/ Indoor wall Injury

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dapperdan - on 22 Dec 2013
Im writing this post to highlight my concern about lack of training of staff at indoor walls / sportcentres.

Today I fell off a boulder problem and broke my ankle at a local wall. Everybody I dealt with immediatly after was shockingly incompetant to be frank.

I was asked to wait for first aid (shouldnt wall operators / instructors be first aid trained?), wich culminated in a bag of water (not ice) being pressed on the ankle, after wich i was asked to fill in a form...give me a break im in considerable pain!?

As there was no wheelchair or way of getting me out to my freinds car, i hopped my way out.

Everbody seemed utterly confused and had no real idea what to do,it was a total flap-fest.I pretty much had to tell them all what was going to happen.

Im fully aware I climb and boulder at my own risk, but i do think places such as this should have some sort of procedure that they should follow following a fall, as it is a high risk of injury.



In reply to dapperdan:

> Im writing this post to highlight my concern about lack of training of staff at indoor walls / sportcentres.

> Today I fell off a boulder problem and broke my ankle at a local wall. Everybody I dealt with immediatly after was shockingly incompetant to be frank.

> I was asked to wait for first aid (shouldnt wall operators / instructors be first aid trained?), wich culminated in a bag of water (not ice) being pressed on the ankle, after wich i was asked to fill in a form...give me a break

They did...
dapperdan - on 22 Dec 2013
In reply to Submit to Gravity:

ahar
In reply to dapperdan:

I don't think that in general, businesses are obliged to provide first aid to customers. Clearly, in a venue like a climbing wall it would make sense. It's certainly not good PR to deal with these things unprofessionally.

Hope you're on the mend soon.
highclimber - on 22 Dec 2013
In reply to dapperdan:

I could understand your concern if you were having a heart attack or a seizure but you twisted your ankle (which may or may not have been broken)and you expected everyone with a first aid certificate, who may or may not be busy looking after the safety of someone else, to come to your asistance? Nice try.

dapperdan - on 22 Dec 2013
In reply to highclimber:

Thats not what i said atall, nice try yourself. I certainly would not expect EVERYBODY with first aid to attend, but i would expect SOMEBODY in the vacinity to have it, and i would expect said person to act accordingly.

I did not twist my ankle, i fell on it, and it WAS broke. I was unnable to walk on it, and had it been a sprain or otherwise i would still have the same complaints.
In reply to dapperdan:
Sorry to hear about it. Often a break is way better than a bad sprain. That aside, what is it that you describe as "acting accordingly" that they should have done but did not do? I'm not sure walls should have ice just in case someone crocks their ankle, unsure what your beef here is. Sure, the form is annoying, but unfortunately bizarre H&S is part of life. As for a wheelchair, I don't think it is acceptable to expect walls to have one. Where do you draw the line? Full spinal collars for possible spinal injuries (e.g. from a fall from height) and people trained to use them? Oxygen cylinders and people trained to use them? Morphine and people qualified to administer it?

Hope you recover speedily mate.
Post edited at 20:36
highclimber - on 22 Dec 2013
In reply to dapperdan:

> Thats not what i said atall, nice try yourself. I certainly would not expect EVERYBODY with first aid to attend, but i would expect SOMEBODY in the vacinity to have it, and i would expect said person to act accordingly.

> I did not twist my ankle, i fell on it, and it WAS broke. I was unnable to walk on it, and had it been a sprain or otherwise i would still have the same complaints.

Do you have X-ray eyes?
dapperdan - on 22 Dec 2013
In reply to nickinscottishmountains:

Its not just a wall, its a gym, pool, wall, courts. The lifeguards are first aiders, they have to be, but the people looking after the wall are what? climbers? Of course they should have first aid gear, its basic, especially in a gym where sprains are commonplace.

I get what you mean about bizzare H&S, but to me, for the staff to think "somebodys hurt, what do we do?" is beyond bizzare.
dapperdan - on 22 Dec 2013
In reply to highclimber:

yes
In reply to dapperdan:
Fair enough. But having a qualification does not make people immune to being rabbit in headlights when something happens. Even in places like hopsitals after years of training, let alone after a 2 day first aid course.
You have now twice mentioned medical gear - what gear did they lack that you are clear they needed? To be clear, I'm not arguing with you, I'm genuinely puzzled, that's all mate.
Post edited at 20:54
dapperdan - on 22 Dec 2013
In reply to nickinscottishmountains:

fair point about the wheelchair, i think as itis a council owned place i just expected abit more. My mate was also fairly shocked at the response, so its not just me being angry.

thanks for your comment.
dapperdan - on 22 Dec 2013
In reply to nickinscottishmountains:

yes your right about the gear comment mate. out of 5 people none knew what to do, and i had to sort myself out. that i think is my main complaint. In a supermarket you expect it, but in a climbing hall you expect more, well i do anyway.
alexgoodey on 22 Dec 2013
In reply to dapperdan:

I've worked at a wall and had no training in first aid there, but as a first aider, I'd personally get stuck in and make you comfortable then get you off to hospital by lifting you to a car. It's not life-threatening but very painful and potentially stressful/frightening (irrespective of age) and the care and wellbeing of you as a customer should come first.

There's a lot of science behind H&S rules on first aid, much of it done on cadavers in the 50s and 60s to look at head and spinal injuries during car accidents. likewise, the provision of defibrillators is based on probability of heart attacks within groups of people of a certain size (which is why you find them at train stations and supermarkets). Ultimately, the first aid provision for a climbing wall, where there's a high risk activity but the majority of risks are mitigated by safety equipment (and experienced staff) would reduce the requirement for first aid provision to the very lowest level.

I don't disagree with your sentiment, but there's method behind the madness.

And now the devil's advocate bit: Did you land on the mat awkwardly? Could you stance have been the fault? Are you a clumsy twerp? Is there any chance you might have osteopenia (early on-set osteoperosis)?

In all seriousness though, from a purely medical standpoint, I hope the break as as clean as possible so it knits together nicely and you're not left with any lasting problems or a long recovery.
alexgoodey on 22 Dec 2013
In reply to dapperdan:

reading more of the above.. yeah, I got kicked in the eye in April at a council leisure centre and was temporarily blinded - very frightening - they gave me an ice pack and a blank look, expected me to get myself to hospital.

yes, blind in one eye and very scared / stressed. Hopeless. Never been back since (eye was fine within a few weeks, the NHS were f*cking brilliant.
splat2million on 22 Dec 2013
In reply to dapperdan:

I used to work at a council leisure centre a few years ago. I agree and think it is perfectly reasonable to expect to be attended by a first aider if you injure yourself at a sports centre. Customers in sports centres are exposed to a degree of risk and so they should provide adequate provision for first aid.
Places with pools should have equipment and staff able to provide full spinal immobilisation (paramedics are not trained to do this in water). I once went to an ice rink that had O2 and people able to administer it (although this might be going a bit far). Almost all these places have AEDs and staff trained on them too.
A dedicated climbing wall is probably different as the frequency of injuries is probably comparatively small, but as part of a sports centre I think you have the right to expect better.

You should send some written feedback to the management, these centres usually take things like this quite seriously and unless you tell them they won't know you are unsatisfied.
dapperdan - on 22 Dec 2013
In reply to alexgoodey:

thanks for the decent reply.

yes its a clean break and should heal between 4 and 6 weeks. It is completely my own fault, i swung off a boulder problem and so landed awkwardly. the A&E were brilliant, ( I love the NHS) Hopefully you can see what im driving at, and i personally think ppl who work at walls should know what to do if somebody is injured, its basic.

Dan.
dapperdan - on 22 Dec 2013
In reply to splat2million:

thanks for the feedbac, i will do exactly this.
Orgsm on 22 Dec 2013
In reply to dapperdan:

What dud you have to sign?

Dax H - on 22 Dec 2013
In reply to dapperdan:
Considering it is the law that companies have to have X amount of trained first aiders per X amount of staff I find it hard to believe that they have no duty to the public.
ads.ukclimbing.com
Simos on 22 Dec 2013
In reply to dapperdan:
I am actually amazed that not everyone is expecting some basic first aid knowledge (don't really care about certifictions though it might be the only practical way of guaranteeing it) and kit at climbing walls, assuming this is a commercial climbing wall of course.

Is that too much to ask for? You spend 1000s on building a wall and then are too stingy to spend 40 quid on a first aid kit, including (please don't be shocked), ice! Does that make sense? To be honest I'd be worried about other safety aspects of the wall if they can't get right even such a simple, basic thing.

And YES, I should sure hope that if I had a spinal injury at a wall AT LEAST someone from the staff should not at least what NOT to do. Is that too much to ask for? Not exactly expecting doctors to perform surgery here, just some basics that will, sooner or later, prove helpful to someone's health.

Anyway rant over :-) hope you get well soon mate!
Post edited at 22:39
Andrew Wilson - on 22 Dec 2013
In reply to alexgoodey:

This sounds like you were minding your own business and got kicked in the eye, whilst at a council leisure centre.
Is that what happened? Or were you participating in a sport of some kind?

Andy.
highclimber - on 22 Dec 2013
In reply to Simos:

I think what people expect vs what actually happens whene incidents like this occur differ very wildly. If it was me that was injured (and indeed I have done the same - only mine was sprained but no less painful) I would ask for assistance - I wouldn't care who it is, I would have the duty manager informed so they can fulfil their H+S requirements and I would either get myself to a hospital or ask for an ambulance to be called.

Then there are those who expect to everyone to stop and see to them, expect the emergency services to be called and then probably, though I'm not say the OP will, put a No-win-no-fee claim in.

dissonance - on 22 Dec 2013
In reply to dapperdan:

> I was asked to wait for first aid (shouldnt wall operators / instructors be first aid trained?)

Generally no. Only some will be first aid trained since it costs (both directly and in terms of lost time) for staff to be first aid trained.
So only a few at a time would be. Although would tend to expect climbing walls to have more first aid trained staff simply because they are more likely to have ones who freelance in roles which require it.
In addition majority of first aiders wont really be that well trained. I was chatting to a friend a bit ago who is one of the office first aiders. The training really comes down to get an ambulance and then, if its really bad, try and help prior to it turning up.

Anyway, leaving that aside. Hope it heals quick.
NicholasHart - on 22 Dec 2013
In reply to dapperdan:

As far as first aiders at walls goes, if I recall correctly it is a requirement of both the SPA and CWA that the instructor holds a valid first aid certificate
1poundSOCKS - on 22 Dec 2013
In reply to dapperdan: A friend of mine fell off a boulder problem at Boulders in Cardiff and landed badly. He was lying awkwardly and couldn't feel his legs. The staff were great, and although they couldn't do anything for him medically, an ambulance was called out quickly and he was taken to hospital. He was getting feeling back and moving his toes by this time, but it was obviously worrying. I only knew him from the wall, so I never found out how he got on, and I'm not in Cardiff anymore.

Andrew Wilson - on 22 Dec 2013
In reply to Simos:

The 3 day "first aid at work" course now does not show you how to treat suspected breaks. The job of the first wider is to prevent further injury where possible (ie stop bleeding), keep the brain supplied with oxygen if unconscious and not breathing, treat LIFE THREATENING conditions such as heart attack, stroke or shock.
In your case I would have expected the staff to have established that you were in a lot of pain and unable to bear weight on your ankle and offered to call you an ambulance. I presume at this point you would have said you had a lift so assistance to the car would be nice but in today's blame culture very risky.
I don't understand what you think the staff did not do, that you think they should have?

Andy
Simos on 22 Dec 2013
In reply to highclimber:

Ok so if you did (touch wood) fell from height, had a spinal injury and because of the way staff handled you, you ended up with a much bigger problem you would have no claims against the climbing gym?

You might think that a spinal injury is different that OP's injury but ignorance is ignorance and if you don't know what to do in one case, you won't know in the other either.

By the way I did have an injury at the wall and didn't even say anything to staff (which i m sure would have helped), i just drove myself to A&E because I could; so I am not the type to make a fuss. But I also had another 2 incidences where I broke bones at exercise venues and needed help so these things unfortunately happen so if a business wants to be taken seriously, in my opinion they should ensure the basics at least.

Of course if you are a business, since as far as I know there is no legal obligation to provide this 'service', you perversely might even be risking more if your staff actually do try and help in such cases.

Anyway I guess it depends on your expectations - for me paying and going to a gym is not the same as hiking up a mountain on my own but everyone's different I guess. Equally when I am sending my son to the pool for example I'd expect a bit more from the venue than if I had sent him by himself to the sea for a swim.
Simos on 22 Dec 2013
In reply to Andrew Wilson:
Totally agree, I too think that this is their obligation. Know how to prevent further injury, be able to assist (including calling for an ambulance) if you are not in a position to do it yourself AND have the basic kit.

Preventing/minimising further injury does imply a basic kit and knowledge...

Ps I am not the OP. I don't think that in this case it would have made a big difference in the injury (luckily for the OP) but similarly I don't believe in waiting for a disaster to happen to highlight issues. To me not even having some basic kit shows me that they would have also been unable to stop bleeding if they had to and help anyone in general.

Also hopping to the car on a broken ankle without staff help (if I read it right) sounds a bit poor to me and not exactly the best idea in the world
Post edited at 23:13
syv_k - on 22 Dec 2013
In reply to dapperdan:

I have had only good experiences with First Aiders at a large climbing wall.

First incident - a guy climbing in my party felt unwell and then fainted (if you're going to faint anywhere, on a top rope is a good choice - you can be lowered down to a mat and not hurt yourself!) and a wall first aider checked out that he was recovering OK, said that we should take him home and gave him a refund on his entry fee.

Second incident - I fell awkwardly when bouldering and managed to bite all the way through my bottom lip. A first aider attended with a big bag of dressings to help stop the bleeding, told me I would need A&E, called me a taxi with my agreement, and went through an accident report in a sympathetic and practical manner. I noticed that they also had cold packs.

It's not an essential part of the entry fee, but it made me have a good feeling about the wall and its management and more likely to recommend it to others. Good service, you know? It is the Castle in London btw.
Otis - on 22 Dec 2013
In reply to dapperdan:

That's a pretty shocking experience and I hope you mend quickly.

As a business, the leisure centre are obliged to have trained first aiders there-for the staff, even if not the punters! I'm pretty shocked that there was nobody there with a clue-especially given the relatively high risk posed by a climbing wall (At my office we are legally obliged to have trained first aiders-despite the biggest risk probably being a paper cut!!!).

It your accident had happened on my watch the treatment would have been simple: immobilise your ankle, keep an eye on you and wait for the ambulance I'd called. Nanny state? Possibly-but that's what the current first aid at work training drills into you.

Anyway, on the plus side.... At least you get to sit on the sofa and be king of the remote control over crimbo! Get well soon!

Mike
tiffanykate12 on 23 Dec 2013
In reply to dapperdan:

I work at a climbing wall within a sports centre - all staff have First Aid qualifications as we're all CWA qualified or above (or at the very least trained).
However, the sports centre does not permit us to administer first aid, instead requiring us to immediately go to the centre First Aid officers. This is fair enough from a business point of view, but whenever an accident occurs we do not hesitate to administer at least basic first aid until the officers arrive, regardless of what our 'superiors' prefer.
We're trained, we use that training - we wouldn't just ignore it.
But we're only trained because we're required to be minimum CWA. Others walls with Site-Specific often won't have this as a requirement.
Not good, but not uncommon.
MischaHY - on 23 Dec 2013
In reply to dapperdan:
IIRC 'First Aid at work' courses don't cover things like simple break management and how to properly move a casualty with suspected/confirmed breaks anymore. My first aid qualification is the proper mountain based 16hr one, and naturally deals with issues like yours in a realistic fashion, as it is an entirely possible/probable happening if you work in the outdoors for long enough. Ironically, my first aid qualification would not be valid in, say, an office.

I'd say it does seem slightly silly that nobody cared for you in a fully professional way, but also this does seem like a bit of a needless whinge. If you're basically fine then get on with your life and let the climbing wall deal with it.
Neil Williams - on 23 Dec 2013
In reply to MischaHY:
In Scouting we are generally told we should call an ambulance for anything even vaguely serious. A broken ankle would certainly be such a case, as cack-handed patient transport could certainly cause complications. So the wall staff should probably have made you as comfortable as possible and then called an ambulance for you rather than trying to move you to your friend's car.

I will back this up given that a broken finger resulted in me being taken in in an ambulance having gone into shock and ended up with very low blood pressure. Would your friend have known how to deal with this? Could it have caused a car accident?

As for the paperwork, it's hard to blame them given how much people get sued these days, and given that most adults wouldn't be conscientious enough to go back and fill it in later, particularly if they didn't visit that wall often. (If regulars, one option to ensure its completion would be to suspend membership until completed).

Neil
Post edited at 11:24
Howard J - on 23 Dec 2013
In reply to dapperdan:

Businesses are responsible for the health and safety of their employees and also of any visitors to their premises. This includes making appropriate first aid provision. The number and training of first aiders will depend on a number of factors, including the number of people at the premises and any particular risks they might face. Similarly, the contents of the first aid kit may vary to deal with specific hazards. The requirements for a remote location may also be different from one in an urban centre with professional help only a few minutes away.

The wall, like any businsess, should have a first aid kit and it should have qualified first aiders. That is not the same as saying that all its staff should be nominated first aiders (although they may have first aid training as part of their instructor qualification).

They don't seem to have handled it very well, but even after first aid training it's easy to panic when faced with an actual casualty. That said, it's hard to see what else they might have done in your particular circumstances. First aid training is mostly about not making things worse, and keeping the casualty comfortable until either professional help arrives or they can get themselves to hospital (or recover). As you were able to get yourself to hospital the question of moving you didn't arise - if your injuries had been more serious they should have called an ambulance rather than try to move you themselves.
Choss on 23 Dec 2013
In reply to dapperdan:

For a broken ankle, shouldnt first aider call for an ambulance anyway. Risk of Irreversible shock, etc?
Andrew Wilson - on 23 Dec 2013
In reply to Choss:

The OP has not confirmed if he was offered an ambulance or not.
Neil Williams - on 23 Dec 2013
In reply to Choss:

Exactly my point. I was shocked (ha!) at how far what was essentially a minor injury, a broken finger, got. And I imagine being a first aider myself helped, even if lying on the floor with my feet on a bench on a canal towpath (got too faint if I tried to stand up or sit on the bench) while calling myself an ambulance made me look rather silly!

If I'd tried to carry on there's a good chance I'd have fainted, fallen in the canal and drowned.

Neil
Neil Williams - on 23 Dec 2013
In reply to Andrew Wilson:

True. If one was offered and the OP declined, it's entirely reasonable that the wall should wash their hands of him rather than being willing to help carry to the car given how they would still get sued in the event of complications.

If they didn't offer one, they IMO should have.

Neil
maxsmith - on 23 Dec 2013
In reply to dapperdan:

I had a similar experience when I dislocated my knee at a (leisure centre) climbing wall.

I popped the patella back in, which was a mistake because the guy in charge then refused to believe I had dislocated my knee.

He didn't offer any ice/first aid so I limped off and drove myself to hospital one-legged...

Ignore all the nay-sayers - immediate ice should be an absolute minimum requirement of any climbing wall.

It massively speeds up the recovery time of most injuries and I still have cause to regret not being given it many years on.
hang_about - on 23 Dec 2013
In reply to dapperdan:

That sounds appalling. Having seen someone deck from the top clip of a climb at the Foundry I was extremely impressed at the speed and efficiency with which help came - staff were there in seconds and knew what to do. Obviously well practised which is how it should be. Best wishes for a quick recovery.
Choss on 23 Dec 2013
In reply to Neil Williams:
Suspected broken ankle, wall first aider should have insisted on an ambulance i reckon. I would have led Casualty Flat on Floor, leg elevated on chair. Ice on ankle, any painkillers, inflammatories available, then monitor and wait for ambulance.

Sounds like wall incompetent to me.
Post edited at 12:07
Neil Williams - on 23 Dec 2013
In reply to hang_about:

"someone deck from the top clip of a climb at the Foundry"

What was the belayer doing, I wonder?

Neil
Neil Williams - on 23 Dec 2013
In reply to Choss:
The wall first aider doesn't have any right to insist that any adult does anything, other than by banning them from the wall in future and refusing any further assistance if their advice is not followed.

But I agree it should certainly have been strongly suggested, or even called anyway, and it does sound like they didn't handle it well.

Neil
Post edited at 12:08
Doghouse - on 23 Dec 2013
In reply to Simos:
> (In reply to highclimber)
>
> > By the way I did have an injury at the wall and didn't even say anything to staff (which i m sure would have helped), i just drove myself to A&E because I could; so I am not the type to make a fuss. But I also had another 2 incidences where I broke bones at exercise venues...
>
>


Are you accident prone? :-))
hang_about - on 23 Dec 2013
In reply to Neil Williams:

>What was the belayer doing, I wonder?

I wouldn't want to speculate as I just heard a scream and then saw them hit the ground. Fortunately the guy seemed to survive without serious injury and left (walking) in an ambulance. I imagine words were had!

Fraser on 23 Dec 2013
In reply to Choss:

> I would have led Casualty Flat on Floor, leg elevated on chair. Ice on ankle, any painkillers, inflammatories available, then monitor and wait for ambulance.

With that injury, I'd probably not have done that. A suspected broken ankle and you lay them on the deck then elevate the broken ankle up to chair level? I'd have used something soft-ish to support the full lower leg, but only elevated it slightly. As a first responder, you shouldn't administer pain killers of anti-inflamatories. (I know you didn't say 'administer' them but the implication was there)

As has been said before, any business should have a suitable number of trained staff and should have procedures in place for such eventualities. Given that it's a climbing wall, the likelihood of visitors getting injured is relatively high, so they shold be more prepared than most for what happened.

To the OP: hope you mend soon!
Choss on 23 Dec 2013
In reply to Fraser:

Im only a lay first aider. While waiting for ambulance for Someone with a broken arm earlier this year, ambulance controller on Phone asked if we had any Aspirin, Paracetamol, or ibuprofen to Hand. Said yes should i give them some. Oh yes was the Reply.
HAL9000 - on 23 Dec 2013
In reply to dapperdan:

From HSE website......http://www.hse.gov.uk/pubns/indg214.pdf

Under the Regulations, you have no legal duty to provide first aid for non-employees, but HSE strongly recommends that you include them in your first-aid provision.

Choss on 23 Dec 2013
In reply to HAL9000:

But being a qualified first aider you have a duty of care, and could be Liable for failing to help any Member of the public who is a casualty in danger?

"Whilst there is no law that forces anyone to treat a casualty this does not mean that one can simply leave a casualty who you know is in danger.  To do so may make you liable through your omission to act"

Is this correct? Anyone Know?
highclimber - on 23 Dec 2013
In reply to Choss:

> But being a qualified first aider you have a duty of care, and could be Liable for failing to help any Member of the public who is a casualty in danger?



> Is this correct? Anyone Know?

Bollox. If you were a nurse or a doctor, maybe you would be professionally obliged to help but there is not legal requirement to help someone - just an ethical one.
Choss on 23 Dec 2013
In reply to highclimber:

We were taught exactly that on first aid at work course about 12 years ago, and the quote you left out was lifted From current Legal Advice for first aiders.

How do you Know Better then?
highclimber - on 23 Dec 2013
In reply to Choss:


> Suspected broken ankle, wall first aider should have insisted on an ambulance i reckon. I would have led Casualty Flat on Floor, leg elevated on chair. Ice on ankle, any painkillers, inflammatories available, then monitor and wait for ambulance.



For a *suspected* broken ankle, there is no need to insist on an ambulance if the patient can get there via other means. It's not the first aider's call as to whether an ambulance is necessary. I'd be pretty miffed if some jobsworth First aider insisted I went in an ambulance for a suspected broken ankle and I don't think the Ambulance people would be too impressed if there were other menas for them to get to A and E.

> Sounds like wall incompetent to me.

How can you determine the Whole wall is incompetent from one person's biased testimony on the events. For all we know there were three kids parties going on and every available staff member was already busy.
highclimber - on 23 Dec 2013
In reply to Choss:

well, for one your first aid is 9 years out of date if you've not renewed it, that is. secondly, this:


Under the Regulations, you have no legal duty to provide first aid for non-employees , but HSE strongly recommends that you include them in your first-aid provision.
Choss on 23 Dec 2013
In reply to highclimber:

Your first Point - fractures can Lead to shock and Death. Delayed shock can occur go Transit to hospital, ambulance crew Better to negate that risk i believe.

Second Point - if i were Running a wall, it would have enough staff to cover, and a customer with suspected broken bones should Take Priority over a Kids party.
Choss on 23 Dec 2013
In reply to highclimber:

Yes, at work.

But by being a qualified first aider you can in theory be liable for failing a duty of care if you Leave any casualty you Know to be in danger.

Thats what i Understand, and was seeking clarification.

Bollox doesnt convince me Otherwise.
highclimber - on 23 Dec 2013
In reply to Choss:

The fact that a climbing wall IS a place of work and customers ARE non-employees doesn't convince you that you don't have a legal responsibility to provide first aid to them? I've no idea what will.
Choss on 23 Dec 2013
In reply to highclimber:
> The fact that a climbing wall IS a place of work and customers ARE non-employees doesn't convince you that you don't have a legal responsibility to provide first aid to them? I've no idea what will.

The WALL as a company may not.

But, any first aid qualified EMPLOYEES, could find themselves PERSONALLY liable for failing a duty of care to a casualty on Site who is in danger.
Post edited at 13:49
In reply to dapperdan:

I think I summarised this at 20:00 last night and you're still all bloody arguing!
highclimber - on 23 Dec 2013
In reply to Choss:

Prove it, if this is indeed what you believe, prove it.
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highclimber - on 23 Dec 2013
In reply to Choss:
> could find themselves PERSONALLY liable for failing a duty of care to a casualty on Site who is in danger.

You appear to be talking about an incident that is yet to occur rather than an incident in hand. so, which is it? yes, everyone has a duty of care to prevent injury where it is possible to do so but there is no requirement, legally, for a first aider to provide assistance.
Post edited at 13:52
Choss on 23 Dec 2013
In reply to highclimber:

If there is a casualty on Site, i think its safe to say an incident has already happened, dont you?
highclimber - on 23 Dec 2013
In reply to Choss:

So are you talking about providing first aid to that person or preventing FURTHER injury from something other than their symptoms?
dpm23 - on 23 Dec 2013
In reply to Choss:

Just my two pence worth:

A first aider at work would have a duty to assist as that forms part of their role. Any other medical professional (or first aider who happened to be there as a member of the public) has no legal duty to interven but we often will because we are nice people. If we do interven, then we must act within the limits of our knowledge and training. If we don't, or we screw it all up, we can be held accountable (don't think that this applies to first aiders, just registered health professionals).

First aiders should not be giving any form of medication to people. If you call 999 and are told to give some painkillers, fine. But I don't think that painkillers should form part of your first aid kit.

Ice and elevation (chair/boldering mat) will be fine and probably make the patient more comfortable. Ambulance - depends on the patient. Some will be mortified at the thought of an ambulance being called, others may be very grateful. And, of course, all fractures/potential fractures are not equal. If the ankle is just swollen, still facing the right way, no bones sticking out etc. and not going blue, then there is no great worry. Emotional shock caused by pain can cause a drop in blood pressure but you would have to have some pretty major underlying health problems for this to be serious.

If the OP had a mate to drive them to hospital or a minor injuries unit, then on the information available, that would be perfectly safe.
highclimber - on 23 Dec 2013
In reply to dpm23:
My point is that there is not LEGAL requirement for this to be so as Choss believes according to something he was told 12 years ago.



> A first aider at work would have a duty to assist as that forms part of their role. Any other medical professional (or first aider who happened to be there as a member of the public) has no legal duty to interven but we often will because we are nice people.
Post edited at 14:03
Choss on 23 Dec 2013
In reply to dpm23:

Thatll do for me. Cheers.
highclimber - on 23 Dec 2013
In reply to Choss:

But that doesn't really fully verify your statement:

> But being a qualified first aider you have a duty of care, and could be Liable for failing to help any Member of the public who is a casualty in danger?
dpm23 - on 23 Dec 2013
In reply to highclimber:

Agreed, there is no legal duty to provide a qualified first aider under current H&S law to non-employees. So the use of 'duty' in my earlier post is definitely my view of the responsibilities of a professional fitness centre/climbing wall in ensuring that their first aiders offer assistance to anyone requiring help on their premises.
Choss on 23 Dec 2013
In reply to highclimber:

It does seem to. Ill Leave you to it on here now. Back to pussy riot thread for me :-D
dpm23 - on 23 Dec 2013
In reply to highclimber:

It's outside my area of knowledge as to whether a first aider at work (or their employer) would be legally responsible for a failure in adequate care, or no care, being given. I am not sure that the lack of a specific H&S law saying they are responsible for providing some first aid care to non-employees negates any possible legal action against them.

Anyone a H&S lawyer?
highclimber - on 23 Dec 2013
In reply to dpm23:

I suppose it depends on the nature of the claim.

> It's outside my area of knowledge as to whether a first aider at work (or their employer) would be legally responsible for a failure in adequate care, or no care, being given. I am not sure that the lack of a specific H&S law saying they are responsible for providing some first aid care to non-employees negates any possible legal action against them.

> Anyone a H&S lawyer?

As far as I know, there are no cases (and certainly none that have been to court) of a first aider being prosecuted for either providing bad first aid or not providing any for whatever reason.
Neil Williams - on 23 Dec 2013
In reply to Choss:

It is perfectly reasonable to delegate the decision whether an ambulance is needed to 999 if there is a good chance one might be.

"fractures can Lead to shock and Death. Delayed shock can occur go Transit to hospital"

Exactly.

Neil
boriselbrus - on 23 Dec 2013
> Ice and elevation (chair/boldering mat) will be fine and probably make the patient more comfortable. Ambulance - depends on the patient. Some will be mortified at the thought of an ambulance being called, others may be very grateful. And, of course, all fractures/potential fractures are not equal. If the ankle is just swollen, still facing the right way, no bones sticking out etc. and not going blue, then there is no great worry. Emotional shock caused by pain can cause a drop in blood pressure but you would have to have some pretty major underlying health problems for this to be serious.

No, no, no. Do NOT elevate it. It's possible the patient won't let you move it anyway and if you try he'll possibly punch you. If the fracture is stable then you just support it. Moving it could well dislodge the bones causing extreme pain, and maybe even parts of the bones to then protrude through the skin or even into an artery. You also don't know of course if the bone has already broken a major blood vessel.

A broken bone is an ambulance job unless there is a very good reason not to, or it's something like a finger where there is no major blood vessel next to it.

Oh, and forget the legal argument. No first aider has ever been successfully sued in the UK for either providing treatment or failing to do so. The law recognises that even a trained first aider generally has no practical experience and so it's unfair to place any expectations on them. Plenty of well trained first aiders completely freeze when presented with an incident and to sue them for being human would be unreasonable.
splat2million on 23 Dec 2013
In reply to boriselbrus:

Ambulance for a broken ankle is almost always overkill. If it is open (this includes any potentially deep wound over the fracture site, not just bones sticking out through the skin) or dislocated (this will be obviously deformed) then an ambulance is indicated as these are potentially limb-threatening injuries. These are rare.
If pain prevents any movement of the ankle and therefore the patient then an ambulance is necessary in order to give analgesia and transport. These are the injuries that are unstable.

Everyone else should get a lift to hospital (or minor injury unit if they have x-ray) with a friend or a taxi (and not drive themselves - even a sprained ankle invalidates your car insurance). Ambulances are for life and death.

Just to touch on "fractures can Lead to shock and Death. Delayed shock can occur" - I do know what you mean, but you will never bleed to death from a closed ankle fracture if that is your only injury. A closed fracture of the tibia (in the lower leg further up than the ankle) might lead to the potentially limb threatening compartment syndrome but this will be exceptionally painful and therefore pain will prevent "movement of the ankle and therefore the patient" so by my advice above will have already been sent to hospital.
dpm23 - on 23 Dec 2013
In reply to boriselbrus:

I agree that a first aider, acting in good faith to provide care for a member of the public injured in their place of employment, will never see the inside of a court room for doing so. Whether their employer could if a really bad decision is made is what I was not sure of.

Other than that, splat2million echoes my view. Unless the ankle is obviously deformed because of a fracture or dislocation, then an ambulance is very rarely truly required. It is often very difficult to differentiate between a bad sprain or a fracture without an x-ray, so a trip to the local A&E or minor injury unit is a good idea if the pain is severe, there is a lot of swelling, or the patient cannot walk a even a few steps on it. A mate and a car is fine for this. Other than that: rest, support, ice, compression bandage and elevation - get yourself home and continue (with some over-the-counter pain relief).
Neil Williams - on 23 Dec 2013
In reply to splat2million:

"Everyone else should get a lift to hospital (or minor injury unit if they have x-ray) with a friend or a taxi (and not drive themselves - even a sprained ankle invalidates your car insurance). Ambulances are for life and death."

Out of interest, what reference/qualification leads you to say this categorically, or is it just your opinion? As I said upthread, Scout First Response training *does* suggest calling an ambulance for such injuries, particularly if you don't have a second adult to either drive or be (qualified) first aider in the car.

The way it is put across is that the dispatcher can decide from a description whether an ambulance should be dispatched, or a response car, or nothing at all, based on your description of a situation that *may* need one.

Notably this is NOT for child safeguarding reasons, as you could take additional young people e.g. a couple of the injured kid's friends or a non-qualified non-driver adult with you to avoid a one to one situation. It's because of the possibility of things getting worse, as it's outwith the remit of a basic First Aider to diagnose, even more so if the driver is the first aider as this might present a road safety issue if they are distracted or have to stop quickly to deal with a worsening of condition.

Prior to recent courses I'd have said the same, ambulances are for things involving unconsciousness or for injuries where moving the patient might cause serious complications e.g. spinal injuries, or where the patient getting to hospital in 5 minutes might save them when getting there in an hour probably won't. But this isn't what is taught now.

Neil
Post edited at 23:05
Oceanrower - on 23 Dec 2013
In reply to Neil Williams:

Is it possible that Scout first aid training is directed at, err, Scouts?

Not adults in the workplace?
Neil Williams - on 23 Dec 2013
In reply to Oceanrower:

Yes, of course it is, and so we might well be more paranoid than an adult customer of a climbing wall. But as most climbing wall staff aren't trained as youth leaders, they might well handle a child injury the same way, no?

Neil
Oceanrower - on 23 Dec 2013
In reply to Neil Williams:

No. It's possibly more likely that a scout will be told to leave well alone and to call an ambulance whereas an adult might be given a bit more responsibility.

And it's a little unlikely that a scout will be driving anyone to A&E
Neil Williams - on 23 Dec 2013
In reply to Oceanrower:

To clarify, a First Response course is the basic 1 day course that all appointed Leaders in Scouting must do, though other assisting adults are not required to do it.

It is not a course the actual kids do.

Neil
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Oceanrower - on 23 Dec 2013
In reply to Neil Williams:

Ah, ok. I misunderstood.

When you said Scout First Responder training, Ithought you meant the first aid training you give to scouts.

Apologies.
splat2million on 24 Dec 2013
In reply to Neil Williams:

This is my opinion as an A&E doctor. There isn't any significant research about it to my knowledge - there has been very little research in to first aid.

It is totally understandable for Scout basic first aid training to encourage people to call an ambulance for a suspected broken limb. A 1 day course should teach CPR and choking and not much else so cannot adequately teach management of a broken or sprained limb (nor should it divert time away from teaching about life threatening problems!). This gives a safe approach and I would not seek to change this for people with very limited training, but it will be overcautious compared to more advanced first aid.

My opinion is what I think should be done by a competent first aider with decent first aid training. I do understand that people with less experience and training will tend to call for help for less serious problems - but the answer is to do more training to acquire more knowledge!
kipper12 - on 24 Dec 2013
In reply to dapperdan:

If you genuinely want to know what the legal obligations are, you should try the agency with enforcement authority. It will probably be your local authority, but may be the HSE.

It does appear odd that no one appeared to be first aid trained, but it may be there is no legal duty.
MikeYouCanClimb - on 24 Dec 2013
In reply to Simos:

>And YES, I should sure hope that if I had a spinal injury at a wall AT LEAST someone from the staff should not at least what NOT to do. Is that too much to ask for? Not exactly expecting doctors to perform surgery here, just some basics that will, sooner or later, prove helpful to someone's health.

Some would say you are making assumptions, others would say you do NOT NOT make sense. Maybe you want to come accross as emotional, perhaps angry and negative or maybe by SHOUTING you think you are more likely that you will be understood as right.

I would say in a soft voice that Ignorance can be bliss.


Scott K - on 24 Dec 2013
In reply to dapperdan:

There is no legal duty to have a first aider, but in this case, the employer would be expected to carry out a risk assessment and have a reason why no first aider is required (if they have more than 5 employees). At a sports venue you would have to assess the potential accidents your customers could have as well-there is a duty of care to them. I would expect a sports club to have a first aider at all times and a procedure to follow. It is also up to the employer to decide what equipment is required for the site.
Simos on 24 Dec 2013
In reply to MikeYouCanClimb:

I would also say in a soft voice that how I come across is irrelevant to the point made here. Instead on focusing on how I come across you could perhaps tell me which bit doesn't make sense so that we can discuss it.

Simply saying that someone doesn't make sense without explaining why doesn't make sense to me.

Back to the point that didn't make sense to you; if someone had a serious injury at a wall, do you not think that the staff should know what to do and have some basic first aid kit available?
highclimber - on 24 Dec 2013
In reply to Simos:


> Back to the point that didn't make sense to you; if someone had a serious injury at a wall, do you not think that the staff should know what to do and have some basic first aid kit available?

Yes they should but the discussion is whether they have a legal obligation or not. It was pronen earlier that they don't.
Simos on 24 Dec 2013
In reply to highclimber:

I made the point too that they don't - I believe only pools (for some reason) do. However I also think it would depend on the case and should a serious case was to go to court the outcome would really depend on the facts.

I don't think the original point was about the legal obligation - it was about the OP's concern on the lack of procedures/competence at a climbing wall. The law often defines the bear minimum of what is acceptable (in the eyes of the law) but you will find that if companies (and people) operated simply on the basis of what is expected by law, they'd either go out of business very quickly or we'd be living in a much worse society.
mikehike on 25 Dec 2013
In reply to Andrew Wilson:

> The 3 day "first aid at work" course now does not show you how to treat suspected breaks. The job of the first wider is to prevent further injury where possible (ie stop bleeding), keep the brain supplied with oxygen if unconscious and not breathing, treat LIFE THREATENING conditions such as heart attack, stroke or shock.

> In your case I would have expected the staff to have established that you were in a lot of pain and unable to bear weight on your ankle and offered to call you an ambulance. I presume at this point you would have said you had a lift so assistance to the car would be nice but in today's blame culture very risky.

> I don't understand what you think the staff did not do, that you think they should have?

> Andy

totally agree Andy.

It can be a difficult decision to call an Ambulance.
Some will call at the drop of a hat, others will take a lift and suffer, thinking that they are 'not wasting the services time'
PaulW - on 26 Dec 2013
In reply to dapperdan:

Seems to me that First Aid is what it says, FIRST Aid.

So stop you dying
Stop things getting worse
Help arrange for further treatment as appropriate.
Nothing beyond that at all.

If you are adult and conscious you can choose whether you need an ambulance or not. Good for you if you think you don't need one but wrong to criticise the centre for failing to have equipment. If it hurts too much too move from where you are then don't be impatient and just wait for an ambulance.
Simos on 26 Dec 2013
In reply to PaulW:
Not sure where you got that definition of First Aid Paul - seems to me that it should be the first aid you get as soon as the accident occurs. If the OP describes things accurately, he received No Aid, not First Aid.

There's no winning for the OP - if he calls an ambulance for this injury, I am sure many people will say he is 'wasting the services time'. If he doesn't, he is criticised for being impatient and not calling for an ambulance.

It's not always easy to think straight after breaking bones by the way - a lot of the time you think you can do things you shouldn't and other times you can't think straight from the pain. It's a lot easier if 'someone' that knows what they're talking about just takes control and helps you out. I am guessing this is what the OP refers to as having some procedure in place.

Most people have hardly ever broken any bones or been in such a situation - bit much to expect them to handle things perfectly in my opinion. Maybe it's not the centre's 'legal responsibility' to help out or administer first aid where needed, but I don't think it's too much to expect (to a reasonable degree) since such injuries are not uncommon at a wall.

By the way, most 'decent' climbing walls I've been to also seem to think so too as they're really well equipped and I've seen them deal with injuries/emergencies really well. Glad they don't stick to the absolute legal minimum, especially since these days in almost all the walls I go too there are regularly groups of very young kids climbing that I am sure would be totally helpless if something like this was to happen to them.
Post edited at 10:27
MikeYouCanClimb - on 26 Dec 2013
In reply to Simos:

>Simply saying that someone doesn't make sense without explaining why doesn't make sense to me.
Sorry, I used a bit of irony with a double not.
Read your own sentence again and see if it makes sense to you.


> "if I had a spinal injury at a wall AT LEAST someone from the staff should not at least what NOT to do"
This sentence is confusing, even if I guess the missing word!

> Back to the point that didn't make sense to you; if someone had a serious injury at a wall, do you not think that the staff should know what to do and have some basic first aid kit available?

Sounds to me like they did have a first kit available and they did know what to do. Maybe they did not reach your standards or that of the op in terms of speed or compassion etc but that is a different issue.

With respect to your hypothetical example of a spinal injury, then it is possible that a first aider would not be aware that a spinal injury existed at the time of the accident. If circumstances meant that such a possibility existed, then they would treat as suspected. The type of action that followed would be dependant on whether they are conscious or not, but either way professional help should be sought asap. The basic first aid kit which you refer to, would normally be of limited value in such a situation. If you don't know why, then I would suggest that first aid training would be a good idea for you or anyone.
xihan - on 26 Dec 2013
In reply to dapperdan:

A counter-example: I had a serious accident at an indoor wall near Paris a few months ago when my rope ripped my thumb off during a fall. The staff (and the whole gym) just stopped everything to lay me down, stop the bleeding, put ice (ok, frozen soup!), call emergency, and prevent my fainting. Just acting according to the book. So there are places where staff is competent and makes the accident as minimal as possible. (Just for the record, despite being rushed to the hand hospital in Paris in less than 45 minutes, I eventually lost the thumb. None of their fault.)
Ban1 - on 26 Dec 2013
In reply to xihan:

.?? Can you explain as graphic as possible how this happerend please.
donald6631 - on 26 Dec 2013
In reply to dapperdan:

>"Im writing this post to highlight my concern about lack of training of staff at indoor walls / sportcentres.

> Today I fell off a boulder problem and broke my ankle at a local wall. Everybody I dealt with immediatly after was shockingly incompetant to be frank."

I'm making no specific comment about an indoor wall, just a general observation, over many years of being told off by well meaning, clueless puppets.

I'm really not surprised at the total lack of training / experience / ability to see what was happening / intervene / make judgements for themselves. I know there are many experienced and sound 'instructors' working at these indoor, vertical gyms. However, many have no climbing qualifications and/or no climbing experience beyond 'site specific' ticks and only a notion of what climbing, even belaying is really about.

They have been put in place by risk averse managers, trained to point out bad practice (eh! you think thats bad practice!!) and, when the wheel comes off, haven't a clue. For this, they will charge you the earth to enter their premises and climb at your own risk. Mmm?

Don't be surprised at your finding. Don't go back, but get on some real rock, where the only rule is you do what you have risk assessed, not what some poor puppet instructed by the insurance company tells you....cause they don't actually know any better

Simos on 27 Dec 2013
In reply to MikeYouCanClimb:

That sentence should have read:

> "if I had a spinal injury at a wall someone from the staff should know at least what NOT to do"

I wasn't commenting much about this particular case - I wasn't there and if the OP is accurate, it didn't sound to me that they reached the standard at least I would expect.

The only way things will improve at some walls (i say some because most from the ones I've been to were pretty good) is if people actually have some expectations of standards - both in terms of safety but also general competence.

I happened to go to quite a few different walls recently and one was bad to be honest, you could tell by the moment you set foot in the place that all aspects (route-setting, competence of staff, safety) would be sub-standard to say the least.
oli.outdoors - on 27 Dec 2013
In reply to dapperdan:

Let's try a lateral thinking approach to this...

If you were outside what would you have expected? The full might of your local volunteer MR team or would you have reached for your pack of 'man up pills' and extricated your self to the road and ultimately hospital.

In short, Are you a self sufficient user of the outdoors or an individual is always happy to receive a big fuss, a pretty Mickey Mouse plaster and a tentative 'there-there'?
Simos on 27 Dec 2013
In reply to oli.outdoors:
Let's try a different approach :-) if your son went to the local pool to learn to swim and passed out while swimming, what would your expectation be? Why would it be different (assuming than it would be) than if he had gone swimming alone trying to cross the channel and passed out?

"Man up" is in my opinion the worst possible mantra for climbing - I am saying this because I saw this even kill people in another sport that has parallels with climbing. You can push yourself all you want but why should others be forced to do the same.

There are so many people that just go to indoors walls to try climbing these days. They are not seasoned climbers or mountaineers - why should they be? To them, it's just another activity like so many others - they pay a decent entry fee to an organised, commercial venue and I think they have the right to expect some basics to be in place. What they would do/expect outdoors (if they ever get to climb outdoors that is) is irrelevant - in fact, it's even the opposite; some people might enjoy climbing but want to do it in a safer and more controlled environment than outdoors, hence why they go to a climbing gym in the first place. It makes no sense to liken outdoors to indoors in this respect.
Post edited at 23:32
winhill - on 28 Dec 2013
In reply to Simos:

> Let's try a different approach :-) if your son went to the local pool to learn to swim and passed out while swimming, what would your expectation be? Why would it be different (assuming than it would be) than if he had gone swimming alone trying to cross the channel and passed out?

Swimming has a special element of rescue, not normally found at indoor bouldering walls.

There are many local authority run sports areas that are totally unsupervised (football pitches, playgrounds), there are even LA run climbing walls that are unsupervised, so the idea that because there are staff on reception at the building, they have a special responsbility compared to the local parky doesn't make any sense at all. You can hire a football pitch without having to demonstrate any competence at all.

I really hope the OP doesn't write to the LA and repeat the claim that the wall carries with 'it is a high risk of injury'.

Firstly I wonder if their accident records would agree, compared to say one LA round here that rents out a hall for roller derbys, that the wall has this high risk. I doubt the OP knows the figures at all.

Secondly mainly LA are poor quality but have been set up by locals persuading the LA to spend some money, I expect they'd be facepalming at the idea of a climber complaining to the LA that the LA haven't prepared themselves for the enhanced risk that they have taken on.

If there is an issue with the staff ( a big if here) it seems like nosedive karma to link it to the activity involved.
oli.outdoors - on 28 Dec 2013
In reply to Simos:

The inherent risks with swimming pools place likely ailments far higher up the triage list than a hurty ankle? As already discussed passing out in a swimming pool requires specialist training for rescue. The risk of a swimming pool injury leads to considerable greater problems. There is very little chance of a broken ankle leading to a greater medical scenario ( inclusive of shock)

If the OP were choking in a restaurant would the OP expect ALL staff to be trained in first aid treatment?

Is the OP trying to get this forum to vindicate him prior to seeking legal advice? Or are you sounding off in an attempt to save face
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Simos on 28 Dec 2013
In reply to oli.outdoors:

I don't think a broken ankle will become anything more serious either but that's really not the point; the point is that if you experience complete chaos at a venue in a reltively simple situation, you can be sure they won't be able to deal with anything more serious either.

E.g let's say someone elderly had a cramp while swimming at a pool and needed a helping hand to get out of the pool but the lifeguard panicked, did not know what to do and in short was unable to deal with the situation. Wouldn't you be sure that the same lifeguard would not be able to deal with a more serious situation where an unconscious person had to be recovered, CPR administered etc? Wouldn't the person that had the cramp have a right to be concerned/complain about the way the situation was handled?

Most people would (reasonably) expect some services at a climbing gym - don't think that because you wouldn't expect the same outdoors makes it ok not to have them. I bet most people would expect toilets for example at a climbing gym but of course not many would expect them on a mountain (similarly for a first aid kit and a bit of ice or some dressings).

There are even (popular) threads on UKC about toilets at crags where nobody is paying for entry and yet people feel strongly that they should be provided (don't disagree) yet some of the same people I am sure would be upset about someone expecting some basic first aid kit to be available at a climbing wall (the cost of the kit is obviously negligible). :-)

Anyway I think on my end I've exhausted the subject - I guess everyone can choose where they climb at the end of the day...

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