Worst case scenario

[Countryman]

Last Dr I encountered in a First Aid situation was interested in giving the guy on the deck Pacetamol rather than checking for a radial pulse. Turns out the guy had an open fracture and was bleeding into his motorcycle leathers and boot.

Next time I'm going to assert myself instead of running the scene.

GPs are not good with traumatic injury. They have limited First Aid training and experience.


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[Nomad64]

Genuine question: who here has dealt with a stab wound in a real-world situation?

Did you find a single £20 note better than two tenners or four fivers to staunch the blood loss?

In answer to your question - "no" but I have had to provide first aid to someone who came off second best in a hand meets 3' circular saw blade encounter 4 hours from medical treatment and managed a stroke patient during the 45-60 minutes that it took for the local MRT and a helicopter to reach a spot in the Lakes with no phone coverage.

A suitcase full of £20 notes would have made no difference in either case and in the absence of any other medical responder, someone with even basic first aid skills can make a real difference.

 

[Buckshot]

this is getting rather tedious now chaps
I know doctors who openly agree they are not the best people to deal with first aid incidents and I know first aiders who would run screaming from anything more than a paper cut. neither is ideal

can we agree that appropriate knowledge is better, regardless of the qualifications or letters before or after the name of the person?

Shall we move on now?

 

[MountainGoat]

Did you find a single £20 note better than two tenners or four fivers to staunch the blood loss?

Ah - it's a conundrum for the ages

Shame those pound notes are gone these days.


In conclusion - I sometimes worry on forums such as this there's a tendency to dismiss genuine, good info for no other reason than it doesn't involve buying the latest gadget.

Forums will likely make money from advertising. Someone entering the foray recommending against purchasing kit isn't exactly good for business. This I understand.

But to dismiss alternative advice that is genuinely useful (i.e. carry some money if in town - almost everything necessary will be within 5 mins, with improvisation being possible in most situations anyway) is not exactly fair.

If the OP wishes to spend wads of cash on gear, by all means he is free to do so. If so, it is ok to say 'I want to own a ton of first-aid gear' - which is very different from formulating an appropriate FAK for the scenario mentioned (in this instance, urban).

OP - advising you not to bother carrying what you are carrying isn't bad advice. It is, however, what you don't wish to hear (or others here) - therefore it is likely interpreted as negative - despite not being so.

 

[Madriverrob]

If the OP wishes to spend wads of cash on gear, by all means he is free to do so. If so, it is ok to say 'I want to own a ton of first-aid gear' - which is very different from formulating an appropriate FAK for the scenario mentioned (in this instance, urban).

I haven't spent wads of cash . You presume a great deal !


OP- advising you not to bother carrying what you are carrying isn't bad advice. It is, however, what you don't wish to hear (or others here) - therefore it is likely interpreted as negative - despite not being so.

I shared an opinion and some kit , I invited comment , you commented, I haven't criticised your comments other than your presumptions about my spending and waltishness , both far from the mark . It is others that disagree with your fundamental ideology .

 

[Countryman]

Tables and rulers time!

How much did the little kit set you back? How much do you value peace of mind?

Not exactly a prefab nuclear shelter and 2 years supply of Mountain House is it?


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[TeeDee]

I know this thread is going from left to right and getting an interesting amount of passionate debate around it - but I must admit I'm finding it interesting.

Please can we all politely carry on. I'm interested to hear more from everyone. Debate, even passionate debate is Good!

 

[Countryman]

I think the addition of cash to any kit is useful. I wear a reasonably valuable watch. Im not precious about it and have always considered it the cab fare home.

Sticking a few quid in a get home kit isn't bad idea. Not sure that was particularly the idea.

Relying on rushing into Boots to buy First Aid supplies doesn't strike me as nearly so clever.


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[Nice65]

He's just trolling mate, leave him to it.

Fact is, in a serious situation in this country results in people pulling together and helping each other, as we've found out recently. A Kiwi mate of mine answered it nicely. "In New Zealand we'd all help each other to rebuild what we lost, and form a community as we did it."

Preppers with guns and knives who think raiding and stealing is how things work out, or low post count trolls, shouldn't really be allowed the airtime, or forum space.

 

[Joe tahkahikew]

I'm curious just how useful a bandage and tourniquet will be in the case of terrorist attack?

The ones we hear about involve many injuries and dead - such as the ones in London.

 

[Countryman]

I'd rather have it than have not in that situation. At least I would not have to improvise until after they were used.

The Manchester bombing had a number of folk that would have been grateful for that small mercy.

Knowing how and when to use this stuff is key.

My "I'm in charge of First Aid Kit" is a wipe clean backpack. There are limits to EDC!


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[MountainGoat]

Funny. Certain members here see a direct reply as a negative, and trolling.

to the OP - I'll give you some more information, since there seems to be some doubt. If you want to make a difference, you need proper training - not kit.

Firstly - get rid of the blood type badge. I trust you know why soldiers use ID tags? It isn't for transfusions for themselves - it is to create a narrower list of possible donors for the injured person (whose blood they'll test again anyway). Transfusion will take place in a sterile environment - point being, they'll have the time to test your own blood before any transfusion. Not to mention no medic is going to trust a velcro badge someone has on their person.

If you really must take something, take tape. That's all you need. Anything requiring more means calling someone anyway. And in the urban situation you mention, emergency services will never be far away.


The success of any intervention should be weighed against the likely outcome of non-intervention. Part of training is being aware of limitation and adverse consequences of taking action.


Many times doing nothing is actually the best option. Not doing something can be difficult.



More specifics RE commonalities:

CPR, since it is raised on this forum from time to time: If someone needs CPR they very likely won't survive (again, I ask how many have experience of this - many here are arrogantly assuming I'm a troll) - in a CPR situation there may be a case/very rare opportunity where you could decompress a tension pneumothorax to treat a cardiac arrest. You could do this with a large cannula or use a knife to make a thoracostomy. Who realistically would have either the knowledge or the guts to do something like this?

Many carry a cannula. Most won't have a cannula long enough (i.e. 15cm). Very easy to damage the internal mammary artery and cause significant internal bleeding. All attempts at invasive procedure have similar risks.

Dressings are unnecessary in the early stages - anything bleeding needs pressure, not a particular dressing. The last stabbing death I saw was from a laceration to the IMA. They had a delay in presentation (again, I urge others reading this to consider matters such as presentation etc), and when help was given (resuscitative thoracotomy), it was too late due to aforementioned delay of presentation.

Being involved in a couple of incidents often makes certain individuals feel like they speak with some authority on a subject - often a miscalculation/over-estimation of competence.

Many people suffer gross deterioration at the hands of the incompetent.

Carry your phone, some money, and water & some tape if you must.

 

[Corso]

bored now...I'm so glad this forum has an ignore button

 

[Nice65]

The OP:

Recent events got me thinking ...... what if I found myself in the midst of a terror attack , say for example Bataclan , Manchester Arena or maybe an explosion on a train or underground ?

The bizarre thinking of prepper troll:

The main problem with doomsday thinking is it is generally always defensive. Now, I'm not advocating what I'm about to say, but if everything collapses it would be far easier to dispose of neighbours and take their provisions than it would to hunt a muntjac on a remote hillside.

Well, after the fairly straightforward post by the OP, you excuse yourself by "not advocating", disposing of neighbours. Too much of the American TV for you I think. We would look after each other in an immediate crisis, clearly proven worldwide. It worries me how much you you seem to assume an escalation to all out war, your paranoia is palpable.

Funny. Certain members here see a direct reply as a negative, and trolling.

Yeah, right

Many carry a cannula. Most won't have a cannula long enough (i.e. 15cm). Very easy to damage the internal mammary artery and cause significant internal bleeding. All attempts at invasive procedure have similar risks.

Not exactly relative is it, a bit like not killing the neighbours, and looting, rape and pillage.

Not at all. My position is one of realism.
You can buy all the equipment under the sun, whether it be first-aid, the latest waterproofs etc - but the likelihood is someone will simply overpower you and take what you have.

If there's any doubt to this, look at any war-torn country - or ask someone what happens on the ground during times of lawlessness.

The best thing to have is knowledge, not a check-list of gear.

If society collapses, you'll likely be attacked. There won't be idylls consisting of certain members of society with similar views on utopia.


Rape, pillage & murder will be flavour of the month in the scenario mentioned.

So, from a simple kit question, to a war torn country of rape, pillage, defence, and most disturbingly, Utopia.


I'm also glad of the ignore button.

 

[nigeltm]

MountainGoat & Old Bones

You have a right to your opinion on the benefit of a doctor or first aider in a casualty situation outside of a hospital setting, such as an urban terror attack as set out by the Op. I do not agree but that is your right.

All I can say is that before I joined Mountain Rescue I was in a situation where a "normal" doctor took control of a casualty incident. Looking back now this doctor made so many mistakes in diagnosing and treating the casualty. The casualty survived DESPITE the mistakes. I know other experienced first aiders who have had the same experience.

Most doctors are not current on immediate and critical care protocols. They change all the time, with regular updates from the Resuscitation Council and other groups. This is so important that in our Mountain Rescue team doctors are not allowed to treat a casualty until they have passed the Casualty Care exam (which I have done 3 times, as well as advanced trauma care courses and I'm going to the MREW medical conference in Ambleside in November).

I agree that a doctor knows considerably more than me and I respect their training and knowledge. Even so, in this this type of situation their training may not be appropriate.

All first aid is intended for is to keep the brain and essential organs oxygenated untill I hand over to an ambulance crew. I'm not performing surgery or diagnosing a cancer. I'll leave that to the appropriately trained doctor. Even then, I wouldn't want a thoracic surgeon trying to perform brain surgery. They're both doctors but their skill sets are different.

MountainGoat. A quick word on your posting style.

This forum is open to differing views and debating those views and being open to counterarguments. It is core to having a conversation and opens us to being convinced we are wrong, as well as being fun. You are entitled to your view. However, while on one hand you accuse people of being closed to your arguments and suggest we are dismissive you show exactly that attitude in response to our views. You come across as hypocritical and closed minded. While I do not expect to change your mind I would expect you to respect differing views. I and others on here have many years experience in many different areas. We have personal experience in a number of areas which gives us an insight which it should be responded to respectfully, in the same way I have responded to your views.

This is a forum for discussion, not battle.

 

[Tonyuk]

A lot of comments for something so basic, the guy was only showing that he was planning to carry a whistle, cylume, torch, gloves, bandage and a cat. Most of you will carry far more first aid stuff than that for a weekend in the ulu and think nothing of it, strange.

If he wants to carry it then all the power to him, he isn't going to do any harm.

Tonyuk

 

[mrcharly]

I'm curious just how useful a bandage and tourniquet will be in the case of terrorist attack?

The ones we hear about involve many injuries and dead - such as the ones in London.

Probably quite useful. There were a lot of people with badly bleeding injuries - stemming bleeding from cuts is pretty much the most important first aid that can be offered.

That said, from my (very limited) knowledge, taking a T-shirt, folding it into a square and applying pressure over a wound is a very effective method of stemming bleeding. Forget about worries of infection for now, it's bleeding to death that is the real concern.

In the event of people being run over by cars, that's a different scenario really. Immobilise, check for head injuries, not sure what else apart from remain with the injured to identify/locate them for emergency services medics.

 

[Corso]

Yes

Even a GP will have gone to medical school for at least 4 years, followed up by 3 years of training to become a GP. They will probably have done rotations during their training on the wards, including A & E, and have to keep up with the journals, refresher courses, extra exams, etc.

I did a first aid course last year - useful, but my medic friends know vastly more than me.

Now I do not know what medical back ground others have and don’t presume to know but having worked in a hospital for 20 odd years I would rather put myself in the hands of a certified first aiders over a GP or any other Dr outside those who are working in A&E/Trauma or critical care.
The simple fact is once they pass a SHO position theyspecialise. They do not keep the skills up to date enough, having little enoughtime to do the job they do and train in their speciality at the same time.
When I was taken unwell with a compromised airway at my GP’s a couple of years back he called paramedics –I’m glad he did he was out of his depth.
My hospital has first aide trained staff and we have themfor a reason….

 

[MountainGoat]

It would appear in this thread that truth is a hard pill to swallow.

I understand and appreciate many here have likely invested considerable time & effort into forming the 'perfect' first aid kit - someone entering the foray describing such kit as unnecessary will, I imagine, grate a little.

However, 2+2=4, irrespective of the entire world believing otherwise.

Addressing each and every item the OP posted:

1) Blood type velcro badge - completely unnecessary as transfusions will take place in a sterile environment. When the patient is being moved, there will be time to test blood. That, plus no medic will rely on a velcro badge as accurate (doing so could lead to death).

The function of blood type indicated on forces ID tags (and their specific use when on tour/battlefield) should be understood, given the blood type badge the OP has is derivative of forces badges.

2) Trauma dressing - unnecessary. Any material will do. Pressure is more important than dressing type.

3) Gloves - unnecessary. If someone needs treatment to the extent whereby time taken to head to the nearest store for a pair of gloves means death, they are dead anyway.

4) Tourniquet - often misused - often with disastrous consequences. One should consider whether failure to act would lead to death of injured. If not, wait for emergency services - which, given the urban/terrorism scenario, will be minutes away.

5) Cyalume stick - your phone will have a torch on it. No need for light. If underground, when emergency services/police etc arrive, they'll have full lighting rig.

6) Whistle - Again, unnecessary. Terrorism response training Initial Response Assessment involves scene overview & analysis - emergency services will be trained in what to look for RE the specific scenario you mention. If anything, your whistling could be a hindrance to services.

The above advice is - as of your request - constructive.

 

[nigeltm]

MountainGoat;
1) Blood type velcro badge
Agreed. Nice to have but not necessary. It does not hurt to have one.

2) Trauma dressing
Strongly disagree. Sterility of the dressing is not an issue in the field. By all means use an oily rag if it stops me bleeding to death. However, modern trauma dressings do more than plug a hole.
- They can be applied quickly, without having to scrabble around for rags. Those few seconds could make a difference.
- they can be an automatic response in a distressing and traumatic situation. There is no need for the person to think too hard if they have a dedicated tool for the job. Think Standard Operating Procedures and learned responses.
- they can be applied single handed, useful if the wound is the stump of your own arm or if you are using one hand to apply direct pressure to an open wound
- they stay in place when you let go. This frees you up to do something else
- modern dressings may be impregnated with haemostatic agents, like quickclot. This greatly improves the clotting of the wound and effectiveness of the dressing. Removing the need to apply multiple dressings to large wounds as the in place dressing soaks through.

3) Gloves
Disagree. They are PPE for my protection, not the casualty's. I do not want to contract blood bourn diseases. It takes seconds to Don gloves and is part of the "Danger" part of the DRSABC process.

4) Tourniquet
You have not said that it should not be carried, just that misuse van be a problem. What do you mean by disastrous? At worst a misapplied tourniquet is ineffective. It is only deadly if applied to the neck for a head wound! Yes, it should be applied if you have the appropriate training but is not a major issue even if all you have seen is on TV.

5) Cyalume stick
Disagree. Personally I would not rely on my phone. Usually the battery is already partially depleted and the light is a heavy drain on the battery. A light stick gives you a guaranteed light source for a known period of time,leabing your phone free to call for help or at least reassure family you are alive (assuming the phone masts hacnot been shut down).

As for being underground and not needing a light, how will you see to apply your t-shirt dressing?

6) Whistle
Disagree. Please see my earlier post about being trapped in a collapsed building.

The above advice is - as of your request - constructive.
Thanks for that and I think I have given a reasoned and constructive counter to your points.

Can I ask what your background and training is? I have clearly set out my position and experience. Hopefully it gives my opinions some credibility.

At this time for all I know you have no background in this area and all your points are Google fuelled tripe. Am I wasting my time giving you the respect of thought out and reasoned replies? Or are you just on a wind up and not prepared to accept the views of people with more experience than you?