at the Royal in Stoke?

Trauma Centre`s a great idea from across the water, shame there isn`t a lot more in the UK.

As you said a different ball game from Pre-hospital / Survival or after a disaster.
Pushing Crossmatched Blood Products v sustaining Perfusion.

 

[Martyn]

Are you based at the Royal in Stoke?

Yep, sure am. Multiple Injuries Unit. You know it?

 

[komodomedic]

edited for being a knob

 

[charliefox]

4, 5, 6...just counting the minutes til the Mods trip over this one

 

[spamel]

Yees, it's gonna happen soon............

 

[Martyn]

I did think about giving him the boot, just for haveing such an openly argumentative first post, but he's entitled to his opinion, no matter how facile.


...ahhhh, I think I know where he's comming from. he's an army trained medic-cum-neurosurgeon.

 

[charliefox]

I did think about giving him the boot, just for haveing such an openly argumentative first post, but he's entitled to his opinion, no matter how facile.:

You must definitely be mellowing in your old age

 

[leon-1]

Just come across this web site and this thread and to be perfectly honest I"ve never come across as many BS fantasists, walt mitty types and big timing nurses in my life

Colloids and canulations, apocalypse scenarios on the common, trauma kits and big knives and as for the discoing in the minefields dits...................

The only danger here is yourselves.

Can I also point out that in my long and varied Hostile/remote medical and military career absolutely without doubt the worst person to have around you in a remote/hostile trauma or medical emergency is a nurse. I include in the term nurse, A-E charge nurses, Nursing practioners, Nurse that watch machines go BEEP. Nurses that "Work in rough tough east end london" etc etc

Basically any nurse whose conversational opener is a list of what courses he/she's done and some deft quoting of the latest clinical study to grace the Nursing times

In fact the only nurse that I've ever seen performed creditably during a Faecal/fan interface was a trainee siberian vetinary nurse with some very swift haemorrhage control and that was because she didn't want to get blood on her boots

:You_Rock_

Perhaps I missed something here. There have been opinions given by medical professionals, nurses, doctors and paramedics yes and pretty much all points made are valid.

I am not someone that looks towards apocolypse scenario's either. Neither do many of the other people that have posted in this thread.

In the end this thread basically sums up certain things, first and foremost know what you are doing, secondly be qualified to do it, thirdly hope to hell you are insured to do what you are doing because in the society of today where litigation is quite a factor then your backside will be grass and there will be a lawnmower coming.

Minefields may well have been mentioned, but we do have a number of serving and ex service personnel, some of which are either first aiders or team medics and as such thier training differs from that of people on civvy street. Pointing out that you would not be able to practice certain things that may be practiced in the forces is valid.

A lot of people here deal with dangerous equipment everyday, if they can get on the relevant courses to allow them to administer to someone who actually requires it I can see no fault in that.

Now on your first post you have managed to really step off on the right foot insulting many of the members and at least one or two medical professionals, take this as a warning.

If you have something to say that is constructive rather than offensive please fill your boots otherwise leave well alone

I had been taught a number of things, Escarotomy, [size=-1]Crycothyroidotomy and how to deal with pnuemothorax, none of these would I even attempt on civvy street.
[/size]

 

[Martyn]

You must definitely be mellowing in your old age

Well, he has a point. There are a lot of nurses who would be completely usless in a trauma setting. For most of us, that's not what the job is about. Most of us look after old granny's with broken hips, dish out some pils, the odd injection and a few bed baths. They would usually be the first to admit, they would be next to useless in a blood bath.

But the job is such, that it is varied. There are also trauma specialists, who are excellent.

If all he has bumped into is the former, it will likely leave him with the feeling he is better than they, despite being unqualified to practice in civi street.


That's life.

 

[Adi]

I have read through all of this thread tonight and what a great thread it is, well done to everyone that has taken part.

Martyn I know you have apologised for what you said about military medics and I thank you for that apology. But, I think your comment about medics working on people because they are going to die anyway is an out of date view. Ok I agree that in the past it was very much like that but each and every conflict has brought advances in medicine and most importantly first aid. In Iraq the modern soldier is more likely to survive trauma than not. That is down to the high standard of care he will receive once casivaced but it is also down to people on the ground being able to react immediately and giving a high standard of first aid.

You just said

I work in a trauma intensive care unit with people who have been crushed in RTA's, ran over by trains, squashed by forklifts, mangled in industrial accidents, fallen off tall buildings and generally not in the best of health. They are the most sever injuries you can have and still be alive and often with the most severe hypovolemic and septic shock you can imagine.

I commend you my friend you do a wonderful job and a service for those you treat but can I remind you that you are a link in a chain but you aren’t the first link someone with equally skill has got that casualty to your care. From your comments I assume you have no experience of battle field injures? Many are very much like the injures you have described above. Crushed, run over, squashed, Split open, bits chopped off, burnt or in my case dropped from a very great height. Many are probably as dramatic as any that you see and I would have thought that on the battle field the numbers of these sort of cases are as high if not higher and it is probably the sad case that the survival rate is lower than that you can achieve.

I don’t feel you can put down the skills of a 19 year old kid that is experiencing the worst imaginable fear, trying to limit his exposure to people that are showing real intent to killing or maiming him whilst his mate is asking him were his leg is whilst cradling his intestines in his arms. That 19 year old will do the very best he can for his mate and will live for the rest of his life wishing he could have done more!

I know this thread was not about soldiers ability of giving first aid and I have taken it off subject a little but I felt you comments were a little off because those lads are very highly trained in battle field first aid and they are very capable of getting critical trauma casualties to better facilities the same as the civil ambulance man or paramedic can.

Anyway as I said a great thread.

 

[charliefox]

Personally I just see it as trolling. I'd love to reply but I'm not going to give him the satisfaction.

I'm off to check my drug expiry dates in the bunker

 

[Hawk]

Anybody can buy canulars and most other medical kit. However all iv fluids are classed as medication and therefore are not available to general public in uk.

 

[Graveworm]

A lot of love in the room back then .

 

[Hawk]

A little late with this one. But there is no such law as the good Samaritans act its a concept not a law.

It's relatively easy to be accused of misconducted if you are a professional medic but generally difficult if you are a first aider providing you act in the patients best interest and don't step outside your area of competence, if you train with an organisation such as st John ambulance they will provide you with free public liability Insurance providing you remain within your scope of practice.

It is not illegal to obtain or possess prescription medicines except controlled ones such as morphine.

However it is illegal to administer or prescribe most unless it's part of your job or you are a prescriber.

It's not illegal to practice medicine but you can't claim to be a Doctor, Nurse or Paramedic unless you are registered with a professional body as the titles are protected in law.

Anybody can give some POM medicines in an emergency situation legally, such as adrenalin for anaphylaxis but this dosent apply to iv fluids.

As mentioned above the use of iv fluid therapy is much less used than in times gone by. The aim now is to support circulation. Keeping a BP of around 90 systolic which is about what you need to have a palpable radial pulse. A much more affective means than cannulating is raising someone's legs in the air.

Sorry if this is duplicate info it's a long thread and I haven't read all the posts