# Modern medicine question



## cabby (May 14, 2005)

Last year at our GP's Surgery I had my first aid kit with me due to an accident.
Having half hopefully asked if they had any lint etc that I could refill the kit with, even asked about field dressings,:grin2: They looked at my kit and had a good natured laugh, anyway got plenty of new updated stock, for which I later supplied sweets and doughnuts. But my biggest surprise was the lack of antiseptic, they gave me some ampules of salt water in their place. Now I can understand this to an extent, but can those members who are knowledgable clear this question up. Should I still go and buy some antiseptic as well, if so which is currently in favour now. 

cabby

I worked for the AA back in the 1970's where we were taught many things including First Aid by the Ambulance training teams. It was an eye opener what one could do with just a blanket and 2 triangular bandages.When you came onto an accident the casualty was made up just like those on the TV today with matchsticks and putty with paint to simulate broken bones, broken ribs, blue lips, blood dribbled all over the place.

Will never forget my first dead body for real.Not my fault either before you all ask.00

cabby


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## listerdiesel (Aug 3, 2012)

I think saline solution is compatible with all body processes and parts, so is safe to use as a cleansing solution. 

Antiseptic wipes obviously contain one of the popular antiseptics which may not be compatible with medicines already being taken or some future treatment that might be needed.

I noticed that when my MRSA test swabs were taken recently they only moistened the cotton buds with saline solution, as they didn't want to destroy the 'evidence' by using something stronger (I was negative)

I wear a 'Warfarin User' bracelet just in case of an accident, so medics know how to treat me.

Peter


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## Penquin (Oct 15, 2007)

NO NO NO antiseptic EVER - if you use it you are rubbing bugs IN not keeping them out....

once opened many "antiseptic creams" will support the growth of a bug called Pseudomonas and you do not want to get that in the wound...

clean, cold fresh water is the ideal material to use, with gauze NOT lint as lint is fluffy and leaves fibres in a wound - less than ideal...

the most useful thing in a First Aid Kit is a pair of disposable gloves for you to wear plus perhaps some alcohol based hand gel to ensure clean hands before and after.

Standard dressings come with the bandage to hold it in place and are sealed and sterile - carry a selection of sizes and an eye pad.

A triangular bandage is great if you know how to apply it as a sling or use as a bandage and the secure with a reef knot, but it will be cut off by ambulance staff as soon as they arrive so they can see the extent of the wound.

If there is severe bleeding (but nothing embedded in the wound) then ask the casualty to press on it directly and firmly (if they can), put a dressing over it so they can press on that and then of the blood comes through that, put another one on top but do not remove the first one, you can even add a third if needed.... if it comes through that then go back to the beginning and start again.

Make sure the cut limb is elevated by *laying the person down* and raising the affected limb - that restricts the blood entering and helps it's return (about the same as a 0.5 litre drip.

Remember blood is *R E D *

*R*EST (lay the casualty down) *E*LEVATE the affected limb and  apply *D*IRECT PRESSURE

Happy to give as much advice as needed...

NB *NO SHARP OBJECTS ARE PERMITTED IN A FIRST AID KIT* - no scissors, safety pins etc.... and definitely no drugs such as Paracetamol..

Aspirin may be used (300mg) in cases of suspected heart attack but beware the person does not have stomach problems as aspirin can make things worse

A Warfarin user would not normally be given aspirin IMO for the reasons given - aspirin works by stopping the blood sticking together - which is similar to Warfarin and other anti-coagulants....

This download may be of use to everyone;

St John Ambulance First Aid Guide

Dave (ex ambulance staff)


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## MEES (Apr 20, 2006)

Many many moon ago as a slender 17 yr old with a "Mia farrow" haircut I was along with 20 male police cadets a " patient" for a big first aid competition.
Dresses as a motor cyclist and made up with injuries and unconscious.
Much hilarity.
No team ( police , fire brigade, mine rescue etc ) diagnosed me ad female - though a couple of teams noted " slight swelling in chest region.
Oh happy days - wish it was still so


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## Penquin (Oct 15, 2007)

MEES said:


> Many many moon ago as a slender 17 yr old with a "Mia farrow" haircut I was along with 20 male police cadets a " patient" for a big first aid competition.
> Dresses as a motor cyclist and made up with injuries and unconscious.
> Much hilarity.
> No team ( police , fire brigade, mine rescue etc ) diagnosed me ad female - though a couple of teams noted " slight swelling in chest region.
> Oh happy days - wish it was still so


I, a team of ambulance staff, an ambulance crew, two police officers, a paramedic and a Doctor all made the same mistake at a Point to Point we were covering - the jockey had so much protective gear that any such guesses were literally that....

After a while she sat up and said "I am a woman NOT a BLOKE" to everyone's chagrin and much hilarity - the paramedic ended up having to buy a round of drinks for all involved.

So we've all been there and made the same mistake.....

Dave :surprise::wink2:


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## MEES (Apr 20, 2006)

That's pretty much what happened though back at the cop shop I never heard the last of it!


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## BillCreer (Jan 23, 2010)

My Scout Master, Alfie Bell, had one and a half legs shot of by German Parachutists when they invaded Crete. He lay around unaided for couple of days till the Germans rounded him up as a prisoner and treaded his wounds.
Alfie talked very highly of the German Doctors who he said, against all odds, saved his life. The German Doctors told Alfie that he would have died if he not been partially immersed in sea water as his wounds had been kept clean till they got to him.

The poor mans stumps caused him to suffered a lot of pain for the rest of his life and war heroes didn't get any special treatment in those days.


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## randonneur (Jan 25, 2007)

Just as an aside, when we bought our first motorhome in France, when we were living there, we were told to carry an unopened first aid kit and that if we came upon an accident we were not to use the kit as it was for the Ambulance/Fire Brigade/Doctors to use. This kit had the equivalent of an Official Certificate on it. Needless to say we have still got the said unopened kit.

The District Nurses who now come to treat my Husband each week use Sodium Chloride 0.9% solution to flush his Hickman.


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## cabby (May 14, 2005)

Funny the things we remember, when an AA patrolman, I had to rush a groom and best man to the church as they had broken down, getting them into a small van was great fun.Aparantly I was compared with having a chimney sweep at the wedding by the brides mother.:wink2:
We carried a kit in the Patrol vans but as said that was for the use of a professional on scene.
As to dressings, I do carry the ready to use dressings to use these days.But I also carry tweezers and scissors, safety pins, bottled water in both the car and van.

cabby

Just point out that in those days we actually worked on the broken down vehicle to get them going again.


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## Penquin (Oct 15, 2007)

Crepe bandages were an excellent replacement for broken fan belts if you did not happen to have a pair of stockings on then Cabby?

An Elastoplast to stop a leaking cooling system?

Safety pins to check spark plug gaps?

Just some (random) thoughts.......

The days when First Aiders could do very much are long gone - I recall learning techniques for immobilising a broken thigh using seven (yes 7) triangular bandages.... Now a vacuum splint is often used or perhaps a traction splint if the bones have telescoped dangerously. Nitrous oxide (Entonox) has now been replaced often by much more powerful painkillers, including morphine when needed (with appropriate crew qualification) and defibrillators have helped considerably with keeping patients alive - they are now available for use in the street in very many places...... (Seattle in the US is reckoned to be the "best" place to have a heart attack as there are more defibs there per 1000 population than anywhere else in the world (and more people know how to use them).

Sadly, in the UK the Government won't even insist on all school-children being taught basis resus. - the cost implications of having to train staff and supply dummies has stopped it (no comments that there are plenty of suitable dummies sat in Westminster are needed).

and it is a known statistic that the success rate of the use of a defib diminishes by 10% for every minute of delay........ ambulances are supposed to get to 75% of "RED" calls (life threatening heart conditions or similar) with 8.5 minutes - and we used to live a 20 minute drive from the ambulance station IF one happened to be there..... at times we had to wait 45 minutes for a suitable 999 vehicle as we were in rural Devon - trying to keep someone alive was "interesting".

PLEASE, PLEASE make sure that YOU can do CPR if it is needed - the Vinnie Jones humorous video for the British Heart Foundation makes an excellent starting point - watch it while you are not needing to know it......... that is too late to learn.....






Dave


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## patp (Apr 30, 2007)

When Mr P was carted off to hospital, the ambulance crew asked if we had any Paracetemol in the house. I said yes and had to go and get it for them! Apparently they are not allowed to carry it?!


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## Penquin (Oct 15, 2007)

patp said:


> When Mr P was carted off to hospital, the ambulance crew asked if we had any Paracetemol in the house. I said yes and had to go and get it for them! Apparently they are not allowed to carry it?!


Correct, no drugs may be carried unless the crew has the right level of qualification and Paracetamol is a drug that CANNOT be overused as even twice the daily dose can be fatal...... i.e. *4g *per 24 hour period *MAXIMUM * for typical sized adults (less for children and those of smaller size) and it is found in such other things as Beecham's Powders, cough preparations and similar so it would be easy to overdose without realising it. Any many patients rarely tell the whole truth about what they have taken..... e.g. "a white one for the water and a yellow one for my heart" is a not atypical offering which may require extensive questioning to work out......

and then when they get to hospital there is a completely different story to the nurse and then another to the Doctor - many people tell the staff what THEY think the staff want to know......

So the easiest way to avoid that is for the ambulance crew NOT to have any available. It may seem odd but is much safer than overdosing and not realising it....

Dave


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## salomon (Apr 20, 2011)

Brings back memories. The things you could do with a trangular bandage !
I used to compete for St Johns Ambulance in first aid competitions. Great fun. 
Like you say, things have moved on a great deal but the basics are the same.
I was rather proud if myself last year when praised by the Pompiers for my first aid skills


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## Penquin (Oct 15, 2007)

salomon said:


> I used to compete for St Johns Ambulance in first aid competitions. Great fun.


Glad you can say that as I used to be one of the judges.......

always interesting as there were so many things to look out for as well as basic first aid skills - such simple things as _*"Did they introduce themselves and find out how the casualty/patient wants to be called?"*_

Using _*"My Dear"*_ or *"Darling"* or similar was *NOT *acceptable - *EVER*......

Dave


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## salomon (Apr 20, 2011)

Penquin said:


> Glad you can say that as I used to be one of the judges.......
> 
> always interesting as there were so many things to look out for as well as basic first aid skills - such simple things as _*"Did they introduce themselves and find out how the casualty/patient wants to be called?"*_
> 
> ...


:smile2:
When i started, I was "#4" in the team, which meant I was responsible for calling the ambulance and listing what was wrong etc. The worst was looking for the phone. Good comps had phones set up....but sometimes you just had to stand in the corner and pretend !The worst time was when I went looking for the phone and discovered an patient that had been completely overlooked !


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## patp (Apr 30, 2007)

Penquin said:


> Correct, no drugs may be carried unless the crew has the right level of qualification and Paracetamol is a drug that CANNOT be overused as even twice the daily dose can be fatal...... i.e. *4g *per 24 hour period *MAXIMUM * for typical sized adults (less for children and those of smaller size) and it is found in such other things as Beecham's Powders, cough preparations and similar so it would be easy to overdose without realising it. Any many patients rarely tell the whole truth about what they have taken..... e.g. "a white one for the water and a yellow one for my heart" is a not atypical offering which may require extensive questioning to work out......
> 
> and then when they get to hospital there is a completely different story to the nurse and then another to the Doctor - many people tell the staff what THEY think the staff want to know......
> 
> ...


Turns out that their diagnosis was spot on. On that occasion he had pericarditis. Only treatment was pain relief. Heart specialist called all the junior doctors to come listen to his classical case. Nearly gave him another heart attack as all the gorgeous young women leaned over him to listen to his heart.


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## Penquin (Oct 15, 2007)

If I was unwell or had had an accident then I would like a Paramedic to be first on the scene - IMO they are usually spot on with what they say, their training is intense (I know 'cos I used the same manual but did not have to do the extensive practicals) and their knowledge base is vast.

Plus the are human and respond like one (usually).

I have been at road traffic collisions where Doctors have stopped, asked me a few questions and then said they were out of their depth already and would see the casualty when they are in hospital with all the support advice and equipment they have there....

Like all professionals Doctors are VERY good at what they are trained to deal with, but unless they have BASICS training they are not trained for such incidents whereas for a Paramedic (or Ambulance Technician) that is what they do on every day of the week.....

So, for me, a Paramedic nearby would be a *major *bonus (sadly here in France the responders are much less trained and even a first aider from the UK has a higher level of skill IMO - they are excellent "_Pompiers_" though well used to dealing with entrapment and fires.....).

Dave


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## vicwo (Mar 6, 2008)

Good afternoon Dave. I see you live in an area of France that I have always skirted by, may have a look this summer. May I ask where you did your ambulance work. Was it in the uk ? 
I saw an old ambulance up here in Yorkshire in my rear view mirror. It was converted into a motorhome and they had the name the wrong way round. Made me smile as it said TAMBULANCE. 

Regards Vic


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## suedew (May 10, 2005)

patp said:


> When Mr P was carted off to hospital, the ambulance crew asked if we had any Paracetemol in the house. I said yes and had to go and get it for them! Apparently they are not allowed to carry it?!


Bloody good job too, this 'drug of choice' for so many ailments is also one i am allergic to. Got severe facial swelling last time i was given some, despite having told medics of my allergy.


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## Penquin (Oct 15, 2007)

vicwo said:


> Good afternoon Dave. I see you live in an area of France that I have always skirted by, may have a look this summer. May I ask where you did your ambulance work. Was it in the uk ?
> I saw an old ambulance up here in Yorkshire in my rear view mirror. It was converted into a motorhome and they had the name the wrong way round. Made me smile as it said TAMBULANCE.
> 
> Regards Vic


Yes it was in the UK, we worked part-time with WestCountry Ambulance Service answering 999 calls when needed as we lived in the country 9 miles from Exeter, we also helped them as full time crew for such special events as The Eclipse (August 1999) and Millenium night (we were at Exmouth and VERY busy until 0400...).

We also ran a St John Ambulance Division and I was i/c one of four areas that made up Devon - as well as training for them at all levels.

We had a full 999 ambulance - part of the emergency reserve for WestCountry, so that also kept us busy. We were qualified to the same level as Ambulance Technicians and my wife is also a HIGHLY qualified specialist nurse who could do things like chest drains, surgical airways and so on.....

It was hard work but very enjoyable - I also had the pleasure of doing things in London such as covering the London Marathon, the Queen's Golden Jubilee events in Buck House and Hyde Park as well as HRH Princess Diana's funeral at Westminster Abbey (eerie walking through London at 0400 in total silence as no cars, trains, buses or aircraft were moving, just the whispers of the crowd lining the streets and of course, Notting Hill Carnival.

We also used to run events for the BBC to teach the public Basic Life Support for "999 Lifesavers" - four groups of 100 people each weekend for three hours for each group. Quite a challenge.....

Do I miss it?

YES, I miss being able to help people and miss the fun of attending events that otherwise I would never have got to see (I saw most of the Pop groups at VERY close quarters including Prodigy, Levellers, SkunkanAnsie and one of the most enjoyable - Bjorn Again ) so my street cred at school was vERY high..... (We often were given souvenirs by the various groups to raffle or auction for fund raising).

But we have moved on and we still teach basic first aid to clubs and associations around here.

But that is enough of my CV.....

Dave


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