First Aid requirements

[sarmed1]

On a seperate but related note.... reading more of the 60-3, I came accross this reference:
(bold areas indicated for emphesis)

1-17 Ground operations
...
c. Ground teams must follow proper procedures upon locating a search objective.
(1) Assess and secure the scene.
(2) Render aid to survivors and prepare survivors for evacuation.
(3) Do not disturb anything at the site except as necessary to render aid to survivors.
(4) Verify the identity of the aircraft, person, etc.
(5) Advise the IC of the situation and request appropriate authorities be notified.
(6) Retain aircraft or other resources in the area until certain they are not needed.
Note: Additional information is available in the Ground & Urban Direction Finding Team Task Guide.

yet, later in the reg:

CAP medical personnel are not provided supplemental malpractice insurance coverage, and any care provided is at the members own risk.

So I am REQUIRED (ie must follow) to render aid to victims, and by product of qualification I msut be certified in first aid (and as we have argued it must be current and from a recognized qualifying agency), yet I do these mandated things at my own risk (because the organiztion doesnt carry the liability/malpractice to protect me???)

I cant see that one holding up in court real well:  if I do not take the risk (ommision), or if I do and it didnt go well (commision) I dont see CAP being able to wash their hands of it.... just saying but it sounds a lot like duty to act and the risk for a negligence suit.  Job requirement to provide aid (CAP regulation directing my actions at an incident), reasonable standard of care (referenced minimum standard by OSHA/ASTM) and an expectation of minimum competency (a card from a qualifiying agency demonstrating skill performance with an expiration date and assumption of maintainnig currency)

mk

sorry to hijack a little, but it seemd kind of relevant to the conversation.....

[Walkman]

^^ I agree our FA requirements are tricky. I'd guess that it's a product of our AUX ON/AUX OFF Corporate status. I'd love to see it more spelled out in the regs:
GTMs will train and certify to do these specific FA tasks...
GTMs may perform these specific FA tasks when necessary.

Not sure if that would work or not, but seeing the limited scope we're "allowed" to do anyway...

[Luis R. Ramos]

I do not see the connection between the inconsistencies of First Aid with our "Aux on/Aux off."

I see it more being a "changing times" development and the inability of CAP to change.

I have been teaching First Aid and CPR since 1980 for both American Heart Association and American Red Cross. Not consistently, I would teach these subjects for about three to five years, stop for about 6 to 8, then do it again. Now I am on my third iteration.

In the 1980's the focus was that communities were going to have more "hands-on" and be more self-sufficient in case of a disaster or attack. The American Red Cross taught three different First Aid classes. Multimedia First Aid, Standard First Aid, and another First Aid class that was more like a class for First Responders.

These classes would not only cover what is now taught, but would also go into patient transport and splinting.

The CPR class was taught more like you were also be alone, and advanced help would be delayed.

I think the shifts were due to that we were still under the Cold War mentality and communities would not be able to get immediate help. Since then, society has made an enormous leap. Cold War is over. Communities now live under centralized EMT/Paramedic services. Not only do we have this, but there are also the Mutual Aid compacts, where stressed communities can rely on their neighbors to provide services. And the Medevac helicopters have come of age, where the Medevac concept was just infiltrating as a result of its development during the Vietnam War.

Both CPR and First Aid have changed in scope and context during my instructor stints.

If CAP would have been as detailed as you state, it would have invalidated the task as the change took place but the organization would not have adapted. Just like the discussions we are having now regarding the Uniform Manual and the NRA badge.

Flyer

[Eclipse]

I agree that there's no "aux on/aux off connection" here, since the regs and qualifications are the same, AFAM or not.

So I am REQUIRED (ie must follow) to render aid to victims, and by product of qualification I msut be certified in first aid (and as we have argued it must be current and from a recognized qualifying agency), yet I do these mandated things at my own risk (because the organiztion doesnt carry the liability/malpractice to protect me???)

You absolutely do >not< "do these mandated things at your own risk".  If you follow the regulations the organization will protect you to
the limits of their ability and if its an AFAM with the weight of the Federal government.

It's only when you start playing "fast and loose" with regs and policies in a fashion which may well be expedient, but will not make sense
to a jury that you risk issues.

Stabilizing a victim by paying attention to the "A-B-C"s and making sure they are warm and safe until professional EMS arrives is what is expected.
However life isn't a textbook, and if they are permanently injured or die and you pull out your expired FA card from 7 years prior, you're just making
the plaintiff's job easier.

[Walkman]

I do not see the connection between the inconsistencies of First Aid with our "Aux on/Aux off."

I agree that there's no "aux on/aux off connection" here, since the regs and qualifications are the same, AFAM or not.

I wasn't around before the change to a more corporate structure, so I was fielding a guess. I was thinking more along of the lines of liability, that maybe without the full-time AUX ON status that muddied the waters enough that insurance costs were different. Just spitballin' really.

I know that the way we do GT quals are much different than in previous generations. How was medical stuff handled back then or was it the same?

[jeders]

I do not see the connection between the inconsistencies of First Aid with our "Aux on/Aux off."

I agree that there's no "aux on/aux off connection" here, since the regs and qualifications are the same, AFAM or not.

I wasn't around before the change to a more corporate structure, so I was fielding a guess. I was thinking more along of the lines of liability, that maybe without the full-time AUX ON status that muddied the waters enough that insurance costs were different. Just spitballin' really.

I know that the way we do GT quals are much different than in previous generations. How was medical stuff handled back then or was it the same?

I think what it really comes down to is one aspect of the regulation changing (these things are done at your own risk) while another aspect was forgotten (you will do these things). Just another one of those unintended consequences that no one realizes until it is too late.

[Eclipse]

I know that the way we do GT quals are much different than in previous generations. How was medical stuff handled back then or was it the same?

Well, in 1956 we were hanging IVs in the field, so that's one side of the pendulum swing.


http://captalk.net/index.php?topic=16769.msg302175#msg302175

Between there and today are likely a lot of lawyers actuaries, and "best intentions".

[a2capt]

Even the PA Ranger School attests to what we used to do vs. what we are now.

It's evident that once we were pretty much a first responder in that we went to look, and were the first on the scene. That's changed drastically. Many times though we may still be the first on the scene, we're in contact with the sheriff and help is in trail and in many cases on station waiting if we've reported sighting of a crash, they move in fast.

The days of getting cadets out of school and sending them out on a ground team volunteer fire dept. style are long gone.

Unless you go to the Ranger School today, some still seem to come back with the mentality that we do just that.

[Luis R. Ramos]

For First Aid, we taught the rescuer that "if a person is suffering from shock, does not show internal bleeding, not wounded in the stomach, and can swallow, make a mixture of water, salt." actual portions escape me at the moment. They were to drink sips of this about 1/4 or so per hour.

The class covered splinting injuries, and offer practice. Now the American Heart Assoc states to cover splinting only if the state allows it.

Multimedia First Aid students practiced Fireman's Carry; Litter Movement (basically the task for GTM3 on this); dragging an injured person in a blanket; and two chair carries for a conscious injured. One consisted of two rescuers sitting the injured in a chair, one rescuer would lift the back of the chair the other the legs. The second chair carry consisted of the two rescuers bending their left arm and extending their rights. The left hand would be placed on one's top right arm right where it bends. The hands of their extended right arms would grab each other's left elbow. This formed a seat. The injured victim would seat here and put his/her arms on the rescuer's shoulder.

What to do in case of poisoning was also left to the care of the rescuer. It taught to induce vomiting if there was no sign of burning at the mouth (indicative of swallowing acid or base solutions) and administering an activated charcoal mixture. At that time, there was no Poison Control Number or was starting to appear.

The basic American Red Cross class was Multimedia First Aid Class to be taught in two days. It used a 16mm film, and was the same format we see now. Watch video, stop, practice. There was even a test. Cannot state what is the contents of the current ARC First Aid class as I am not an instructor for this class. But the American Heart Association class is given in 5 hours without a CPR module, and 7 if with a CPR module. It does not cover injured transfer, and it is taught with the assumption that there will be contact with another agency providing advanced care. the test is optional, back then it was not.

CPR has seen the same context shift. In 1980 it was two days as well. If a heart attack was witnessed, the rescuer would give a pre-cordial thump on the middle of the chest, by raising a fist not higher than a foot from the chest. Non-healthcare rescuers, as well as health care rescuers were taught to feel for a pulse. Now the AHA teaches non-healthcare rescuers to look only for no breath, and if there is no breathing to begin compressions. The AHA now teaches that only health care providers are to feel for a pulse. In 1980 you would begin CPR by 1) checking for responsiveness, open airway one hand under the neck the other on the forehead and pulling up, 3) checking for breath by listening for breathing sounds, feeling for air coming out in your cheek, and looking for chest movement. No breathing, give four breaths then check pulse. No pulse, then begin compressions.

We also taught to check dilation of the iris to both healthcare and non-healthcare providers to check for CPR effectiveness.

Now AHA says to 1) check for scene safety, 2) check for response, 3) check for breathing, no breathing call for help and begin compressions then breath (healthcare providers will add feeling for a pulse after yelling before compressions). Now we do not listen or feel for air. We practiced two-rescuers whether it was a healthcare provider or not. Now AHA practices two-rescuer only if it is a healthcare provider. In 1980 we practiced both responsive and non-responsive victim choking. We practiced hand position only on students and warned not to give thrusts, and practiced non-responsive choking victim by 1) turning victim on the side and giving back slaps, 2) placing him/her back right side up then giving abdominal thrusts, looking for something in the mouth then breathing... And we also taught that if we suspected neck injury, instead of opening the airway with the hand under the neck, to pull the jaw up and away, which usually resulted in separating the lower jaw from its normal position.

Many were the manikins torn up in the eye by police and firemen when opening the eye to check for CPR effectiveness, and in the mouth again by police and firemen when practicing by opening the mouth to remove an object.

But I had fun. I was a member of an organization that served as a reserve for the state Civil Defense (not all members went out). We also provided First Aid to Boy Scout camps. Some classes were held at a hospital, and they would provide free lunch. We would place the infant on our shoulders, some people would gasp then laugh. I almost had a CO2 extinguisher discharged in my face by one of our members who was in his teens, but he moved his arm 45 degrees, and pressed the button, it delivered... And I was permitted to watch several operations without being a medical student. The director of the AHA CPR program under which we taught was also head anesthesiologist, so he was able to let us go into the operating room...

Sorry for the long post, it was asked...

Flyer

[RiverAux]

I would be in favor of CAP having a program to teach our own First Aid classes if we can do it in accordance with an accepted national standard for both the training and those giving the training.  There is nothing magical about the Red Cross or AHA that makes them fundamentally different from CAP in their ability to teach this class.  Why give money to other organizations when we could do some of it ourselves with a little effort? 

Its pretty stupid that when I've got an ER doc in my unit (which has been the case in the past) that the ER doc can't jump through a few easy hoops to be a certified trainer and then be able to use a CAP First Aid training program and teach it to our cadets. 

[lordmonar]

I would be in favor of CAP having a program to teach our own First Aid classes if we can do it in accordance with an accepted national standard for both the training and those giving the training.  There is nothing magical about the Red Cross or AHA that makes them fundamentally different from CAP in their ability to teach this class.  Why give money to other organizations when we could do some of it ourselves with a little effort? 

Its pretty stupid that when I've got an ER doc in my unit (which has been the case in the past) that the ER doc can't jump through a few easy hoops to be a certified trainer and then be able to use a CAP First Aid training program and teach it to our cadets.

+1
To be an ARC or AHA instructor....you just gots to pay your money and take the course....fill out a bunch of agreements and then you are set....assuming you collect the money and send it up the chain.

First Aid Training is not really propietory information.

We just need to get a working group together, figure out what qualifications we need and write the text.

BITD we had teams that had people who knew how to do IV's.......that may be a little farther then we want to go......but there is no real reason why we can't go that far....IF CAP was willing to accept that level of risk.

Like I said befor....IMHO ARC First Aid Training does not go far enough for our Ground Team needs.  NOLS has a wilderness first aid for first responders that is probably a better fit for out Ground Teams is a worst case scenirio.

[Walkman]

I would be in favor of CAP having a program to teach our own First Aid classes if we can do it in accordance with an accepted national standard for both the training and those giving the training.  There is nothing magical about the Red Cross or AHA that makes them fundamentally different from CAP in their ability to teach this class.  Why give money to other organizations when we could do some of it ourselves with a little effort? 

Its pretty stupid that when I've got an ER doc in my unit (which has been the case in the past) that the ER doc can't jump through a few easy hoops to be a certified trainer and then be able to use a CAP First Aid training program and teach it to our cadets.

+1
To be an ARC or AHA instructor....you just gots to pay your money and take the course....fill out a bunch of agreements and then you are set....assuming you collect the money and send it up the chain.

First Aid Training is not really propietory information.

Plus, ARC instructors no longer have the ability to do the classes at free/reduced rates. ARC courses are pretty pricey, IMO. Having this ability internally would ease that burden for sure.

[Spaceman3750]

I would be in favor of CAP having a program to teach our own First Aid classes if we can do it in accordance with an accepted national standard for both the training and those giving the training.  There is nothing magical about the Red Cross or AHA that makes them fundamentally different from CAP in their ability to teach this class.  Why give money to other organizations when we could do some of it ourselves with a little effort? 

Its pretty stupid that when I've got an ER doc in my unit (which has been the case in the past) that the ER doc can't jump through a few easy hoops to be a certified trainer and then be able to use a CAP First Aid training program and teach it to our cadets.

+1
To be an ARC or AHA instructor....you just gots to pay your money and take the course....fill out a bunch of agreements and then you are set....assuming you collect the money and send it up the chain.

First Aid Training is not really propietory information.

Plus, ARC instructors no longer have the ability to do the classes at free/reduced rates. ARC courses are pretty pricey, IMO. Having this ability internally would ease that burden for sure.

Yes and no, unless there's been a development in the last few months since I've been a little off the ARC radar... If you have an AP agreement there is a minimum fee plus supplies (I'm not going to post the fee here since I'm not sure if that's covered by some NDA somewhere), which is much lower than the rate you pay to take a class at the chapter. Once upon a time I taught FA classes to CAP for as little as $10, now I think that number is somewhere around $25 and you get to keep the ready reference card.

If they're requiring the full (insert whatever the current horrible number is) I'm bridging to AHA...

[lordmonar]

Plus, ARC instructors no longer have the ability to do the classes at free/reduced rates. ARC courses are pretty pricey, IMO. Having this ability internally would ease that burden for sure.

The ARC started "cost recovery" back in the late 80's early 90's......they have just gotten more adamant about it.

So yes....even if you got one of your squadron members to be an ARC instructor and though "we'll just buy one set of books and do CPR for everyone in CAP" would be a direct violate of the provider agreements that each instructor is supposed to sign.

[tsrup]

BITD we had teams that had people who knew how to do IV's.......that may be a little farther then we want to go......but there is no real reason why we can't go that far....IF CAP was willing to accept that level of risk.

Like I said befor....IMHO ARC First Aid Training does not go far enough for our Ground Team needs.  NOLS has a wilderness first aid for first responders that is probably a better fit for out Ground Teams is a worst case scenirio.

No no no no to IVs.
That is an advanced prehospital skill that takes hours of patient contact to be certified with.  Unless you want cadets running around ERs starting IVs on people, or starting them one themselves at the squadron for months on end in order to get the proficiency, it's best left alone.

Not to mention the physiological knowledge needed to know when an IV is and isn't indicated cannot be taught in one lesson.

I've even heard that Combat Life Saver is doing away with teaching soldiers how to do IVs because now soldiers get so into getting a line started, they forget to do the ABCs first.

Sorry for the pile on what you probably meant as a throwaway comment, but it needs to be known that there is more to IVs than just a skill.

[SARDOC]

No no no no to IVs.
That is an advanced prehospital skill that takes hours of patient contact to be certified with.  Unless you want cadets running around ERs starting IVs on people, or starting them one themselves at the squadron for months on end in order to get the proficiency, it's best left alone.

Not to mention the physiological knowledge needed to know when an IV is and isn't indicated cannot be taught in one lesson.

I've even heard that Combat Life Saver is doing away with teaching soldiers how to do IVs because now soldiers get so into getting a line started, they forget to do the ABCs first.

Sorry for the pile on what you probably meant as a throwaway comment, but it needs to be known that there is more to IVs than just a skill.

Yes, Combat Life Saver, no longer teaches intravenous therapy and more focuses on early application of tourniquets and Chest Decompressions.  They have had numerous instances of Soldiers bleeding out while the Life Saver was too focused on starting an IV instead of just stopping the bleeding.

[lordmonar]

BITD we had teams that had people who knew how to do IV's.......that may be a little farther then we want to go......but there is no real reason why we can't go that far....IF CAP was willing to accept that level of risk.

Like I said befor....IMHO ARC First Aid Training does not go far enough for our Ground Team needs.  NOLS has a wilderness first aid for first responders that is probably a better fit for out Ground Teams is a worst case scenirio.

No no no no to IVs.
That is an advanced prehospital skill that takes hours of patient contact to be certified with.  Unless you want cadets running around ERs starting IVs on people, or starting them one themselves at the squadron for months on end in order to get the proficiency, it's best left alone.

Not to mention the physiological knowledge needed to know when an IV is and isn't indicated cannot be taught in one lesson.

I've even heard that Combat Life Saver is doing away with teaching soldiers how to do IVs because now soldiers get so into getting a line started, they forget to do the ABCs first.

Sorry for the pile on what you probably meant as a throwaway comment, but it needs to be known that there is more to IVs than just a skill.

Yes....you are piling on me......for a more or less throw away comment.

Just some comments I need to make.

While I support whole heartedly cadet's involvement in ES......I completely disagree with the concept that GROUND TEAMS=CADETS.  That is one of the reasons why we have so much trouble getting traction with outside agencies when we try to get our GT's into their operations.  If we are going to bill ourselves as an SAR agency we need to make sure we have the capability with out including any cadet participation.

Second Comment......IF.....IF CAP were to be okay with the risk.....then yes it would be assumed that the member's who performed this level of care would have the proper certifications and training to do so.

[a2capt]

In the past when we've had ARC classes organized for the unit, it's been where the instructor does it for the cost of the books and supplies rentals spread across the participants. 

[tsrup]

BITD we had teams that had people who knew how to do IV's.......that may be a little farther then we want to go......but there is no real reason why we can't go that far....IF CAP was willing to accept that level of risk.

Like I said befor....IMHO ARC First Aid Training does not go far enough for our Ground Team needs.  NOLS has a wilderness first aid for first responders that is probably a better fit for out Ground Teams is a worst case scenirio.

No no no no to IVs.
That is an advanced prehospital skill that takes hours of patient contact to be certified with.  Unless you want cadets running around ERs starting IVs on people, or starting them one themselves at the squadron for months on end in order to get the proficiency, it's best left alone.

Not to mention the physiological knowledge needed to know when an IV is and isn't indicated cannot be taught in one lesson.

I've even heard that Combat Life Saver is doing away with teaching soldiers how to do IVs because now soldiers get so into getting a line started, they forget to do the ABCs first.

Sorry for the pile on what you probably meant as a throwaway comment, but it needs to be known that there is more to IVs than just a skill.

Yes....you are piling on me......for a more or less throw away comment.

Just some comments I need to make.

While I support whole heartedly cadet's involvement in ES......I completely disagree with the concept that GROUND TEAMS=CADETS.  That is one of the reasons why we have so much trouble getting traction with outside agencies when we try to get our GT's into their operations.  If we are going to bill ourselves as an SAR agency we need to make sure we have the capability with out including any cadet participation.

Second Comment......IF.....IF CAP were to be okay with the risk.....then yes it would be assumed that the member's who performed this level of care would have the proper certifications and training to do so.

What would be the point of CAP starting IVs anyways?
Even if the member was an AEMT, Paramedic, Nurse, etc...

[Ned]

Military Practical Joke:

During particularly warm brigade-level field exercises for our Guard unit, I would suggest to soldiers that looked a little peaked wandering around in their full battle-rattle that they drop by the Battalion Aid Station and tell the medic that they felt a little dizzy.

I would then go watch as a half dozen college students and 7-11 clerks who were school trained 91 Alphas for two weeks tackled the patient, stuff them into one of the medic tracks, and practice putting lines into each arm to treat the soldier for "dehydration."

They sure needed a lot of practice to get the lines running.  It was hilarious.

I always felt a little bad about that . . . . .

But at least the medics got trained.

And reminded me to drink a lot of water.