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Do you know first aid?

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 matt25 02 Sep 2016
Hi,
It seems to me that there are a lot of people out in the hills and mountains who may know what they are doing, but they lack first aid skills if anything goes wrong. And that is a scary thought if something happens to you.

A lot of people say they know first aid but when actually tested, they have forgotten more than they thought. This includes professionals like instructors and coaches, most first aid courses get renewed every 3 years. Can you remember everything you learned on a 2-day course for 3 years?

I want to get your opinion on my plan to create a free online first aid course that teaches everything an outdoor first aid course would. This could be useful for people who don't need official training and as a supplement to refresh those already trained.

The benefits are short organised videos that you will be able to look at whenever you want, including quizzes and updates to keep you up to date on the latest techniques and news.

I would love to hear your opinions on any of this, I hope this is allowed as It will be free, I am just wondering if it is worth my time.

Cheers
 Greasy Prusiks 02 Sep 2016
In reply to matt25:

If done well I think it'd be an absolutely fantastic resource.
 minty1984 02 Sep 2016
In reply to matt25:

I think this would be a great idea. I have done a few first aid courses in the past as they we required for my job. Obviously this is also useful being a keen climber. Just thinking about it now I have forgot a big portion of what I was taught?...

I personally would find online refresher videos very useful.

Not sure if there would be any regulations on offering such a service though? If not then go for it
 spenser 02 Sep 2016
In reply to matt25:

The problem with first aid is that when it's required in a climbing situation it's usually either noddy stuff (plasters etc) that everyone knows or it's the really serious stuff (broken bones, seizures, unconsciousness) which tends to make people panic, dealing with this hasn't been covered on either of the first aid courses which I have previously attended.
St John's Ambulance has some good resources on their website, the only issue is that they're meant for relatively easy environments (ie, not the bottom of a sea cliff with an abseil approach), there may well be some utility in writing stuff which fits with outdoor first aid.
 Morty 02 Sep 2016
In reply to spenser:

> The problem with first aid is that when it's required in a climbing situation it's usually either noddy stuff (plasters etc) that everyone knows or it's the really serious stuff (broken bones, seizures, unconsciousness) which tends to make people panic

This.

And not just in a climbing situation.



 JJL 02 Sep 2016
In reply to matt25:

What?!

Like this?!
http://www.firstaidforfree.com/

Sorry mate. The issue is not that it's not already there online. The issue is that it's all already there online, but people don't look it up.
 Bootrock 02 Sep 2016
In reply to spenser:




> The problem with first aid is that when it's required in a climbing situation it's usually either noddy stuff (plasters etc) that everyone knows or it's the really serious stuff (broken bones, seizures, unconsciousness) which tends to make people panic, dealing with this hasn't been covered on either of the first aid courses which I have previously attended.

> St John's Ambulance has some good resources on their website, the only issue is that they're meant for relatively easy environments (ie, not the bottom of a sea cliff with an abseil approach), there may well be some utility in writing stuff which fits with outdoor first aid.

While I agree hugely with the first bit, I disagree with the idea that first aid courses doesn't cover that sort of stuff, certainly First Aid at Work (and above) does. And youth First Aid does, the only ones that don't cover it much in depth is Heartstart.
What sort of FA courses have you done, If you don't mind me asking?

What I find is that it varies completely on who your instructor is. I have taken numerous first aid, and medic courses and used to teach youth first aid and it really does take a good instructor, to not just follow some book, you need to encourage out of the box thinking too. End of the day it's about common sense, methodical thinking and prioritising.
Some of the worst instructors I have ever had in any topic have been first aid instructors, and it's incredibly frustrating.
Training and confidence in your abilities help combat panic.

You raise a good point though, the "normal" first aid stuff is usually set in a street, or "normal" setting, a nice warm room and you usually have to mould it to the situation you are in. There are courses you can take, wilderness first aid, Medicine in Remote Areas, and other such courses but they tend to be quite expensive.

With a bit of imagination though, you could rig up some sort of scenario. Or bastardize stuff you have already covered into a situation.
Although, remember, you are a link in the chain of survival, you need to get professional medical/rescue assistance as soon as possible, and the Fire Service, MR, SORT teams have the ability to do technical rescue, I wouldn't encourage anyone to attempt a technical rescue, unless it's that grey area of an imminent threat to life. Then that's a judgment call, your safety comes first, the What's the D in DRSABC? Danger, to yourself and the casualty.

I would encourage anyone to take first aid courses, not just for the hills but for everyday life. It is an essential life skill.

I usually carry 2 sets with me when I head out, a small personal kit and a slightly bigger kit, depending on what I am doing, with more technical stuff in.

End of the day, if someone goes tatties over the side, doing something is better than nothing, as long as you only do what your trained to, you're covered by the Good Samaritan act.








 jkarran 02 Sep 2016
In reply to matt25:
Creating a free course is a generous offer.

As an aside, how much difference to the outcome does it make whether someone is trained but a bit out of date/rusty vs recently refreshed on the latest greatest ideas? The basics are pretty basic: summon help, prioritise who you can help, keep warm, oxygenated, immobilised if necessary, removed from immediate danger if even more necessary. Do people really forget that and do the bits they forget really make much difference?

I suppose perhaps current training lends people the confidence to have a go rather than walk away but that's not a luxury you typically get when climbing goes wrong?
jk
Post edited at 20:13
OP matt25 02 Sep 2016
In reply to matt25:

Thanks for the replies, some interesting points.

It is completely true that first aid courses are so varied all over the country people will get different knowledge with instructors focusing on some things more than others.

I think one resource that says everything you need to know that you could access after doing a first aid course could be really useful to some.

The key things I want to do to stand out from the others is:

First I want to add Specific modules that cater for the outdoors, specific techniques and tips that will help if there isn't an ambulance 8 minutes away. Including specific rescue procedures and that people in the outdoors should know.
a very organised course with quick informative videos that tell you what you need to know
A place that you can ask your questions and for them be answered
Monthly reminders to keep you on your game, check your knowledge and keep you up to date

If you were offered all this after completing a first aid course, would you do it?
Cheers
Matt
OP matt25 02 Sep 2016
In reply to jkarran:
I think there is a massive difference between some one first trained and someone even 6 months later.

First of all, training typically takes place over two days. There is a lot of information to take in and a lot of it probably won't stick in the first place.

Yes, the simple stuff like cuts and to get help will come naturally as we have been drilled it in since we were young

However, I have worked with a lot of other instructors, teachers and people who claim to have first aid training that i have unfortunately seen many things done wrong. This may be something as simple as forgetting how to tie a triangular bandage but it could also be how to deal with something more serious where i have seen people put in more danger due to someone doing the wrong thing.

Its just something that will help us all to be ready in an emergency.
 balmybaldwin 02 Sep 2016
In reply to matt25:

The best thing I've seen for this is the St Johns Ambulance App for your phone. you download it and it just sits there until you need it.

Obviously get yourself trained at first is the main thing, but for those things you might easily forget through not using it's great for when the shit hits the fan and ou find yourself unsure of what to do or how seriously to take certain symptoms
 jkarran 02 Sep 2016
In reply to matt25:

Fair enough people forget stuff but surely most remember the key details adequately? I'm really wondering what the evidence is about currency vs outcomes.

It's the stuff like forgetting how to tie a bandage I don't fret about at all, frankly I don't have a bandage and I'd probably improvise with climbing kit before I even thought to look for one anyway.

Anyway, none of that is to put you off creating a valuable resource!
jk
 spenser 02 Sep 2016
In reply to Bootrock:
On rereading my post I think my wording may have been a little unclear. The courses I did (REC2 and First Aid at Work) covered how to deal with serious incidents (broken bones, blood everywhere etc), they didn't particularly cover anything about keeping your head in the event of an accident, the only thing which I've found which does that was first aid simulations as a cadet. Regular (once every 2-3 months) first aid simulations would be far more useful than refresher videos I reckon, my employer runs paper based exercises once every couple of months but I've only just been put on the list of first aiders so haven't attended one yet.
 Rich K 02 Sep 2016
In reply to matt25:

The British Red Cross have produced an excellent free first aid phone app with video instructions.
 Bootrock 02 Sep 2016
In reply to spenser:


Yea, I agree totally, sadly that's the way the world is going, it's all about paper and ticking boxes.

As soon as you start paying lip service to training, and it becomes about ticking boxes, that's when people end up dead.

And unfortunately some people just have a head for keeping calm and some don't, the equaliser is good training and rehearsals.

I do agree with a post further up, about details and finer points. I agree, people do get hung up on facts and figures and details. When it always remains the same. Is it safe, are they breathing, is help coming? A lot of instructors get hung up on diagnosing rather than dealing with what they have got.
If it doesn't look right, it doesn't feel right, doesn't sound right? It's probably not right. Mark and move on.
As a first aider you are just a link in the chain, you're just keeping them alive.

The one point I would highlight to climbers is to automatically assume a C spine injury with a trauma casualty.
The paramedics have their own checks, and that's what they are there for, but as a joe Bloggs, if there's any doubt, then there's no doubt. Keep that head and neck still. And always seek professional medical aid.

As said above, there is an app for first aid by the BRC. It's a really good learning tool and I sometimes have a go now and then to help keep skill fade at bay.


 marsbar 02 Sep 2016
In reply to spenser:
I'm always happy to recommend high peak first aid.
Scenario based training on a muddy hillside.
Post edited at 21:30
 SAF 02 Sep 2016
In reply to Bootrock:

> The one point I would highlight to climbers is to automatically assume a C spine injury with a trauma casualty.

Whilst i agree with the majority of your post, first aiders do still get very tunneled visioned on the "c spine" issue.

On occasion this can be almost comical, think...big burly "i'm a first aider" workman pinning down a non english speaking eastern european man who has had one to many drinks, fallen off his bike and cut his chin, and just wants to carry on his way home!! I had to tell the guy repeatably to let him go, as the foreign guy looked on the verge of punching him.

But more seriously it can be detrimental to the patient in an exposed environment if the patients C spine is put at a higher priority than there risk of hypothermia...in major trauma even a small dropped in temperature is massively worse for there survival chances, where as the C spine may not even be injured....so there has to be a balance in priorities.



In reply to matt25:

IME, the hardest thing to learn is incident management. The actual techniques to use a re pretty straightforward. It's the stuff about DRSABC, getting incident details, finding out who is involved, dealing with non-casualties, calling emergency help, etc. that is the real problem.

On the courses I've done, I was able to recognise and deal with the conditions of an individual (the one in front of me). Dealing with the entire incident (multiple casualties, etc), was much harder, and I found myself getting very focussed on the casualty in front of me. To the extent that I didn't hear a colleague shouting that they'd found a cardiac arrest. Just didn't hear it. Very revealing.

Anything you could do to provide practice scenarios would be good. Bit tricky online, but...
 Bootrock 02 Sep 2016
In reply to SAF:
Yea agreed. It's situationally dependant. use that good old common sense.
I am sure there's a statistic of something like 95% of spinal injuries happen at the point of accident, and that the chance of it happening from an over zealous first aider winging your head about is quite small. I will see if I can find the article, it was a really interesting read. But again, if your a first aider and your not sure, if there is any doubt, then there is no doubt.

Environment is a big factor too, an extreme example would be Lads on operations in the Middle East, after patrolling in such hot conditions with large amounts of kit, if they got injured, once stripped of body armour and clothes rudimentary treatment given, then thrown on a Helicopter, they would start to go down with Hypothermia.

you can disappear down a rabbit hole of what ifs and the such, you just have to go in with an open mind and out of the box thinking, to slot the peices in where you need them.
Post edited at 22:42
 Bootrock 02 Sep 2016
In reply to captain paranoia:

It's so easy to get drawn in on one casualty or the casualty in front of you, or screaming the loudest. Easy to get tunnel vision and almost "forget" your surroundings. Just remember, if they are screaming, they have an airway.

But again, there's no substitute for hands on training and experience. And watch out for skillfade


 marsbar 02 Sep 2016
In reply to SAF:

After a car crash, I climbed out of the car window, which at this point was unfortunately at the top of the car. I went along with whoever it was that really thought I should sit down, rather than wander about - a good call. However when someone suggested getting me strapped to a board I was rather less convinced.
 marsbar 02 Sep 2016
In reply to captain paranoia:

We did do multi casualty triage on the course I went on, however this may have been due to the majority of the group wanting it, and doing the 3 year refresh rather than being complete beginners.

All the serious incidents I've been at, there have been too many people trying to help one casualty while others need help too. I have so far luckily never been the most qualified at a scene, so I've left others to deal with the main casualty, and done minor first aid and general scene management, for example stopping the idiot who thought they would just try and drive through the the scene, (wasn't possible and could have injured the many bystanders, and in the way of the ambulance)
preventing the driver who hit the motorbike from going to see how the biker was (not in a good, not something he needed to see, and would have been in the doctors way).

Knowing you need to be able to see the whole picture is worth remembering.
 due 02 Sep 2016
In reply to spenser:

> The problem with first aid is that when it's required in a climbing situation it's usually either noddy stuff (plasters etc) that everyone knows or it's the really serious stuff (broken bones, seizures, unconsciousness)

...about sums it up for me. There aren't many bits of truly lifesaving kit that you are realistically going to (or can) carry everywhere you go. At least some training is fundamental as that is what you will fall back on when it goes tits up, but the more advanced you go the more you realise your approach to first aid, and what interventions you can do, isn't really going to change much.

Carry a pencil and paper that will work in the wet, a (big) Israeli dressing or two, a SAM splint where your rucksack frame used to be, and some duct tape. Then keep them warm.
Bingers 03 Sep 2016
In reply to matt25:

I'll come clean for starters - I'm a professional first aid trainer with a particular specialisation in Outdoor First Aid, I also work for the Ofqual accredited Awarding Organisation that specialises in Outdoor First Aid and represent them in the national First Aid Awarding Organisations Forum and I had a significant part to play in writing the Institute for Outdoor Learning's Guidance for Outdoor First Aid. I am also one of the more vocal opponents of online training for first aid.

My bottom line stance is that nothing beats a good quality, practical face to face first aid course where the participants put their training into practice with scenarios and in the case of OFA, outside, wearing the kit they would have in their chosen activities. The participants should be formally assessed to known, published standards by trainers/assessors who meet certain regulated standards in terms of their own qualifications, CPD, knowledge and experiences. Not just anybody can run a good outdoor first aid course. Anybody can try to, but that is not the same thing.

The OP stated that it could be useful as a supplement to refresh those who are already trained. Great, I totally agree. The tradition of the certificate's licence to practice being three years, is clearly too long and if the industry was starting again from scratch, the certificate duration would be less. However, I do find that once renewing candidates who previously did a practical course, start putting things into practice again, they "unlock" what was previously trained and often can do it quite competently. I find OFA candidates are particularly good at this. Having some online resources to keep refreshed in between courses would be a positive thing as the underpinning knowledge and practice would already be there.

I would take issue with using it for those who "don't need official training". Whilst instructors and NGB award holders have licence to practice issues and formal duty of care requirements, are the lives of your mates any less important? We train many people who just want to be able to look after themselves, friends or even strangers if the worst happens when they are out. The standard should be the same.

If you were to go ahead with producing a freely available resource, it should be a quality product that is accurate. It should follow current best practice, it should be clear and not open to different interpretations and it should be checked by somebody who knows what they are doing. Ideally people with sufficient knowledge and qualifications should be prepared to put their name to it. A medical professional with an interest in the field would be a minimum here. To do the job properly takes time and resources, checking and double checking with second opinions from others. You want to make it free to view which is a great desire, but to produce it, it will cost you (at the very least professional indemnity insurance). How will you recoup this cost?

Part of the problem with having free material is that some people will think that they have been sufficiently trained by seeing something without actually having put it into practice themselves. Given the choice, many would opt for the free online version rather than the paid for quality, hands on training, but are they going to have the same standard of experience at the end of it? Would unscrupulous employers use it as a way of saving money, so a race to the bottom ensues. People can produce something with the best of intentions, but then there are unexpected consequences as it gets used for purposes that you did not have in mind.

Think carefully about your planning, what you want to cover, how you will do it, your accuracy, your quality assurance, your costs and how you will host it. Good luck, if you do it, I would like to see it and would give constructive feedback. I hope it would be better than most other online training that I have seen.

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