Remote First Aid Course Review and Development - Your Views needed..

Submitted: Tuesday, Jan 13, 2009 at 07:15
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Hi All,
I will be spending this Thursday with some other staff undertaking a review and re-write of the Remote First Aid Course that is run by one of the largest providers of first aide courses etc in Australia.

WHilst I have read previous posts, I don't have time to go back through all the archived posts about this topic.

I would really appreciate the following feedback from this forum.

If you have done the course;
- What was good?
- What was bad?
- What content / subject matter would you prefer?
- What useful tips of the trade would benefit a course like this?

If you haven't don this course;
- What do you think should be in a "Remote First Aid Course?

I look forward to all of you input and feedback..

Cheers
Shane
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Reply By: Bob Y. - Qld - Tuesday, Jan 13, 2009 at 08:23

Tuesday, Jan 13, 2009 at 08:23
Shane,

Neither Wife nor I have done the "remote" course, but have done senior first aid.

Our thoughts are the following:

Burns; Fractures/breaks/sprains; head injuries; bleeding; snake bite; seizures; heart attack/strokes; asthma attacks and most importantly, some" DON'T PANIC" advice for novices & others.

Maybe some use of communication equipment too, but one would think they have this already? Vehicle rollovers need to be covered as well, including removal of patients from vehicle.

Also, some substitution suggestions, such as strips of shirts, instead of bandages, or towels as neck brace etc.
Advice on minimum first aid kit requirements for travellers.

Sounds like a solid thursday coming up, with lots of butchers paper & white boards??

Cheerio,
Bob.
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Can't remember most of it.

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Follow Up By: ben_gv3 - Tuesday, Jan 13, 2009 at 12:18

Tuesday, Jan 13, 2009 at 12:18
Bob,

He's asking for notes on a Remote FA course not a Paramedic/Rescue course.

Only SES/Rescue are taught to do removal of patients etc. It's pretty complicated with a high chance to do further damage.

I've done both Senior and Remote Area FA and IMHO there wasn't a big difference between the two. Remote FA was more about patient stabilisation, stretcher bearing etc, NOT rescue.

I've done cerviacle (neck brace) trg and using a towel is too soft. I've trained with using a folded up newspaper but you'd have to be really careful.

I agree though that comms trg, how to deal with RFDS etc would be great.
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Follow Up By: Motherhen - Tuesday, Jan 13, 2009 at 13:24

Tuesday, Jan 13, 2009 at 13:24
Ben, if you are the only one on the scene, i think Bob's list do come under first aid not paramedic. You can't do CPR on a victim is trapped in a wreck. Apart from communications equipment, these points have all been covered in past first aid courses if have attended - although over the years the course has been getting shorter, eg concentrating on immediate life saving, instead of spending hours learning the correct techniques of using bandages.



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Follow Up By: Top End Explorer Tours - Tuesday, Jan 13, 2009 at 14:20

Tuesday, Jan 13, 2009 at 14:20
The remote course I attended 5 weeks ago dealt with everything you described Bob and more, I did mine with Red Cross and the instructor was an ex army medic, We did a 2 day course, 1 day theory 1 day practical in the field.

I am now confident that I could nurse a patient for an extended period EG: over night or longer, I am confident that I could assist with a patient extraction as well.

So for me the course I did was extensive and sufficient.

Cheers Steve.
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Follow Up By: Bob Y. - Qld - Tuesday, Jan 13, 2009 at 21:55

Tuesday, Jan 13, 2009 at 21:55
Yeah, whatever, Ben. I've got broad shoulders.

If you picked me up on anything, it should have the omission of CPR.

Wife & I discussed this @ brekkie this morning, and that's our list. We've been together in remote areas for 30 years, and those were the points WE felt most important, after our experiences in areas like the Gulf, Barkly Tablelands & here on the Diamantina.

If I was in a vehicle rollover that started to burn, I'd much prefer the rolled-up towel to your folded newspaper, Ben, as a neck brace. In that scenario, doubt if I'd like to wait the 3 or 5 hours for the local ambos to arrive either, with a proper neck brace.

I feel the most important point is that we all do these courses, so we can care for each other, in areas far removed from 000, paramedics & almost instant care.

Thanks for your support, Motherhen & Steve.

Regards,
Bob.
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Reply By: Peter_n_Margaret - Tuesday, Jan 13, 2009 at 09:29

Tuesday, Jan 13, 2009 at 09:29
Shane, we are much like Bob.
Add some advertising to your list. We are aware of the course, but haven't done one and that is a mistake.
Also when to wait for help and when to go to it (if you can).
How to stay alive in the mean time.

OOO. I spent 15 minutes talking to someone on 000 once on a sat 'phone without getting to first base. I reccon he was in a different country. There must be some tricks to make this system work better?

Thanks for your efforts.
Cheers,
Peter
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Reply By: Member - Kiwi Kia - Tuesday, Jan 13, 2009 at 09:46

Tuesday, Jan 13, 2009 at 09:46
Hi Shane,
With regard to your - 'What useful tips of the trade would benefit a course like this? '

I have found that people often get to carried away at the scene of an medical emergency and try and do to much. I try and remind people that there is a big difference between emergency first aid and medical aid. As far as possible I push the "Stabilise them & ship em out" and 'keep an eye them' approach. By all means learn a lot but don't get blinded by an overload of information.

.
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Follow Up By: Motherhen - Tuesday, Jan 13, 2009 at 17:05

Tuesday, Jan 13, 2009 at 17:05
True Kiwi Kia - but a big difference between regular first aid and remote.

Mh
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Follow Up By: Member - Kiwi Kia - Tuesday, Jan 13, 2009 at 18:36

Tuesday, Jan 13, 2009 at 18:36
Motherhen, I am not criticising. Shane was asking for ideas that could enhance the effectiveness of a course. I am suggesting that in my experience emphasise should be on NOT trying to be what the average traveller clearly is not - a medical practitioner. One of the first requirements of anyone assisting in a medical emergency is "Do no harm".
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Follow Up By: Motherhen - Tuesday, Jan 13, 2009 at 18:50

Tuesday, Jan 13, 2009 at 18:50
Kiwi Kia, no criticism of your input intended.

Mh
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Reply By: DIO - Tuesday, Jan 13, 2009 at 10:08

Tuesday, Jan 13, 2009 at 10:08
Any course or training that will better equip you and provide you with skills that could save a life or at least prevent additional medical complications are worth undertaking. e.g. First Aid, Life Saving, Driver Training, etc. So instead of you asking silly questions regarding what to expect etc, how about you provide us with a synopsis after you have completed the course. Tell us why we should do it, who can benefit from it and was it of any value.
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Follow Up By: Sir Kev & Darkie - Tuesday, Jan 13, 2009 at 11:22

Tuesday, Jan 13, 2009 at 11:22
DIO,

Re-read the post....................................he is re-writing the course NOT doing the course.


Cheers Kev
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Follow Up By: Hairy (NT) - Tuesday, Jan 13, 2009 at 18:40

Tuesday, Jan 13, 2009 at 18:40
Hahahahaha....
Dio strikes again.
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Reply By: Steve63 - Tuesday, Jan 13, 2009 at 11:14

Tuesday, Jan 13, 2009 at 11:14
Have done the senior first aid course but not the remote course. I suspect the difference is that a plain first aid course is about stabalising the patient until qualified aid arrives. If this is going to be days a bit more may be required. Much of what needs to be done is likely to be at the direction of RFDS. So if they say do x you know what they mean. I also suspect that a lot of the things that are no longer in the first aid courses will be included. The thing is to be able to use the kit you have to keep your patient alive until help can be reached or arrive. I suspect the issue will be differencating when to go the extra step. Some harder things will be when to not do something.

Steve
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Reply By: Motherhen - Tuesday, Jan 13, 2009 at 13:47

Tuesday, Jan 13, 2009 at 13:47
A welcome question Shane. I have maintained Senior First Aid Certificate over many years and changes, but have not done remote first aid. Nor have i ever heard of it, apart from time to time on this site, no doubt because I do not live in a remote area.

The main thing is how to cope when you are alone. This must also involve a higher degree of patient care as help may be many hours away. If no-one is within screaming earshot at the time, you are all on your own.

Being in a rural area, every time the instructor says 'don't leave the patient' or 'send someone else to call for an ambulance' the class members always say 'but we are most likely alone with the accident victim in a paddock/beach or wherever'. So strongly is this in rural people's mind, that some years ago when the course included role playing; having one person to play the role of a victim, and a classmate to come in as 'first on the scene' to assess and apply first aid. For the embedded object test, I was to play the victim and chose to have a knife embedded in my thigh whilst fishing on the beach. The lady sent to assess came in with the first questions - how far away is your car? and how are we going to get you off this beach? as this remoteness aspect was foremost in all our minds.

Refresher CPR needs to be an important part of every course.

Motherhen
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Reply By: Crackles - Tuesday, Jan 13, 2009 at 14:58

Tuesday, Jan 13, 2009 at 14:58
All 1st aid courses that I've done centre around what action is taken till the ambulance arrives in 30 to 40 minutes. A remote couse I'd see will need to include how to stabilize a patient for up to a day (in each situation) & transport them if neccesary. Some additional back ground info on other medical conditions would be handy also.
Cheers Craig...............
AnswerID: 344102

Reply By: Member - DAZA (QLD) - Tuesday, Jan 13, 2009 at 15:05

Tuesday, Jan 13, 2009 at 15:05
Hi Straps

We completed a similar course 18 months ago, through a federal
government agency, mandatory for their contractors, when it come
to Snake Bites, he insisted that we look into Venom Test Kits,
for when Identification of the Snake is unavailable, that was all well and good if we carried that type of equipment, he stated that in
some cases it is part of the First Aid Kit in Remote Areas now,
I argued that in most cases we are in mobile phone range from any
ambulance centre or 000, as we maintain government buildings ect,
I passed the course, but I think some of the training didn't apply to
contractors like our selves who never go off the beaten track with
our work.

Cheers
Daza
AnswerID: 344103

Reply By: The Landy - Tuesday, Jan 13, 2009 at 17:20

Tuesday, Jan 13, 2009 at 17:20
One area that doesn't appearto get a lot of attention (specifically) in remote area first aid, is the treatment of young children. As four-wheel drivers many of us travel in remote areas where medical help may be some time away and the deterioration of acute children illness can occur before adewuate help arrives.

Perhaps this might be an area worth looking more closely at....

Good luck with this.
AnswerID: 344130

Follow Up By: Member - Phil G (SA) - Wednesday, Jan 14, 2009 at 12:41

Wednesday, Jan 14, 2009 at 12:41
Landy, that is very true.
Management of dehydration, febrile illnesses, and emergencies such as near-drowning in small children are often glossed over or omitted. I gave a talk on Paediatric CPR to a group of 4wders once and none of them had covered it in their first aid training.
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Reply By: Member - Kiwi Kia - Tuesday, Jan 13, 2009 at 19:38

Tuesday, Jan 13, 2009 at 19:38
Shane, another thought. There are some good (and cheap) items available these days that the ordinary person can (and does) use on a daily basis. I have people around me that do their own blood tests several times a day for diabetes and certain renal problems. I carry a blood pressure monitor that gives a digital readout for blood pressure, pulse rate and also indicates if the patient has arythmia (less then $50). The automatic defribulators are becoming smaller and cheaper almost by the day. Some members of this forum carry portable pressure breathing devices (CPAP) with them on the road. As many people now carry satellite phones and / or HF radio a lot of good hard factual information can easily be relayed to RFDS etc. and good advice for patient management can be given in return. Perhaps an introduction or demo of some of this equipment and how it can be used to gain diagnostic information could be beneficial. On my 'away from home' trips I get every one to write down a list of their ailments and medications and place them in a sealed envelope in the glove box of their vehicle. In the event that the information should be needed we can pass on the envelope or information to the appropriate people.
AnswerID: 344160

Reply By: Robin Miller - Tuesday, Jan 13, 2009 at 22:09

Tuesday, Jan 13, 2009 at 22:09
Hi Shane

We used to do the senior first aid courses at work for about 8 people , but chucked it in when the accreditation period was reduced , think its only 2 or 3 years now.
(they already had low credibility - when you were not even supposed to have panadol etc available - if person wanted it)

Most of the first aid courses seem to basically and up to do nothing except don't make the situation worse and seemed of little value above common sense.

Any real remote first aid course would have to have as its basic assumption that help isn't going to come in a hurry and may be up to a week away.
Robin Miller

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Reply By: Member - Straps (SA) - Tuesday, Jan 13, 2009 at 22:27

Tuesday, Jan 13, 2009 at 22:27
Many thanks to all for the varied feedback, discussion and comments.

I welcome many more in the next day or so, if possible.

Cheers
Shane
AnswerID: 344205

Reply By: Member - Alastair D (NSW) - Wednesday, Jan 14, 2009 at 17:27

Wednesday, Jan 14, 2009 at 17:27
Shane,
My wife and I did the 3 day Remote FA course run by the St John's Ambulance. Overall it was quite good. The instructor was ex army and had an interesting approach that kept people involved and awake.

The course was strongly predicated on professional help being available in fairly short time. We felt that more was needed on looking after a patient for a period of days if help could not get in due to location or weather etc.

I recognise that FA is to minimise further harm and stabilise the patient but some simple interventions can be very effective provided they are the right ones at the time.

We also found that the book provided had sections that were quite different to what we were taught. A lot of things are changing and we were told to do updates regularly.

Having a lot of hands on practice in different scenarios was a strength of the course. It was noticeable how timid most people were at the start but grew in confidence as the course progressed and the standard approach became embedded. I think it is essential that any course has a good mix of theory and practice. I was pleased that the course we did put things into practice very early.

Our course had a good balance between illness and injury. It certainly covered what we felt was most likely to present to us during 4wd trips. If a major event occurs then one hopes that the communication devices one should have work correctly.

I think some people expect to be taught more about how to treat people and make them better. Sure this can be done for things like dehydration, heat stroke etc but with injuries a lot of harm can be done if the wrong 'diagnosis' is made. Emphasis must be on harm minimisation and stabilisation.

Good luck with your task.

alastair
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