Thread 64244832

Hello anons, not sure if this is off-topic but I figure this is the best board to discuss this.
>be me
>first aid training comes from army reserve
>here we are taught to look for and fix catastrophic bleeds BEFORE checking airways/breathing
>be looking through my country's road safety regulations/training
>first aid advice here tells everyone to look at breathing first
Now I think this is retarded and will get people killed, specifically because car collisions are one of the few common civilian circumstances which can produce catastrophic haemorrhages. Am I nuts? Is army first aid better than civvie first aid? Discuss. Also share anything vaguely combat medic related, that shit is great

Bleeding first makes sense, you can go 5 minutes without air no worries but you can bleed out in that time and no amount of CPR will help.
As for why I'm guessing they are worried about telling people with no training to focus on bleeds because retards will tourniquet minor bleeds because they have never seen anything worse than a paper cut.

A good rule of thumb is when you find conflicting information go with the more in depth source. In this case one focuses mainly on road rules with a little bit of first aid while the other is nothing but first aid.

>>64244832 (OP)
In a car crash, you're generally going to be dealing with either amputations, which will usually be obvious without going down the checklist, or impalements, which are less critical since they're typically plugged by the impaling object. Small holes that rapidly leak large amounts of blood are fairly specific to battlefields and firing ranges.

Is the gun censored to avoid harming redditors?

It's because massive hemorrhage is the number one cause of preventable death on the battlefield. In civilian medicine, that's not true.

>>64244886
lmao I only just noticed that
fucking kill me I just got that image off of google for the sake the thread

>>64245495
typically, what about battlefield medicine (up until now) has made it so that people are dying of haemorrhage in "preventable" ways specifically? Like I get that haemorrhages happen a huge amount in war, just what is it exactly that we've been doing "wrong" about treating them? not focusing on them enough in casualty drills/protocols?

>>64244858
>retards will tourniquet minor bleeds because they have never seen anything worse than a paper cut
It's pretty nuts how much you bleed even for non-lethal wounds. I got a bad head injury where a chunk of my scalp kinda degloved/ruptured and although I was actually in very little danger (as I later found out), the whole side of my face and chest was covered in rushing blood, so much so that at the time I was genuinely worried that I was gonna die. I know better now of course but it was bretty spooky.

>>64244832 (OP)
My training was from the Red Cross years ago, and from a bunch of scoutmasters who were surgeons and EMTs. I was always taught that when you first walk up on a victim the very first thing you do is assess anything that is still an active threat and might be to you. I.e. a car crash where the car is still on fire, an electrocution where the live wire might still be a threat, falling debris from a collapsed building. After that you assess the victim's condition. We were taught to check "ABC" , meaning "airway-breathing-circulation", but it's also sort of assumed that if you see major bleeding then that's sort of a priority. This is something you have to learn to assess, and it's going to vary based on the exact circumstances. Clearly if someone has a minor wound but is choking you're going to ignore the wound for now and focus on the choking. OTOH if it looks like they're breathing but they've got a massive wound you're going to focus on the wound first.

>>64246492
NTA, I think the real underlying difference between military and civvie medicine isn't what's effective, it's what kinds of wounds are being caused. Hemorrage is very common in the military because gunshots, bombs, shrapnel all cause it and there's lots of that stuff going on. Most civilian incidents that need emergency medical are things like slips & falls, broken bones, sprains, and motor vehicle accidents. Now car crashes absolutely can cause physical trauma but that's not as common these days with seat belts, air bags, etc. Blunt force injuries are more common.

>>64246509
head wounds in particular bleed a lot.

>>64244858
Nope, airway is primary concern unless arterial bleed. If its a vein or a capillary you got time to open up that airway and start to give O2 or ventilate. That is assuming youre working alone which EMS almost never does, so ideally you can get both done.

Someone better check kirks airways asap

>>64246521
Yeah I got taught XABC in EMT school, which is Life threatening( almost always arterial) bleeds, and the aforementioned ABCs

>>64246521
oh yeah no same here, I always take that as the given "first step" being assessing the situation and any ongoing dangers to yourself and the victim. but then from there is when you get a variety of flowcharts on what to focus first. I suppose what irked me the wrong way is reading the recommended first aid chart and seeing bleeding remarkably far down the list of stuff to check for when we were always drilled so hard on bleeds above all else. probably mainly because catastrophic bleeds are the easiest/most "fun" to simulate in training exercises, it's a lot harder to get someone to pretend to have a spine injury and make that a rewarding piece of training than it is to get a dude to roll around fake-screaming and you've gotta wrestle him to get a tourniquet on

>>64246521
Its amazing how much this applies to even things like fires. Firefighters have been killed by arsonists before, as recently as June of this year in Coeur d'Alene, Idaho.
So sometimes it isn't about a victim exactly, if can be any emergency situation you're showing up to.

>>64246678
as an anecdote - the british army's battlefield casualty drill equivalent of the "assess the situation for danger before anything else" is that the first step in the casualty flowchart is "have you won the firefight yet" - if you haven't won the firefight yet, then the immediate drill is to "win the firefight" before anyone's allowed to start triaging (the idea being that the person unfortunately needs to start looking after themselves or the whole fireteam will weaken in effectiveness, lose, and be killed or worse). Obviously this is hyper context/role dependent (dedicated combat medics for instance aren't gonna not help you just because there's a firefight still on) but I always liked that aspect

>>64244832 (OP)
What country though? You would think that detail is important. Also I can't really say why you was taught to check for bleeding first. If you're not breathing your heart is also stopped and you're essentially already dead, and your only hope is that someone does CPR to buy you a few extra minutes for a hospital to revive you before brain death. Yes, a few minutes. Doing anything on the battlefield when someone isn't breathing is pointless even with a fast medivac. It could just be for morale reasons. Sounds cynical but heartlessly triaging someone who looks fixable is pretty bad for morale.

>>64246599
>fingers going like that
Even if he somehow miraculously survives, he gonna end up hot wheels

>>64246492
Medicine is driven forwards by war, and our understanding of trauma care has been massively improved by Iraq and Afghanistan. Lots of the developments in civilian trauma have been taken from the military. A lot of it is our understanding of major haemorrhage and how to treat it, things like damage control surgery, the golden hour, whole blood transfusion and the like. Even 20 years ago people were smashing in bags of salty water (doesn't clot and doesn't carry oxygen) then trying to do complex trauma surgery in an unoptimised patient. Nowadays it's all about giving whole blood/blood products and rapid surgery just to gain stability, then continue resuscitation before going back for more definitive management. There's way more stuff obviously with advances in radiology, anesthetics, surgical techniques, intensive care, monitoring etc etc. It's a very interesting field.
t. anesthesiologist shitposting in the OR

>>64246821
Truth nuke, best example probably being the Cat tourniquet

>>64246846
elaborate on the cat tourniquet my nigga
>>64246821
excellent post anon thank you

>>64246863
This bad boy you see on every larperators carrier setup is actually pretty good at stopping bleeds turns out
Combat Application Tourniquet

>>64246753
Oh hes dead buddy, you dont survive that kinda hit. The loss of blood pressure to the brain alone would probably do it, not to mention the blood fountain.

>>64246961
>miraculously survives

>>64247037
Hes literally dead, but yeah no you are correct if he did survive, brain damage for sure

>>64247079
Nah yeah definitely croaked but just hypothetically

>>64247133
He already answered your hypothetical so I don't know what more you want.

>>64246599
Any guesses as to type of weapon used? I'm gonna run for president on the policy that I will make that weapon our national gun and I'll win in a landslide. Literally no one liked that faggot.

He who saves his country commits no crime.

>>64247435
Gonna guess .223 of some kind? Didnt look like the exit wound sent much flesh flying off or split the neck open too badly, and the blood seemed to mostly come from the entry wound itself which I guess means no major cavity or exit wound to the side or back of the neck, which I would have said rules out something like a .308 or 6.5 etc.
Just going off whats most available, it has to be so kinda AR type right?

>>64244832 (OP)
Can only speak from a civilian side but the training for first responders always begins with danger and then airway breating circulation etc
It's a uniform training model to make sure everyone has the same assessment pathway, and as said before massive haemorrhages aren't as common in civilian EMS
>t. paramedic

>>64244832 (OP)
We are also trained for stop the bleed first. I am a prison swat team medic and most responses we are trained for involve stab/slash wounds. I would advise everyone reading this thread to get a tq and familiarize yourself with basic first aid principles. Take training if you can, most colleges offer first responder classes for cheap.

>>64246481
>>64244886
>censored
no that's normal for concept renders/portfolio stuff where the focus is one particular asset and not something that might be unfinished/placeholder or done by another person
https://www.artstation.com/artwork/oAdR3q

if you look at the rest of his profile you can see how other stuff that wasnt his work is left blank too

>>64244886
god damn you are so excited to get offended by things.

>>64247435
why are you replying to your own post to get engagement?

>>64247465
.308 FMJ is used for bird hunting in Europe so it's not like it makes you explode to bits

>>64246740
>Country
bongland
>If you're not breathing your heart is also stopped and you're essentially already dead, and your only hope is that someone does CPR to buy you a few extra minutes for a hospital to revive you before brain death. Yes, a few minutes. Doing anything on the battlefield when someone isn't breathing is pointless even with a fast medivac
This makes sense if you're talking about minor bleeds that won't kill (where you can still do CPR), but doing CPR on someone missing a limb or with an arterial (or otherwise catastrophic) bleed is retarded anon. You'll end up literally pumping the blood out of someone and accelerating their death. The whole point of CPR is to get air back into the bloodstream and then trying to get that blood circulating manually. You should always treat that which will kill someone first, and a catastrophic bleed (on a purely time-to-death basis will be that)

also just to take a look at your scenario
>If you're not breathing your heart is also stopped and you're essentially already dead, and your only hope is that someone does CPR to buy you a few extra minutes for a hospital to revive you before brain death
In the scenario you describe, if the person was also missing an arm and a leg, THAT's what would kill them first and what you'd need to adress before even beginning to adress a stopped heart and lack of breathing.
>It could just be for morale reasons. Sounds cynical but heartlessly triaging someone who looks fixable is pretty bad for morale.
this is nonsensical anon

>>64246877
oh yeah love these fuckers

>>64246678
You got massive hemmoraging, like a artery being hit, then you got bleeding which is badically big cuts but not one of those bigass veins in the body

>>64249200
this just seems like semantics to me. In our acronym the "C" stands for "Catastrophic Bleed" which is just another word for massive haemorrhage

Any of you guys been here, the National Museum of Civil War Medicine in Maryland? Looks fuckin' neat

>>64246821
>anesthesiologist
Why the fuck do you guys charge so much? Is it that hard to make sure you give a fat/skinny person enough juice so they don't overdose or are awake and feel the whole operation but are paralyzed and can't communicate during it?

>>64249317
not a medic but I'd hazard a guess that it's not the salaries of the anaesthesiologists that drive the price up so much as the cost of the medication used - considering how essential anaesthesia is, I'm certain the pharmas have no problem driving the price up to insane levels thus which the hospitals then pass onto the consumer

just spitalling tho I have no idea what I'm talking about

Depends

>>64249317
Its an extremely delicate process

>>64249317
Anaesthesiologists are guys keeping your heart rate, blood pressure and o2 stats stable while the surgeon is hacking away. You want them to know what they're doing.
>>64249337
Nah, most anaesthetics are pretty cheap as far as I know.

>>64247465
>>64248909
FMJ .308 causes a lot less damage going through the neck (assuming it doesn't hit bone) than .223 ever could. A bird or the human neck has so little depth to penetrate that .308 doesn't have time to tumble or fragment. The first 10-15 cm of .308 wound channel looks like it was made by stabbing the target with a sharp stick, as opposed to grouse that I've shot with .223 that had their guts blown out through a fist sized hole in their stomach because I shot them from the behind and the bullet immediately tumbled when hitting the scapula of the bird.

>>64244832 (OP)
off topic but delivering first aid in that bulky ass outfit would be a nightmare, Those gloves alone would make it hard to manipulate the gear and instruments, not to mention having to clean them all the time.

I'm trained as a Red Cross volunteer and occasionally get to be the medic at local events, I really should get a tourniquet to fiddle with in my down time. We have some, of course, and I know how they work and they're pretty much retard-proof, but during a true emergency you never know. A buddy of mine got called for an incident where the dude lost his hand (well, from how they described it to me it was barely hanging by and they amputated it), first time he saw something that bad, he spent five seconds fiddling with the tourniquet before putting it on the other guy and felt guilty about it.

>>64249989
Surely you can just grab one from your next shift?

>>64249169
>if the person was also missing an arm and a leg, THAT's what would kill them first
They're already technically dead if they're not breathing.

> doing CPR on someone missing a limb or with an arterial (or otherwise catastrophic) bleed is retarded anon.
That piece of common sense has already been repeated multiple times already, nobody is going to continue to repeat caveats just to satisfy your autistic ass.

if you're just some random civilian they teach you DRABCD (danger, response, airway, breathing, CPR, defib) because it's far more likely that some old fuck is gonna collapse in a restaurant than that you're going to be dealing with a mass casualty event with traumatic amputations etc.

if you're doing real medicine stuff they teach DRSABCD where the S is for severe bleeding. so it becomes danger -> response -> control severe bleeding -> airway -> breathing -> CPR -> defib.

also, if you're a random civilian who does their first aid course once every 3 years to get a little extra pay for being a safety warden at work you're not going to be able to know what is severe bleeding and what isn't, so someone has probably done the maths and figured that cases of people delaying CPR/airway clearing to control non-severe bleeding are likely more damaging overall than people who bleed out.

LASTLY, if you're some random fucking civilian, what the fuck are you gonna do to control severe bleeding anyway? you gonna make a junctional tourniquet out of a belt, a shirt, and a shoe?

i guess to summarise yes controlling severe bleeding first makes more sense but the simple fact is that most people can't do that. if they tried they would just fail and their efforts would be useless, and likely delay care that might actually matter in situations where they might actually have a chance.

>>64249317
>Is it that hard to make sure you give a fat/skinny person enough juice so they don't overdose or are awake and feel the whole operation but are paralyzed and can't communicate during it?
yes.

yes, it is that hard.

and it's also extremely important because without anaesthesia surgery basically becomes impossible. so anaesthesia is something very difficult and essential and we need a lot of it, so people who can do it get to charge whatever they want.

>>64250911
>LASTLY, if you're some random fucking civilian, what the fuck are you gonna do to control severe bleeding anyway?
They teach you how to make improvised tourniquets. I mean, what did you think they teach? To just shrug your shoulders? Smoothbrain.

>>64250938
>They teach you how to make improvised tourniquets
gas explosion in your building right now, two casualties with amputations and one with massive penetrating traumatic abdominal injuries. using just what's on your desk, how are you gonna control the bleeding?

now maybe you're more prepared than most and have a crash trolley sitting beside you but you get the point. it's not that these things are impossible to do, it's that they're so far down the list of what's likely to be required as well as so unlikely to be done correctly that focusing on it is a waste of time. and while people are wasting time trying to control non-severe bleeding, they could have been doing CPR.

for 99.99% of everyday emergencies the most important thing for people to do is fucking START CPR. adding another thing for them to worry about, and a relatively more complex thing, when the probability of it ever mattering is next to zero, probably just makes things worse.

i don't know any of this for sure obviously but i'd assume that the people who set the first aid advice are aware that severe bleeding is dangerous and have reasons for the decision they made not to worry about it in the first aid advice. and like i said if you're a real healthcare provider as opposed to like an office safety warden in an accounting firm then you get taught DRSABCD instead of DRABCD because you're expected to be able to deal with it usefully.

>>64250911
>DRABC
this
(defibs weren't common when I did my course)

>>64250938
not in my (pre-cellphone) day, cause they reckoned we'd overdo it and the casualty would lose a limb
I seem to recall that we'd basically just slap a dressing on, put pressure on the wound, and keep (what's left of) the limb elevated

>>64244832 (OP)
>>64244860
The chance of anything that causes obvious catastrophic bleeding is pretty minimal in a modern car unless extreme speed or a fall off a cliff or something is involved. You're much more likely to encounter concussions, broken ribs and potentially other internal breaks, whiplash-related injuries, etc.

>Am I nuts? Is army first aid better than civvie first aid? Discuss. Also share anything vaguely combat medic related, that shit is great
Don't worry about the differences. As long as your'e there, going through your checklists, doing the best you can with the tools you have or you don't, that's the best anyone can ask. Do that, and walk away at the end of the day satisfied. Also ANY CPR is a hail mary, last ditch save attempt. You should expect to never see a successful one.

>>64244858
Remember it's CATASTROPHIC bleeding.

>>64246492
>>64246551
Different risk profiles.
See the ER docs that practice combat surgery in urban ERs.

>>64246821
Remember your ABCs. Airway. Breating. Chair.

>>64249317
They get paid to wake people up at the end of it.

here's a question for the thread - has anyone here actually been a paramedic/first responder OR been one of the first people present at an incident giving first aid, and if so what was your experience? Particularly, what was your experience with regards to CPR?
>t. OP who is enjoying this thread discussion

>>64251002
Not if you get hit by a semi, manage to flip on the freeway or head on something that doesn't give above 55.

>>64251503
Don't greentext a self-referential t., OP.
Good thread though.
A lot of the better generals like first aid and body armor have dried up.

>>64251626
call me a newfag if you want to but I was under the impression that
>t.
could be used self referentially (or at least that's how I've been using it other than to take the piss out of others)

>>64251800
Then you should leave out the meme arrow

>>64251805
why

>>64251835
Because meme arrows is for quoting, insulting misquotes or relating a story

>>64247465
>and the blood seemed to mostly come from the entry wound itself
That's the exit wound. Entry was under the ear on other side of his head

>>64246877
When I took a Stop The Bleed course these were the ones the trauma surgeon teaching it specifically recommended, the CAT tourniquets from North American Rescue.

>>64244832 (OP)
Military prioritizes bleeding because, well, people are trying to kill each other. Civilian medicine is more likely to be medically based as opposed to trauma so breathing is prioritized. MARCH still works for an accident.

>>64250911
>you gonna make a junctional tourniquet out of a belt, a shirt, and a shoe?
I had a patient who got a tactical timmy tourniquet from a ratchet strap and a butter knife. She had a vericose vein rupture, you could have stopped it with a finger over the wound.

>>64250983
I'd prefer we train people to prevent CPR being needed. I consider anyone that codes a write off anyway.

>>64251503
I am an active EMT, I took a medic course and flunked out due to other reasons but I know my shit. I just worked a code last week (guy coded after fucking his wife) what do you want to know?

>>64251619
True, but I assume the standard guidelines OP was talking about assume that most accidents are gonna be the blunt force internal injury kinda stuff with no obvious external signs of injury, hence breathing first.

>>64251002
That was my point. You probably won't encounter life threatening bleeding, if you do it probably won't be the kind you can do anything about in the field, and if is the kind you can do something about, it will probably be obvious.

Meanwhile, on a battlefield people get little holes poked in them from bullets or shrapnel that aren't immediately obvious, so on a battlefield it makes sense to check for small holes bleeding profusely.

>>64249310
>tfw glowy dirt literally saved your life

>>64244832 (OP)
If this is an actual question and not some excusenfor sone politically irrelevant bullshit, civilian medical must never cross the boundaries of military medical, and vice versa. They are two completely idfferent realms where it doesn't matter if you're a certified open heart surgeon, unless you have CLS training, you won't do anything more conplicated than applying C3.

This is because in the Military, you have the right and expectation to do shit you are not legally allowed to do in the civilian world. For example, stripping someone bare, even a female, to check for wounds wouldn't fly in the civilian world but its happening in the Military.

And just the same, the shit you could reasonably do in the Civilian world they don't care about because the Combat Medic will do it better, faster, and your priority is first and foremost plugging holes, with number 2 being Doc's bitch.

>tl;dr civilians can sue you for the shit the military expects you to do, and the military trains for the lowest common denominator.

>>64253112
>This is because in the Military, you have the right and expectation to do shit you are not legally allowed to do in the civilian world. For example, stripping someone bare, even a female, to check for wounds wouldn't fly in the civilian world but its happening in the Military.
Are you implying that military medics strip people bare just to perform an assessment or that civilian paramedics would let a woman die rather than cut her pants off if she was shot in the leg? Because either way, you'd be wrong.

>>64253112
>>64253147
Particularly if you're a trained first aider in most countries you get a fair bit of leeway as long as you're staying within your qualifications, and actual paramedics and doctors get more protections again.
You can't force treatment on someone (usually) but if you're say, a first aider running into a car crash and someone's either unresponsive or unable to affirmatively consent otherwise you're absolutely not going to get into trouble for removing clothing items to inspect for injuries if you have any reason at all to.

>>64253225
I always found it odd that the russian/ukrainian word for "to use" is so fucking long/relatively complicated for something so frequently in use

>>64253112
I'd love to read about some cases where first aid caregivers (whether simply just civilians nearby or actual paramedics who got called) saved someone's life in good faith but then got sued for some kind of misconduct. Like I wonder what goes through the mind of someone going through with a lawsuit like that.
(I'm not talking about DNRs here though that's a whole different can of worms)

>>64251305
>Different risk profiles.
This is the most concise and precise answer for OPs question.
>>64244858
>you can go 5 minutes without air no worries
Stopping oxygen to the brain results in permanent damage within 90 seconds.
>>64252774
>I'd prefer we train people to prevent CPR being needed.
In a somewhat wealthy society, this would mostly mean banning smoking and making people exercise. The average person is most likely to encounter someone having a heart attack, not a life-saving-tourniquet-situation (which is, by the way, almost impossible to verify).
>>64251503
My experience is that breaking rips with your hands while doing it and then seeing the hematoma appear around the "joints" of the Sternum is weird.
It felt weird violently pressing on lifeless flesh.

>>64254127
>In 2006, Peng Yu had encountered Xu Shoulan after she had fallen and broken her femur. Peng Yu assisted Xu Shoulan and brought her to a local hospital for further care.
>Xu Shoulan accused Peng Yu of having caused her to fall, and demanded that he pay her medical expenses.
>The court held Peng liable for damages, reasoning that despite the lack of concrete evidence, "no one would in good conscience help someone unless they felt guilty"

>>64252783
well idk man is it a fun story to tell? if so tell it nigga
>>64254219
"weird" seems like a fairly normal reaction to this kind of stuff to be honest

>>64254219
maybe I'm biased because I'm a smoker but I personally think being a low level smoker (handful of cigs a day at most) but eating healthy and exercising plenty is better for you than not being a smoker but eating like shit and not exercising. not that that was your point just I think smoking is over-demonised because all the stats they parade round tend to refer primarily to people who smoke multiple packs a day for decades in a row (which is actually inaccurate to most smokers)

>>64253147
Shit for brains if Doc THINKS he finds a hole, your shit is coming off no questions asked, first off. Second it doesn't sound like you're a paramedic, which even then civilians who are cognizant can refuse treatment, in the military Uncle Sam owns your ass and you're at the discretion of Doc once a fucking gain.

>>64253168
If you're an EMT or have serious medical training, sure, the courts will rule in your favor so long as you have reasonable medical suspicion. If you don't have the training, or any training at all, the courts wont rule in your favor generally.

>>64254358
Yes, in a way. You are basically adding a poison to a healthy body, and they just have an unhealthy body. Your scenario also heavily promotes a death by cancer, since cardiovascular issues are less likely to get you.

>>64253147
You can only properly evaluate someones skeletomuscular system and movement with most of the body uncovered. I suppose something skintight would work too.

>>64254432
Perhaps it's mainly because I'm young but I'm thoroughly posessed by the notion of "fuck it, I might die any day, what's the use in living to extend my lifespan by ten or even twenty years when I can live to feel great now". I recognise the retardation of this on a conscious level but it still grips me. Incidentally if you're smart enough you realise this mindset is still conducive to things like healthy eating and exercise because exercise and good food are fucking awesome

>>64254425
>Shit for brains if Doc THINKS he finds a hole, your shit is coming off no questions asked, first off.
Give me one example, even a story you heard at the bar once, of a medic stripping someone naked in a combat zone to check for bullet holes.
>which even then civilians who are cognizant can refuse treatment, in the military Uncle Sam owns your ass and you're at the discretion of Doc once a fucking gain.
That's a completely different issue, and yes, it's true.

>>64244832 (OP)
ABC’s first because if airways, breathing or circulation is blocked the heart rate will slow anyway.
It’s also faster to take care of.
If you know the basics of casualty care then once breathing is sorted then yeah tourniquet and celox a hemorrhaging wound.
Most normal folks don’t carry a tourniquet as a fidget tool so for them they’re not expected to do as much.
Plus, working on a open wound is a great way for a booger picker to develop hepatitis.

>>64254683
yeah this makes sense but it goes out the window if the person you're approaching has a leg blown off
you understand what I'm getting at right? You're not seriously supposing you'd ABC someone with a leg spurting?

>>64254717
You’re approaching this with the same knowledge you have.
We don’t teach regular folks about wound care because regular folks won’t stop for an accident.
People trained in CPR will do what they learned.
People with casualty care will do the same.
Then first responders.
Then nurses
Then doctors/surgeons.
It’s less of a liability to the public if we don’t tell them to try and stop a spurting femoral from bleeding out because people pick their noses and lick their fingers. I’m not kidding about that. I saw a guy pick food from his teeth with hands covered in his friends blood.

>>64254717
I would obviously assess the abc’s first. If I’m the only one, and you can see a gusher, of course I’ll put a CAT on the leg, because it’s about the MDCOA for the casualty. Training people on MLCOA is smarter because they will focus on their Area of Responsibility

>>64244832 (OP)
I think you are very confused, man.
There are several algorithms for several emergencies.
You are probably confusing ACLS and ATLS.
ACLS are algorithms for cardiac arrest and cardiac-related emergencies: it follows the ABCD method, focusing first on A (Airways) first because the patient didn't get into any trauma and probably doesn't have major bleeding in act (at least, externally; internally perhaps but out of an hospital setting, you probably can't do much about it).
ATLS is for trauma-related emergencies and it follows the XABCD method, focusing first on X (major bleeding and trauma related injuries) because if you don't deal with those to start with, covering all the other bases is futile.
Study more and learn to adapt, man

>>64252246
Its because theyre the only ones worth buying, heard some stuff about the same company making another good one but the hospital I work for just uses these

>>64253112
>good samaritan law
Just act in good faith and dont do shit youre not trained in simple as

>>64254640
Dude even civilian medics expose unresponsive patients all the time, its not a big deal

>>64254717
XABC my boy

>>64246521
It's still "massive bleed" over first contact stat check. Milfag is right. Should be:

ALARMing things like blood fountains
Breathing, it it happening and is it blocked
Circulation, pulse, pressure, stroke check
DING to the fuckin head, check concussion

>>64244832 (OP)
>Now I think this is retarded and will get people killed, specifically because car collisions are one of the few common civilian circumstances which can produce catastrophic haemorrhages. Am I nuts?
no
MARCH is king i.e.
>massive hemorrhage
>airway
>respiration
>circulation
>head injury
if someone's having a heart attack or has been knocked unconscious to the point that they're not breathing, there's absolutely nothing that you can do outside of a hospital anyway unless you have an AED or NPA/chric kit

realistically as a civilian, the best things you can carry in your car are a big fat ABC fire extinguisher (not the gay tiny chem "portable car extinguisher"), trauma kit, halligan, and multitool
realistically an AED isn't going to be used for 80% of cardiac problems
a combat trauma kit will handle most MARCH issues in terms of stabilizing someone until they can get to the emergency room
a standard size ABC fire extinguisher will either put out a car fire or allow you time to extricate someone
a halligan tool will realistically allow you to pry a jammed door or pop a window

>>64253112
>bro i'm a big bad pog you're not allowed to do the shit i do
if I see arterial bleeding I'm 100% TQ'ing it, and I hope to god if I have junctional arterial bleeding, some random civilian will have the balls to fill it with a sock so I don't exsanguinate
show my balls to the world if you think I'm hemorrhaging
you don't have any information to back up what you're saying, you're just spewing irrelevant shit. if someone gets shot up in a mass shooting, they're not going to, nor would a court allow a civil suit if I accidentally see their tits while looking for bleeds on a wounded person

>>64254920
Is the H in MARCH not hypothermia ie treating for shock, feel like head injury stuff goes in the secondary assessment category when you’re palpating and doing HALO tests and PERRLA
t. Civilian EMT

>>64254947
job site stuff, you can't forget the head. I did safety study for my union and my ABCD above has that D as #4 but #4 is still up on the list.

>>64254947
it's context dependent, or both
if there's a C-spine injury or possible C-spine injury, you stabilize that before attempting further interventiojn

>>64254957
Oh yeah no Im checking the head real quick in any trauma/suspected stroke/syncope case just for safety unless theres some crazy arterial bleeding going on in a limb
>>64254960
True although theres been some pretty interesting studies lately showing cervical collars are applied in cases where they dont need to be, not that Im not gonna put one on a MVA patient or abytnjng

>>64254983
>>>64254957(You)
See above ABCD, you just agreed with it, A is for ALARM!

>>64254908
Yes, therefore that's not the thing he's talking about, because he's specifically talking about things that civilians would never do.

>>64255148
no the first thing I do is expose them and me, in an emergency everyone has to get naked. Obviously.

>>64251835
lurk moar

>>64251800
.t is "translated" implying Engrish or retardation

>>64255320
"t." is shorthand for "signed" in Finnish or some shit, that's the way it's used on 4chan. With a meme arrow it's implied that you're finishing someone else's post by adding the signature, like so:
>>64255320
>t. Newfag

Without the meme arrow, it's implied that the poster is signing his own post:
t. Oldfag

>>64255385
That's ".s" now.

>>64255484
>t. Reddit

>>64255488
/b from Boxxy Time cover wave, /k from BF1 meme era

just wanted to say ty for making this thread gud and answering my question well
hopefully the discussion continues but no worries if not
t. OP
a continuation question:
>>64255301
How would the fact that the victim in an incident happens to be a yoked, 10/10 bad bitch with huge tits change your actions?

>>64255931
Good thread OP

>>64256076
thank you anon
I hope your day has gone and will continue to go well

>>64255931
>How would the fact that the victim in an incident happens to be a yoked, 10/10 bad bitch with huge tits change your actions?
"It's nice to be naked with you again, Tiffany. I thought you got married..."

>>64254640
ME you fucking idiot, Im CLS trained, as by actual 68w's, and its generally not bullet holes Im looking for, its fucking shrapnel you wont feel between adrenaline and the wound sealing itself back up. If I have reason to suspect you're bleeding somewhere, 5 fucking words to the SL, or 30 seconds with the RTO is all it takes if you in your infinite fucking wisdom want to argue about your man titties hanging out so I can make sure if you don't have internal bleeding after your TL found you positive after a blood sweep so I can have someone send up a 9 line while I'm providing care.

>>64254920
Which is immaterial either way because you're both mouthbreathing, dribbling, retards with the reading comprehension of a toddler, because what I specifically said was under no circumstance do civilian medical qualifications pass in the military and vice versa.

Let me repeat that since you're both registering room temp, I don't give a shit if you're fucking McGyver of Medicine, you attempt to apply more than tactical combat casualty care to someone injured in the field, you are in violatikn of UCMJ and I as CLS can and will tell you to fuck off if you get in my way. Moreover, you want to play fuck fuck games and not listen to me, that can turn jnto a UCMJ in a heart beat.

Just the same, MILITARY MEDICAL QUALIFICATIONS DO NOT PASS IN THE CIVILIAN WORLD. You try and shove quikclot in a spurting fucking arterial wound, congratulations, you're on the recieving end of an open and shut civil lawsuit that good Samaritan laws do not cover, BECAUSE MILITARY. MEDICAL. QUALIFICATIONS. AREN'T. ACCEPTED. IN. THE. CIVILIAN. SECTOR.

Cry harder that you couldn't pass tape and how your angst over never enlisting isn't projected in every verb and noun you write.

>>64254947
Its both, we treat for head first then hypothermia due to blood loss dropping internal core temp like 20 degrees best case scenario.

Take a stop the bleed course, its the best thing you can do as nonmed. BLS is good too, but stop the bleed is a lot better for the general public. If you manage to get a finger on an arterial bleed and hold it, ride in the ambulance with the EMT because I wouldn't take my finger off it. You'll get a million high fives when you make it to the hospital, because you did the right thing and might have saved a life.

>>64256142
>You try and shove quikclot in a spurting fucking arterial wound, congratulations, you're on the recieving end of an open and shut civil lawsuit that good Samaritan laws do not cover, BECAUSE MILITARY. MEDICAL. QUALIFICATIONS. AREN'T. ACCEPTED. IN. THE. CIVILIAN. SECTOR.
You're pretty aggressive for a guy who doesn't know what he's talking about.

Good Samaritan laws vary from state to state but they often protect everyone, trained or untrained, who provides first aid so long as they don't act in a grossly negligent or wantonly inappropriate manner. Even for those states which do require training, they frequently only require training "sufficient to provide cpr in accordance with the standards set by the American Red Cross" (or some variation on that theme) which military training certainly does cover.

>>64246509
>It's pretty nuts how much you bleed even for non-lethal wounds.
While not as bad as yours I can corroborate how much head wounds bleed. Last year I tripped and smacked my brow against a door handle and even though it wasn’t even half a inch in length the dam thing had blood going all over my face and the carpet

>>64254347

Not particularly, we were sent for chest pain with difficulty breathing, the company I work for has an agreement to serve as transport (as basic life support) for a township that provides their own medics (advanced life support). So we came after the cops but before the medics, we walk in and see the wife and someone else just sitting on the couch, I walk up to them to talk but they just point down the hall, where I see the cops doing compressions. I did not expect this so I pull a face and start to help them. They had the aed on so I was going to wait for it to analyze before taking over. Eventually the medics and more guys showed up and we got to work, I probably ended up doing half the compressions, think I broke about 4 ribs, ended up doing shocks by stacking 2 monitors hitting this guy with 400 joules. He did get a pulse back, not a healthy one but enough to transport. Whatever happens after that I do not know. I only found out because we were getting a history and the wife said "I don't care, we were having sex, that's what we did". Good for them but it was just too much excitement for his ticker.

CPR is rarely a good story, I worked an employee at a nursing home, probably a PE, she was in a locker room where we didn't have room to work. She was panicking because she couldn't breath, she was moving air but no exchange was happening, probably. Anyway I picked her up and she was dead by the time I got her on the stretcher, didn't get that one back. A fun one is a guy that was having a heart attack, I asked him for his age for documentation and he gave it to me then paused and said "You know, my dad was my age when he di-". My partner and I shit a brick, never had someone do that before, we did a round of compressions and a shock and got him back. Guy was sitting in the stretcher looking around asking what happened. Worked an old lady that rescinded her DNR to get a procedure done. Pretty boring stuff, if you know, you know.

>>64255931
>How would the fact that the victim in an incident happens to be a yoked, 10/10 bad bitch with huge tits change your actions?
Once I got sent for a back pain, I get there and it's a fucking sorority trip, one chick just got this sudden back pain that dropped her to the floor, the medic want's a 12 lead so I'm putting the leads on her chest, under the left tit. I'm finishing up when I look down and see my zipper is open. I try to fix it sneaky like and it opens again, and again and again. I'm hoping no one saw and when I get a minute I check my pants and the bottom tooth of the zipper got bent, damn thing would split open from the bottom. I felt like I was in a cheap comedy.

>used to be EMT, keep my cert because why not
>moved to doing safety work because it pays better
>laugh every time i see a job listing for EMTs that pays 21/hr (24 for medic lmao)

>>64244832 (OP)
The ABC algorithm was first developed in 1957 in a civilian context where airway obstructions and cardiac arrest where considered a much more likely cause of death than in the military. This was also back when everyone thought tourniquets did more harm than good so catastrophic hemorrhages couldn't be easily treated in a first aid setting.
Not to mention the simple fact that ABC is catchier than MARCH.
>>64245495
>It's because massive hemorrhage is the number one cause of preventable death on the battlefield. In civilian medicine, that's not true.
OPs question was answered in the fourth post. The thread has filled up with some absolute nonsense since then.

>>64254920
>if someone's having a heart attack or has been knocked unconscious to the point that they're not breathing, there's absolutely nothing that you can do outside of a hospital anyway unless you have an AED or NPA/chric kit
That's not true.

Performing a jaw thrust/head tilt on someone who is unconscious and not protecting their airway or providing someone who has had a heart attack with cpr until the ambulance arrives can absolutely save their life.

>>64257634
People think they're being nice when they tell me I should make more.

>>64257681
smart EMTs get hired on at fire departments (the ones that actually pay you) or get their RN, dumb EMTs keep bouncing between shady private EMS companies thinking the overtime makes up for it.

>>64257689
My, what a revolutionary statement.

>>64257634
>>64257689
>>64257709
>what is a CCP and why do they earn so much more than me!?!?!?

>>64257720
i make 70k/yr as a safety guy with just an osha 30 and a dream. best part is that i dont have to be around poop and im not in an ambulance all day.

>>64257744
Jokes on you man, I've got grandma calling me sweetie and saying I have a nice ass.

>>64257666
>That's not true.
Satan, I think what throws people is they mistake 'not going to save a life on its own' for 'not going to save a life'. They hear that it's not Clean, Pretty and Reliable like when it's a meet-cute in a movie and then fail to understand that the entire point of CPR and other first aid for serious situations is to extend the window of opportunity for better equipped medical intervention to arrive.

Here in Australia we use 'DRS ABCD' for first aid training. It adds checking for environmental danger, checking if a patient is responsive and if needed sending for help at the top before you get onto the more traditional steps. So explicitly as part of commencing CPR and AED use you should already have either tasked someone else to get help or be calling an ambulance yourself.
Interestingly between when I first got a cert and I redid my qual earlier this year they've completely removed mention of checking pulse, you're meant to entirely go on respiration now. I think the theory is that pulse is too easy to fuck up for someone not practicing regularly and that is probably stressing out in the moment. Could see someone fixating on getting a pulse to the point of starting CPR later than they should've too. Breaths are part of CPR again though, they went away for a while.

>>64258456
>don't check pulse, just breathing
i got taught that too
>pulse but not breathing will have their heart stop very soon
>breathing but no pulse won't happen
how true is that, medfags?
i know i wouldn't rely on myself feeling for pulse

>>64250930
>without anaesthesia surgery basically becomes impossible


Just bite down on a belt or something ffs

>>64258679
>>pulse but not breathing will have their heart stop very soon
Depending on your definition of soon
>>breathing but no pulse won't happen
Again, it depends.
Someone almost certainly won't be breathing normally with no heart beat but it's not uncommon for people to start gasping or snorting during a cardiac arrest. It's called agonal breathing and it's a problem because it often causes bystanders to delay cpr, thinking the patient is breathing normally.
Another example would be someone who's heart is still beating but they've lost enough blood that their beating heart is no longer generating a palpable pulse.

The reason checking for a pulse isn't taught anymore is exactly what >>64258456 said, it's simply too difficult in the stress of an emergency and it risks an unacceptable delay in starting compressions. Getting compressions started quickly and continuing them with as few interruptions as possible saves lives, fucking about trying to find a pulse ends them.

>>64250983
fuck off i have my booboo kit plus my IFAK that is FAT as fuck cause i was in an active warzone and made a big FAT ifak to have with me during my time in a city cause the ruzzkies shit out drones and missiles everyday and I had to take care of a girl plus myself in the event of injury in the city. After my 2 visits there I realised that carrying an IFAK even in everyday life in a city might reveal itself to be invaluable so here we go, nigger. Some of has have shit to work with a casualty or at least on ourselves and loved ones.

>>64249317
Apparently it is. Once upon a time, I woke up while a dentist was sewing the roof of my mouth shut. Not biting his fingers off was probably the most difficult thing I've ever done in my life.

>>64259008
Somwhat relate but a buddy of mine had to get a tooth operated on without anaesthesia because the tissue was inflamed meaning local anaesthesisa wouldn't work

>>64261931
Also local anesthesia and anesthesia that turns you off are 2 totally different things, dissociating the body when it's getting cut up is pretty damn important.

>>64258789
To help some of you folks that might try to help, ignore agonal breathing, it isn't real breathing, more the body attempting to perform a function.

>>64250983
There was a shooting a few blocks from an event I was working on time, so now I do carry a tourniquet and know how to use it. It's not unheard of for people/businesses to have first aid kits on hand, and tourniquets aren't exactly expensive or hard to find.

>>64263275
You never know when they'll be useful.

>>64244832 (OP)
think about the why

protecting airway/breathing is cool because a blocked airway kills someone quickly but there's no point in protecting an airway if your patient is about to bleed out in a minute

also, don't forget, unless you're by yourself, you can do multiple things at the same time, if you can coordinate stopping a bleed while someone protects airway, forget about the gay ass algo, use the people you have on-scene and put people to work

but thinking about the why and coordinating a hecking big trauma is hard and next to impossible for untrained laypersons, so follow the first aid algorithm that is taught to you in an accredited course

>>64258456
literature finds that n*rsoids, paramedics, even doctors have mediocre accuracy at finding a pulse when the patient is bigly sick and/or everyone is panicking

I'm a nurse starting to study for surgical/scrub nursing. What's a fun speciality I should do

>>64249317
>What the fuck is so expensive about turning off my life support control center and making sure I don't die?

>>64265915
>but thinking about the why and coordinating a hecking big trauma is hard and next to impossible for untrained laypersons
Can confirm, the algorithm is especially useful because if nothing else it makes them feel like they know what to do, and confidence is a huge factor.

>>64244858
This. Next time OP know playing a video game does not equal training in the subject, are you 13 years old?

Had first aid training in both a general person context and an industrial worker context. General person training told us to check for breathing first, industrial training told us to check for catastrophic bleeds first. It all depends on context.

>>64268421
low quality bait anon

>>64268534
low quality thread op

>>64268421
arma 3 with ace and kat medical is surprisingly not bad for a video game

>>64266816
surgical n*rsoiding is highly specialized, do a year of basic bitch ward nursing so if/when you burn out, you're not totally useless outside of theatre

i would pick trauma surgery because it seems like the only specialty that isn't the same surgery all day every day

>>64268544
I'm not gonna take constructive criticism from a nigga with hair twice as long as his arm

>>64266816
I think orthopedic is fun, personally.

>>64268433
Industrial accidents can be quite the mess.

>>64273217
one from a place right next to where I work
>they manufacture paint and other material for marking roadways
>they have some sort of hydrualic arm that grabs bags of prepared dry material and moves it
>its inside a fenced off area with sensors to detective if anyone enters it as a failsafe
>sensors are prone to get covered by dust so they have to be cleaned every once in a while
>one kid goes inside to clean it, other assumes malfunction and hits the override
>the arm presses down on the victim from behind and pins him to the conveyor
>operator “hears a noise” and stops the machine
>it essentially pushed the kid’s spine through his ribcage and crushed him against the conveyor

>>64244832 (OP)
Different organisations teach first aid differently OP, based on the sorts of injuries/situations they're likely to deal with and weighted for the scenarios they're likely to find themselves in.

In a military/reservist context I'm assuming you're talking about infantry first aid training, rather than being trained as an actual medic. Therefore your training is intended to give you the skills to slow down the dying process until someone who actually knows what the fuck he's doing can get to the poor bastard who needs help. Most first aid boils down to 'slow down the dying long enough that the professionals can actually fix things'. The focus on bleeding from your reserve training is probably because, in a military context, the most likely lethal/serious injury is going to be a gunshot/shrapnel wound - rather than a heart attack, respiratory problem, etc.

>tl;dr - military first aid teaches you to deal with the likely military injuries in a military context. Civilian first aid teaches the same thing for their injuries and contexts.
>If you'd done first aid training in a chemical plant they'd have put a lot more focus on initial treatment of chemical burns and poisoning than on bleeding injuries.

>>64274110
Jesus christ that's why you lockout tag shit.

>>64274177
anyone here worked in a chemical plant before?

>>64277543
No, live by one though. Chlorine.

>>64274255
Never trust other people for your safety.

>>64244832 (OP)
dr c abcd
danger - yourself, others, patient
response - alert, verbal, pain, unresponsive
catastrophic hem - high pressure/vital bleeding - tourniquet limbs, pack gauze at joints, pressure/seal rest
airways - clear obstructions, establish airways (npa)
breathing - check rise/fall of lungs, even/uneven, stop look listen
circulation - take pulse, check wrist or neck, check for minor bleeding
disability - check for broken bones, any other injury

>>64284348
Australian?