First Aid

[nater]

Glad to see some other medics on here!!! I'm a full time Paramedic, also trained as a firefighter, but I would rather be on the ambulance. I've been a lifeguard, Basic-EMT, Advanced-EMT, and finally a Paramedic. I've provided emergency care at a large amusement park, large factory, and from an ambulance. I can't imagine another career.

 

The basic first aid courses are a great place to start, I would agree that anyone in this hobby should take them.

 

I admit, I cringed when I read the posts about putting limbs in milk. Like was posted just above, cool them down, don't let them freeze, call 911 or get to an emergency room. dic, also trained as a firefighter, but I would rather be on the ambulance.

 

Cookieman, if you decide to pursue further opportunities in EMS and have any questions, I'd be glad to answer them for you.

[Cookieman]

Glad to see some other medics on here!!! I'm a full time Paramedic, also trained as a firefighter, but I would rather be on the ambulance. I've been a lifeguard, Basic-EMT, Advanced-EMT, and finally a Paramedic. I've provided emergency care at a large amusement park, large factory, and from an ambulance. I can't imagine another career.

 

The basic first aid courses are a great place to start, I would agree that anyone in this hobby should take them.

 

I admit, I cringed when I read the posts about putting limbs in milk. Like was posted just above, cool them down, don't let them freeze, call 911 or get to an emergency room. dic, also trained as a firefighter, but I would rather be on the ambulance.

 

Cookieman, if you decide to pursue further opportunities in EMS and have any questions, I'd be glad to answer them for you.

 

Thats great, thanks nater.Right now I'm applying for special Police constable which assist the courts transporting prisoners.Its a 4 hour exam followed by a 1 hour physical strength and cardio test.

[Arthur]

Great! We have a full ambulance crew and a full fire team too (I use to be an airport fireman long ago) However with our geographic spacing perhaps an 8 minute response is beyond us!!

 

SO if you have an interest in life, go do a first aid course, and do it soon. You don't have to become an EMT but a basic grasp of first aid will help in case of emergency. AND for those that pay for emergency treatment may keep the bills down too.

[kaizoku]

Still, holding an amputated finger in my mouth.... EWWWWWWW!

 

It doesn't have to be in your mouth it also can be in the victims mouth and it is always better than losing a finger/hand.

So in my opinion I would rather put it in my mouth so it is better preserved and for those who think I just got it from

nowhere I have acquired the information from my brother since he has studied at a pharmaceutical university and I also got the information out of

a biology book and think about it why do animals like cats and dogs like themselves when wounded? I think that that makes sense because their

instinct tells them to do so.

Edited December 24, 2010 by kaizoku

[dagabu]

It is actually better and i know it sounds disgusting to put the amputated finger/thumb/hand in your mouth because your saliva has the ability to kill bacteria and if it does kill the bacteria then

it will likely get infected then when you put it in nutritious substances like milk, because bacteria will grow there faster and it won't die. Also milk has a lower temperature then the body

which is 37 degrees Celsius and that is much better than the temperature that milk would have because when the temperature is higher the slower the bacteria will grow. When the amputated part

is in your mouth then do not suck the blood out of it there may be some oxygen in the blood that will preserve it also longer and it is warmer. And to create more saliva move and press with your tongue down in lowest

mouth part that will improve the production of it, while having the amputated part in your mouth so the saliva will reach the amputated part also do not try to bite it or cause more harm that will lessen your chance

that the surgeons will be able to sew it back and if they are able to sew it back it's functions will decrease because the nerves won't grow like it would have without the harm. I appreciate it if anyone who would like to improve

this post.

 

 

Now, you do know that that is completely false right? 3-4 minutes and flesh starts to deteriorate, cooling retards degradation considerably.

 

"because when the temperature is higher the slower the bacteria will grow."

 

Is nonsense, bacteria love temps between 42° and 140°, anybody that has had high school science knows this.

 

"why do animals like cats and dogs like themselves when wounded? I think that that makes sense because their

instinct tells them to do so." My instinct also tells me to do things that are not healthy, it is the ability to choose between the healthy and unhealthy that makes us human. Also, my dog ate through her stomach because she had a hernia... instinct.

 

BTW- Rotten meat does not make flies either.

-just saying

Edited December 24, 2010 by dagabu

[kaizoku]

Now, you do know that that is completely false right? 3-4 minutes and flesh starts to deteriorate, cooling retards degradation considerably.

First of all if you are gonna put into something cold like water then the blood cells will absorb the water because of osmosis and if that happens the side with the highest concentration ( the water)

goes to the side with the lowest concentration ( blood cells) and then they will absorb it until they explode. saliva is made up from a mixture of chemical substance and not only water so the blood will

absorb less water and saliva has a chemical compound that kills bacteria and flesh needs constant body temperature so that the cells still can function because they are still ''factory's'' because catalysts

in the cells will function optimal and of course they will die eventually because there will be no chemical compounds anymore like glucose, salts, amino acids, ect to supply the cells and if you freeze it you will put to a stop and that is point where bacteria will strike because cells won't be able to create antibodies.

"because when the temperature is higher the slower the bacteria will grow."

 

Is nonsense, bacteria love temps between 42° and 140°, anybody that has had high school science knows this.

 

that's why cooking meat is worthless because they definitively won't die when cooked at a temperature of 80 degrees Celsius.

 

"why do animals like cats and dogs like themselves when wounded? I think that that makes sense because their

instinct tells them to do so." My instinct also tells me to do things that are not healthy, it is the ability to choose between the healthy and unhealthy that makes us human. Also, my dog ate through her stomach because she had a hernia... instinct.

 

I have never typed anything about that this applies to every animal.

 

BTW- Rotten meat does not make flies either.

their instinct tells them to eat something and since rotten meat still contains amino acids and proteins the fly would be still able to convert it of course it would not be smart because it is full of bacteria but still.

[Arthur]

kaizoku Please note that you are arguing against paramedics and ambulance crew from Europe and America on their best subject. Please be very careful. Please go and do a first aid course in your country, please learn from the best that you can afford. One day it could be you, or your nearest and dearest who needs first aid in a hurry, and then it will need to be right first time without reference to textbooks or internet forums. The current best practise when dealing with amputated body parts is to cool them to almost freezing, then get the victim and the part get to a hospital seriously fast. At body temperature a amputated part is useless after about ten minutes, if cooled to about 1 celcius the part will be viable for an hour or so. However if the part has frostbite it's finished.

[Mumbles]

No one said soak it in water. Everyone has mentioned cooling the body part with cold packs, not putting it in ice water.

 

I also suggest you really re-evaluate your biology, such as where antibodies come from and how they work, how blood works, and what causes limbs to become non-viable for reattachment. Once you take a look over these things, you may want to rethink your statements.

[dagabu]

Gee, I dont know what to say, I hate to have an argument on Christmas Eve and you seem to have your mind all made up and everything so I will leave you to your beliefs.

 

Merry Christmas everyone!!

[DasSchaben]

Question for the paramedics here. If someone loses a limb or suffers a serious burn, what are the chances of that person going into shock/losing consciousness/facing a medical emergency other than the obvious physical damage?

 

It's interesting to hear from first line responders. There's some good information in this thread, thanks.

[Algenco]

Question for the paramedics here. If someone loses a limb or suffers a serious burn, what are the chances of that person going into shock/losing consciousness/facing a medical emergency other than the obvious physical damage?

 

It's interesting to hear from first line responders. There's some good information in this thread, thanks.

 

I'm not a Paramedic but I have slept at the Holiday Inn and had advanced First Aid.

 

The odds of a person with those injuries going into shock are very high

[nater]

Question for the paramedics here. If someone loses a limb or suffers a serious burn, what are the chances of that person going into shock/losing consciousness/facing a medical emergency other than the obvious physical damage?

 

It's interesting to hear from first line responders. There's some good information in this thread, thanks.

 

 

 

When you loose a limb, sometimes your arteries will constrict to reduce or prevent blood loss. This helps prevent shock from blood lose, but does not eliminate the chances of going into shock completely. Your body has many mechanisms to compensate, but once those are exhausted, people rapidly deteriorate. I've only responded to a handful of amputations in my career, and they were all relatively minor like fingers and toes; hardly life-threatening.

 

Serious burns are are bigger problem. When the body is burned, you loose ability to control heat and retain fluids. People will rapidly become hypothermic and dehydrated. Going into shock and passing out is a very real possibility from burns.

[dagabu]

To add some, traumatic injuries caused by lacerating are completely different then by pulling. The plus side is that the vessels taper and clot quickly with a pull amputation but the tissue damage is more severe but a laceration causes excelled blood loss.

 

By the time we would arrive to aid a burn victim, they would already have been stabilized by the first on the scene, often a wife or policeman. We simply provided a ride to the hospital after administrating IV fluids.

 

Shock kills a lot of people, most are not that severely injured. A good medic understands the signs and keeps the injured alert and warm.

[DasSchaben]

Interesting stuff. Keeping the injured person alert seems to be a key point, especially in the context of chemical injuries, I'd imagine. Our local Red Cross provider is offering Standard First Aid certification in February. Probably worth checking into.

 

About the posts on amputation and lost fingers, etc., would First Responder training provide that type of background? It's one thing to do your homework and understand this in theory, but I would guess that real-life experience with first aid would help considerably. (Panic, and that emergency scenario information you read on the internet goes out the window.) Either way, knowing how to stabilize the patient until emergency crews arrive seems to be the most important point, whatever your level of formal training is.

 

No idea how common these injuries are in pyrotechnics, but yeah, better safe than sorry.

[dagabu]

Not currently, stabilization of the injured is the focus. Unless the question is asked, the training doesn't cover amputation but to discuss pressure points and blood stoppage.

[nater]

My first responder class did touch base on amputation injuries, but nothing more in depth than what has already been discussed in this thread. Should you decide to take a first responder class, consider their main role is to keep someone stable before the ambulance gets there and initiate CPR or basic airway management if it is needed. Even then, more often than not for traumas all we can do on the ambulance is support someone until they make it to a surgeon.

 

In an emergency, the best thing anyone can do is stay calm, call 911 (or whatever is similar in your country), put pressure on any major bleeding, and keep the victim warm.

 

As far as pyro emergencies go, I suspect amputations are low on the list. Most amputations are caused by woodworking and car accidents. Depending on the severity of the accident, I would expect to find burns and lacerations to various degrees. If it is an explosion in a shop, I would expect anything.

[Updup]

I asked my Uncle about the whole finger in mouth or ice water, he is a EMT.

 

His reply "Neither" He told me you want in in ice, but not ice water, as the water is what will get it infected since it will wick into the finger. Plus, you don't want it frozen, you just want it to be cold.

[dagabu]

Just like I was saying. put a cot on the open end, ice pack it and GO!

 

Or you can stick it in your dogs mouth...

[Sapper]

It seems people know little about general first aid, smart things to do when the accidents has happened.

 

This is a sticky thread, and I will not lock it, so you can add your tips and hints. I will edit your post into this one every now and then, so that in the end, this will be one big sticky with what to do when various things happen. As my cousin is a doctor, I will ask him for advice on all the things you post, so we get a professionals opinion on what to do.

 

TREATMENT OF BURNS:

 

Whenever you get burnt, the smart thing to do is to cool the area that is burnt IMMEDEATLY. What you use, cold water, an ice pack, ice cubes or anything else you might have at hand, doesn't really matter. Keep the cold there for 20 minutes.

 

This is to reduce inflammation of the area. The cold temperature prevents a lot of blood coming to the area of damage. If you do not put something cold on the burnt area, it will swell up much more, and damages will be greater both to the surrounding skin and the deeper tissue.

 

Water is not the best thing to use on 3rd degree burns, as it tends to dry out the area of damage, something you don't want to happen. In 3rd degree burns, the best thing to do is to cool it with an ice pack or a bag of ice cubes. AFTER this cooling, you can wash the area with mild soap and water to get rid of any shit that might be left in the wound, like potassium oxide, sufur oxides, carbon, and other nastiness. Dry the area carefully.

 

For all burns, it is smart to put on fatty creme/lotion after the cooling period. This is to keep the skin moist. If your skin dries out, it will not be as flexible, and it might even crack open, destroying even more skin, or stretching the burnt area. Keeping the skin moist(with fat, not water) will also accelerate the rate of healing.

 

On 2nd degree burns(blisters) it is of course smart to leave the skin on, not rip it off. The skin will heal faster and and nicer if you keep the skin bubble on. Also, ripping off the skin raises the chance of the area getting an infection.

 

Painkillers are OK, but in pill form is better that the type you smear on the damaged area(at least for 3rd degree burns).

 

Disinfectant is not needed on 1st and 2nd degree burns, and even on 3rd degree burns(you should get to the hospital fast) there will be no bacterial/viral infection before you reach the hospital.

 

If you need medical attention(mostly 3rd degree burns, and larger 1st and 2nd degree burns), go to a doctor AFTER having done all this.

 

LOSS OF LIMBS

 

If you are so dumb or unlucky that you lost a limb, say a finger, hand or something like that, be sure to find the limb(if you are in condition to), put the limb on ice, so it can be operated on later on. It may not work anyway, but it is better to have that possibility.

 

BLEEDING

 

Elevate area of the wound and apply direct pressure to slow the bleeding. Again, don't cut off the surculation as this could lead to the limb, if this is where the wound is located, needing amputation. The wound should be rinsed with water and then smartly bandaged, don't just use a little tiny band-aid for a large gash!

 

 

In the sase of the loss of a limb do NOT put tke limb on ice, unless it is wrapped and protected from FROSTBITE or the limb may no longer be viable.

All US army Combat lifesavers are trained to wrap the limb is a moist cloth to keep it from drying out.

and rember if surgical treatment is administered within 8 hours there is a good chanch of saving the limb depending on the condition of the limb,

My uncle cut his thumb, with a razor blade, at the age of 5, they reattached it and it works fine and that was over 50 years ago

[Sapper]

None of these say anything about shock and my last comment I forgot to

 

 

There are several forms of shock but for what we are discussing hereit would be HYPOVOLEMIC SHOCK ---shock caused by hemorrage, burns(plasma loss) and / or decreased body fluid and electrolytes.

signs and symptoms:

casualty may become agitated or uneasy, flushed skin, rapid palse, shallow breathing, dizziness, upset stomach or vomiting, may be disoriented.

 

treat by having the patient lay down with head to 1 side so as not to choke if vomiting occurs, elevate legs, keep patient warm with a blanket or whatever, DO NOT GIVE FOOD OR WATER

SEEK MEDICAL ATTENTION IMMEDIATLY!!!!!

shock is a life threatening emergancy

[trialuser]

signs and symptoms:

casualty may become agitated or uneasy, flushed skin, rapid palse, shallow breathing, dizziness, upset stomach or vomiting, may be disoriented.

 

 

 

With respect this is incorrect.

Skin will most definately not be flushed.

It will be be varying degrees of pale, cool and sweaty.

I'd agree with the other signs though more or less - breathing is not necessarily shallow but definately at an increased rate..

Often shocked patients feel very thirsty.

Most adults compensate well untill more than about 15% of circulating blood volume has been lost - perhaps look a bit pale.

Kids compensate very well for longer and then crash drastically when they decompensate.

Current UK Paramedic practice is to maintain a systolic BP of around 100mmHg with crystalloids, too agressive fluid therapy can serve to dilute clotting factors in the blood and blow off fragile newly formed clots.

With penetrating abdominal trauma (in the absence of head injury), some authorities prefer a permissive hypotension of a bit less than this. Lower than about 80mmHg for too long and you start to get organ failure and damage

In the wilderness situation in first degree shock I go for oral fluid. It's why they give blood donors a cup of tea here.

Cheers

Martyn

[Guest no6]

This is a great topic.

 

Thanks for all the insight.

[Arthur]

There are several opinions, and as no two incidents are quite the same probably there is no single right answer, however we do play with a dangerous hobby so we could all consider a first aid course as valuable. In the UK one can buy a three day First Aid at Work course and certificate, I expect there is a like course in the USA and all the other jurisdictions represented here.

[dagabu]

In the US we have emergency responses written by the AMA and that is shared with the medical field. It is then considered "best practice" and is usually trained based on the AMA's recommendations. This means that there are several 'carved in stone' ideas but the rest can vary slightly from state to state or city to city.

[guntoteninfadel]

Ok, I read the first two pages pretty close then got bored to tears with all the well intentioned advise. IF you are in the US and IF you have the ability just call 911! The paramedics will know how to treat your injury and can advise you on the severity of the problem. Generally speaking more lives/limbs are saved by the paramedics knowledge than the loss of time to the ER. I have seen many more bad outcomes from people rushing thier loved one/friend/spouse to the hospital and screwing up the prehospital treatment. Also, currently ER personnel are not required to contact LE for anything other than possible assault cases. Gunshot wounds, stabings, strange lacerations and general beating fall into this category, burns not so much.

 

I have worked in emergency rooms the last ten years all over the southeast US. Burns are very very serious but any concocted story will more than likely be believed because YOU would not believe the stupid shit people do to themselves!

 

I am sure that other countries have emergency medical systems in place but I have had no experience with them.

 

later

 

gun