First Aid Training and Article

Yesterday I redid my First Aid training for the first time in, well a significant period of time (lets just say that AED's were a look but don't touch item in courses).
It is amazing how the "rules" have changed - 30:2 CPR ratio regardless of age now, and breathing no longer recomended in many countries.
There are now easily available tourniquets, and I clearly need to have a reassessment of my emergency kit.

Now 15yrs ago I was told about using tampons for gunshot wounds and a few made it to the emergency kit but I see that has now been kicked to touch.
https://pracmednz.com/the-myth-of-th...n-shot-wounds/
They still make great fire starters though.

The last couple of first aid courses I went to had simulator AEDs so you could still practice with them on the dummies. I'd like to do one of the pracmed courses at some point. Have only heard good things about them. Is there a reason why they don't recommend breathing in many places? A result of covid perhaps?

it went out when the Anully Injected Death Sentance was prevalent..A.I.D.S has scared the crap out of many as has the various types of hepatitis.
its entirely up to you if you do or dont....
the rules change and it pisses me off...3 of us on last course all learn CPR on infant in same way years ago...cradled in your arm,so can breath,and walk to phone etc nd can quickly safely flip them over if the ystart to chuck... yeah nah..now its on table...but FFS thats the beauty of doing it on arm..you can put them on table STILL ON ARM and then move them in instant....
the 30;2 yip it got confusing so simplified.... tourniquets come in and out of fashion... the triangle bandages do to.....
the very best first aid courses are run by outdoors folks catering for outdoors folks...you in shit and dont have a first aid kit..so you improvise..thats real world stuff and once learnt it sticks

The cost of defibrillators has come way down. Consideration for one at home?

I've seen various changes of ratio over the years. I think at my last refresher they said don't get hung up on it as in the heat of the moment you will have forgotten the exact numbers. Just get in there and do it.

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Originally Posted by Pixie Z

The last couple of first aid courses I went to had simulator AEDs so you could still practice with them on the dummies. I'd like to do one of the pracmed courses at some point. Have only heard good things about them. Is there a reason why they don't recommend breathing in many places? A result of covid perhaps?

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It was a pracmed course I did this time, got to practice with two different AED.
Trainer was ex usarmy medic who had also been a paramedic after he got out, so plenty of full spectrum real life experience there.
The breath recomendation being dropped overseas appears to have been for a number of reasons - people doing it wrong, studies suggesting it makes little difference, the cpr itself bringing in a little air, plus potential of catching bugs as Micky Duck said.

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Originally Posted by Barefoot

Yesterday I redid my First Aid training for the first time in, well a significant period of time (lets just say that AED's were a look but don't touch item in courses).
It is amazing how the "rules" have changed - 30:2 CPR ratio regardless of age now, and breathing no longer recomended in many countries.
There are now easily available tourniquets, and I clearly need to have a reassessment of my emergency kit.

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For children, the CPR ratio is still 15:2 for healthcare professionals. The guidelines do change based on the evidence available and professional consensus opinion. It is accepted that the evidence is weak, but it's a best "guess". The key point is to do chest compressions. For those that are really interested: https://www.anzcor.org/

On a more philosophical note, I question the expectations associated with CPR in remote areas where help is many hours away, especially where the primary cause of cardiac arrest is non-cardiac (e.g. haemorrhage secondary to a gunshot wound). Definitely do it as you have nothing to lose, but don't expect a good outcome.

oh they are quite open about the low sucess rates now...pitiful really but better than doing nothing.... and rural,expect to be doing it for over an hour,yo uwill be shattered in 20 minutes.

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Originally Posted by Micky Duck

oh they are quite open about the low sucess rates now...pitiful really but better than doing nothing.... and rural,expect to be doing it for over an hour,yo uwill be shattered in 20 minutes.

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We have more than a few times as a crew of 4 ended up doing cpr for over an hour. It's not much fun, but they are always alive when we put them on the chopper.

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they arent dead..until they are cold and dead
good on you,the world needs more first responders who give a shit

Way to much time is spent on CPR.
From a first response point of view, a small percentage of call outs are CPR events. But a large portion of first aid refresher courses are taken up with CPR. Once you know it you know it. One thing that sticks in my mind, an old registered nurse told me, if you are getting a pulse in the patient groin, you are doing good CPR.
Regarding tourniquets, apparently no one has died because of a tourniquet, plenty have died without one.

Growing up with a father who was a paid professional ambulance technician in England, his advice to us 3 kids was always doing something is better than doing nothing and basically CPR only keeps the brain alive until they the pros arrive with their equipment, his only other advice was if you suspect head or neck injury do not move it.

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Originally Posted by Happy Jack

his only other advice was if you suspect head or neck injury do not move it.

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Good advice, but it has to be taken in context. Airway management takes precedence over C-spine protection. Lack of oxygen will kill you quicker than a spinal cord injury. There are measures that can be taken to protect the C-spine when manipulating an airway, but proceed you must.

did it 3x in my nursing career -my rationale -"ya not dyin on me -its too much bloody paperwork".last one i blew him up like a set of leaky bagpipes. Actually in the real deal (as those whove done it willk now)youre running on adrenaline so clasroom calm and adhering to instruction goes out the window as "28 29 30 breathe ...1 2 3 is your sole focus. .As Brads puts it its not much fun youre hopin wonderin and prayin the bloody cavalry will arrive very bloody soon
.yes we managed to revive em although all suffered major brain damage and eventually life support was turned off.
2 were from choking -_heimlich manouver does work!
last one a hanging
My satisfaction is in knowing at least we made an effort to maintain life.

Part of the issue with the cpr and breaths thing was that exhaled air from a hard working and panicky/shocked first aider is usually very deficient in oxygen, and apparently studies have shown that you get more benefit from continuously moving the blood in the person receiving first aid than stopping and trying to top them up with exhaled air in that deficient of oxygen situation. Better is using a bag mask without supplementary oxygen i.e. fresh air, best is a bag mask with oxygen but either way circulating the person's blood is the objective.

Safety for the first aider is the other concern, if the person receiving CPR has taken or been exposed to something or has a contagious illness/virus/whatever you can end up with a multiple casualty event which is again less than ideal. It's different if it's a family member or someone close to you and you know their situation intimately but for a stranger I would 99.9% of the time not feel safe to do direct breathing in a CPR situation. It's a bloody pain - literally - having to do CPR on a callout as someone noted it's usually for a LONG period of time while you wait for ambo's and critical care to arrive all the time trying to keep family from completely melting down, not my favourite jobs.

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Originally Posted by No.3

Part of the issue with the cpr and breaths thing was that exhaled air from a hard working and panicky/shocked first aider is usually very deficient in oxygen, and apparently studies have shown that you get more benefit from continuously moving the blood in the person receiving first aid than stopping and trying to top them up with exhaled air in that deficient of oxygen situation. Better is using a bag mask without supplementary oxygen i.e. fresh air, best is a bag mask with oxygen but either way circulating the person's blood is the objective.

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There has been a lot of discussion in resuscitation circles about ditching artificial ventilation altogether, but there are some situations where it is important (e.g. children; drowning). In an effort to keep the guidelines as simple and consistent as possible, artificial ventilation remains in the algorithms.

You can now get single use AEDs for about the cost of a PLB and not much bigger. than PLB My son works from St Johns and keeps one in his car for non work situations.
https://cellaed.io/nz
https://smartfirstaed.co.nz/product/cellaed/

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Originally Posted by MB

Good advice, but it has to be taken in context. Airway management takes precedence over C-spine protection. Lack of oxygen will kill you quicker than a spinal cord injury. There are measures that can be taken to protect the C-spine when manipulating an airway, but proceed you must.

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But airway management is not being taken in context either. Sure airway is number one, but if they must be moved to maintain that, then they need to be moved correctly. That was of major importance in the old days. Now we are just told to move them with little regard to keeping the spine supported. And newby trainies don't learn any different.