How much First Aid Training is enough?

[Eagle707]

rdclements:

Thanks for the tip about the Red Cross! I'll definitely be working on developing a connection with our local office. I also meant to refer to WFA as "the answer to everything" facetiously but I could hardly expect that to translate into text. In all seriousness, thank you for noting my mistake and thanks again for the Red Cross info!

[Rockford8070]

I think a lot of people are forgetting what first aid is. It's FIRST AID. It's not an EMT, it's not a trained medical professional. It's not comprehensive, it's basic. It's a stopgap until a doctor or EMT can get the situation under control. And no, it's not perfect. But are you going to require an EMT to go on every scout outing?

 

If a person has a severe medical problem the responsibility is with the individual to explain to the leader what the risks, signs, and symptoms are. Or are you going to just tell a leader you have suchandsuch, and let the leader read up on it and make his own decisions?

[resqman]

"I think a lot of people are forgetting what first aid is. It's FIRST AID. It's not an EMT, it's not a trained medical professional. It's not comprehensive, it's basic. It's a stopgap until a doctor or EMT can get the situation under control. And no, it's not perfect. But are you going to require an EMT to go on every scout outing?

 

If a person has a severe medical problem the responsibility is with the individual to explain to the leader what the risks, signs, and symptoms are. Or are you going to just tell a leader you have suchandsuch, and let the leader read up on it and make his own decisions?"

 

You are correct. The problem I see is there is no First Aid requirement for SM/ASM. 1-2 hour overview during IOLS is not adequate training in my opinion. Scouts are often an hour from the

[CalicoPenn]

Thanks, Vol - I wasn't looking for compliments, and frankly, it was pure luck as I had just gone through some CE training not 2 months before concentrating on Diabetes so it was fresh in mind.

 

Rockford, you're right - it is probably overkill and unneccessary that there be an EMT on every trip, and yes, it is first aid - but in a sense, what we're talking about shows what could be a weakness in first aid training. My tale was to illustrate the same concept that Vol had mentioned in response to a question by Twocub on how that training has helped, and that answer was to be more open to possibilities beyond the obvious.

 

I see as a weaknesses of "First Aid" training that we don't spend as much time on potential medical issues as we do on treatment for trauma. No, a first aid course shouldn't need to spend a whole lot of time talking about all the possible symptoms of medical issues that people might come across, but in a nation where diabetes is rapidly becoming (sad to say) a norm, shouldn't we spend a little time on it? In first aid training, when we see bleeding, we see a concrete problem that we can handle, and most of the time, don't really need to know how it happened. Somehow, we need to get better at getting folks who take first aid classes to understand that vomiting can be pointing to a whole range of possibilities - and though we may not be able to tell what is causing it, we can remember not to make a snap judgement that can rule other things out.

 

 

[Proud Eagle]

There will never be enough First Aid training. No matter how much you have you are one extra variable or symptom from being out of your depth, and I hate to say it, but the situations where people most often die are the ones where a whole lot of the variables went the wrong way. First Aid exists only for those marginal cases where just a little extra help keeps the person alive long enough for someone else to have a chance to carry them through to the next stage. CPR has conversion rates that make it seem nearly hopeless, but again there are a few cases on the margins where it can make the difference.

 

The real question with First Aid knoweldge is not how much is enough? But rather what can we teach to a large enough group to be of worth? After all, if First Aid training is going to become as involved as EMT training, you will never have any more First Aid trained people than there currently are EMTs. You see this in play with the reviesed CPR instructions for 911 over the phone advising chest compressions only.

 

It is only practical to set a standard that can actually be achieved widely. Further, it is better to teach a small set of skills well, than a medical encyclopedia they will quickly forget.

 

I am all in favor of increasing standards and raising the bar. But if that means fewere people ever aquire any of the useful knowledge or skills, or fewere retain it and are willing to use it, then the higher standard defeats itself.

 

This is why medical training and first aid training both require various levels, each progressively more advanced. Far better for more to have the most basic certification than none at all, which if we are realistic is often the real world choice.

[vol_scouter]

A problem with first aid courses is that they often skip some of the important problems that are LIKELY to be encountered. CalicoPenn discussed one - diabetes. Type I has been a problem in scouting for years but little is addressed. The mostly common cause of death in the US in the great out of doors is anaphylactic shock. This is a topic that is often not covered or not covered in detail. That is sad because an injection or two of epinephrine can save a life. However, the provider needs to distinguish this from shortness of breath associated with a myocardial infarction (heart attack) which is not to difficult. So I would like to see a revamping of the adult at least first aid courses.

[Eagle92]

One of the problems as I see it is Epi pens. They are considered a prescription, and when I did CSDC training, I was told the cub has to do it himself. We can help him, bu the cub must do it.

 

I know my first encounter with with epi pen training was with the Eckerd Foundation, and their FA training. BUT we had a set of standing orders that had to be kept with us at all times and followed to the letter.

[Eagle007]

Vol brings up another great point with why it is so important for the scouters to know about a scouts medical history - allergies or anaphalaxis.

 

I would definitely want my son's scouters to know if he were allergic to bee stings, for example. I'd also want them to know that my son carries epi pens and what they are/will be carried in on outings in the event he gets stung and needs help retrieving them as well as in the assistance of administering said epinepherine.

[BrentAllen]

We cover Epi-pens in WRFA and even have demonstration pens for participants to practice with. We usually have a scenario involving them, as well. The question comes up, if, out on a trip, you had a Scout (Bill) get stung and goes into anaphylactic shock who did not have an Epi-pen, and there was another Scout (Tom) on the trip who had a pen, would you take the pen from Tom and use it on Bill who was going into shock? I'll come back later and post our staff answer. What would you do?

[Eagle007]

Brent, as a nationally registered EMT, I can't.

 

More later.(This message has been edited by Eagle007)

[perdidochas]

As a layman, I would take Tom's epipen, and inject Bill with it. I would live with the consequences of illegally using a prescription drug on a different person. However, my profession and livelihood aren't on the line.

[Beavah]

Yah, there yeh go posin' hard questions, BrentAllen .

 

Actually, I don't think da question is hard at all. I can't speak for what 007 is thinkin', but as an EMT I would of course administer lifesaving medication to someone as needed in an emergency situation. Just like the whole cock-and-bull about needing to "assist" the gasping 6-year-old with injecting himself. What complete nonsense. Yeh grab the injector and you administer the medication yourself so that you're sure the boy is getting the treatment he needs. After the fact yeh can play wink-wink-nudge-nudge about "assisting."

 

I love law and policy, eh? It serves an important purpose in society. But it's only valid so long as it serves its purpose. Hard cases make for bad law. Medical emergencies are not the place for legal professionals to be tryin' to split hairs. In an emergency, yeh do what you have to do to try to save a child's life. Then, if need be, yeh deal with the other stuff later. And in that, you rely on the good will, common sense and decency of the review board, the county prosecutor, or your fellow citizens.

 

Having known folks who have done exactly that, I can say that I've never seen anything close to an adverse outcome on licensure, let alone anything worse.

 

But if yeh sit there and watch a boy die when yeh have the wherewithal to treat him? How could yeh live with yourself? And I reckon the exposure is every bit as great.

 

Beavah

(This message has been edited by Beavah)

[Eagle007]

Beavah, I said as a nationally registered EMT I can't (one person's prescribed medication to help another). I also said more later.

 

Now for the "more later". I can't do this based on my scope of practice. That opens up a whole new can of worms. I didn't say I won't based on an emergency. I will do everything in my power to keep this scout from dying. Truly emergent circumstances dictate exigent decisions. If I knew that the other scout's epipen will treat the anaphylaxis and will cause no harm to the scout in need then you had better believe with all your heart that I will be using the auto-injector. I will also be getting that scout to the nearest medical facility, ASAP.

 

I will always do what is in the best interest of another person and be ready to defend my actions in court.

[CalicoPenn]

Nope, I'm not going to us Tom's pen on Bill - not unless Tom has a spare or two - I'm going to treat Bill to the best of my abilities operating as if I don't have access to an epi-pen. It is not my decision to make to use Tom's property for someone else, and I will not put Tom into the position of having to make the decision either. Even if Tom volunteers his pen without asking, I can not in good conscience use it knowing that Tom is not, or may not be able to, make an informed choice on how such a decision might affect him.

 

That's what makes this question such a good study in ethical decision making. The choice between actuality and potentiality. If I don't use Tom's pen, there is a good chance Bill might not make it. If I use Tom's pen, there is a good chance that Bill will make it. Seems like a pretty easy choice to make.

 

Except...

 

If I use Tom's pen on Bill, I may be saving Bill's life, but I'm putting Tom's life in that much more jeopardy. Tom is carrying an epi-pen knowing he could go into anaphylactic shock if stung. It is more likely that Bill going in anaphylactic shock is unexpected. What happens if Tom gets stung after having his pen used to save Bill's life - a pen brought along with the express purpose of helping Tom should he get stung? Is the probability of such a scenario taking place low? Yeah - probably even ridiculously low - but then so is the probability of Tom ever needing to use the epi-pen in the first place.

 

Let's make it even more interesting - you're the lead on this trip and if you're seriously ill or injured it will put every one on the trip at risk and the epi-pen is yours. Do you use it on someone else and risk needing it yourself?

 

 

[clemlaw]

>>>would you take the pen from Tom and use it on Bill who was going into shock?