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Lofstedt Report - Removes HSE training provider approvals
medicdog Offline
#41 Posted : 09 December 2011 13:35:32(UTC)
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"Monkey Hear Monkey do"!!



http://www.bbc.co.uk/iplayer/console/b017t3yz



Its just about half way through the programme..listen to the Paramedics comments about Training near the end of the programme.
yogi760 Offline
#42 Posted : 09 December 2011 16:37:44(UTC)
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Thanks for this medicdog..... very interesting..... "no real need for training" was an "interesting" comment by the Dr.... no of course you don't need training....... just place the pads on the chest over that GTN transdermal patch and watch it go bang!!!

medicdog Offline
#43 Posted : 09 December 2011 18:20:16(UTC)
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OK...lets take that comment into context, first of all there is absolutely NO evidence of this EVER happening out of MILLIONS of uses fo these machines world wide...quote me ANY happenings of this ANYWHERE. Second, what is the greater risk,, the PT dying or getting a tiny burn in the almost impossible likelyhood that a Patch MAY explode should a lay person without training deliver a shock over a patch.
amandajlay Offline
#44 Posted : 10 December 2011 02:02:09(UTC)
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Ok, AED's are in the public domain TO SAVE LIVES. They would not be unless safe, & the 2010 guidelines would NOT suggest that a person arriving at the scene of an incident asks for one unless it was safe, so I kinda think the whole gtn patch / implanted defib / pacemaker is blown out of the water...if there was sufficient cause for concern, then it would NOT have been included in the 2010 lay persons guidelines (unless you know far more than ILCOR, which I doubt)



For the record, when it comes to competence, I am an RGN, with ITU course,A&E experience, acute medical & surgical experience, did ALS, did UKRC GIC (invitation only), taught, stopped, end of story & I keep updated...am I unqualified to teach AED use...? (at the end of the day am probably more qualified than many trainers, but am not desperate & am busy enough!!)



The whole point is to save lives...for the odd patient who ends up with a burn, should we ditch teaching the guidelines which are to use an AED if available...if they were so worried, the guidelines would not have changed...get a little perspective please people!!
medicdog Offline
#45 Posted : 10 December 2011 10:45:52(UTC)
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Again a point well made with sound reasoning and sense, precisely the correct attitude and perspective Amanda.
PrivAmb Offline
#46 Posted : 10 December 2011 13:21:54(UTC)
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You are absolutely right. We all know that 13 year olds can quite adequately drive cars and outrun trained police drivers without ever having a single lesson. Whats a driving licence but a bit of paper anyway. You can get away with not being trained, so why bother?

As for there being no instances to anyone's knowledge that a patch containing nitroglycerine has combusted during defibrillation, could it be that it was recognised early on that it was a forseeable risk, and that anyone who has been properly TRAINED has recognised this hazard first off, along with not operating a unit in the presence of flammable gasses and fluids on a vibrating surface

There is a BMJ article I cannot get to just now that is all about fires caused in operating theatres and on wards resulting in death/serious injury to patients and I know that GTN patches are covered in that article.

GTN also has its own UN number UN3064 - an important consideration if working in areas of danger outside of a first aid classroom or in an aviation/mrtitime/offshore role. You see, the properties of GTN - Tri nitro mixed with Glycerol rather than its cousin TNT which is mixed with Toluene, is although it can burn, it will detonate if exposed to a shock. Anyone that knows anything about explosives will understand detonation and how to cause it, and one of the ways is to expose the explosive to a high voltage wave of Faraday's finest. This is why it has been accepted that items such as defibrillators, camera flashes and tasers can be used in an improvised device to cause a detonation as they all operate in the principal of a charged capacitor giving up all its energy at once, and things like fertillizers containing nitrates are a favourite of the terrorists who exploit the detonation properties of nitrate, and add diesel to the mix to give further fuel to the explosion. If exposed to a flame, it would just burn. If exposed to a shock, it will detonate. Most IRA bombs were constructed like that, and the results I think we have all seen such as Canary Wharf amongst others.

marmite Offline
#47 Posted : 10 December 2011 16:24:13(UTC)
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Ok boys and girls aren't we getting a little off topic now.



Should all people have training in first aid - duh!  No brainer - Yes they should.



Can you operate an AED safely with no training - yes; that's what they are designed for.



Would you be scared to do so in a 'real world' scenario without any training - probably, but it doesn't mean you should not try.



Is an AED likely to explode - probably not.  Is some nasty orgainsation waiting in breathless trepidatioin for the day it does?  I shouldn't think so.



That is all.  Thank you.
Tacanman Offline
#48 Posted : 10 December 2011 23:12:32(UTC)
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My kids are mad into the Myth busters programme.  I seem to remember not long ago watching with interest as they tried to explode a GTN patch using an AED.  Despite several attempts with the AED and then exposing it to shocks well in excess of AED voltages they were unable to do so unless my memory is letting me down.  I know there is a risk and obviously I cover this when carrying out AED training but in all seriousness, the alternative is much worse.  Yes if you remember remove the patch but if its forgotten the chances of it going bang IMHO is so small.

By the way my background is an electronics engineer dealing with equipment delivering several thousand volts at high current I do understand the risks involved in such things.  I have also been providing First Aid in a wide variety of places sometimes in hostile environments, sometimes in work places all around the world.  
yogi760 Offline
#49 Posted : 11 December 2011 13:46:13(UTC)
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OK guys.... All the comments are of course valid, I feel however that my comment was taken out of context! Of course an AED can be used without training; The point I was trying to make was that it is better to have "some" training in its use. Thanks!
admin Offline
#50 Posted : 11 December 2011 15:53:57(UTC)
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Thanks: 1 times
Like a lot of professionals that are called in to talk on TV/Radio on a subject, doesn’t mean that they are an expert on the topic. I.e. checking a pulse in first aid

Defibs are safe, you can connect one to any person from fully alive through to totally dead. They will only shock after finding a suitable heart rhythm where administering a shock is beneficial.

Most people think AEDS are dangerous. They are totally safe in line with any home electrical appliance.

We need to reverse myths and misunderstandings and really make people appreciate just how safe and beneficial they actually are.
Dave
These Kitchen people are back, so i am not sure what you next plan is with these people.
PrivAmb Offline
#51 Posted : 11 December 2011 18:27:34(UTC)
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Admin, they are not totally safe. They are a dangerous item with safety features designed into them. There is a difference. Just because the machine says to stand clear and not touch the patient does not mean that people actually will. They need to be comtrolled by the person who is about to press the button - a human factor safety feature that cannot be factored into the machine, otherwise it would be fully automatic and operate itself.

The defib in the radio broadcast was a Heartsine PAD - a Public Access Defibrillator. Hence the amount of instructions and commands it gave out along with the metronome timer. These units, apart from the one I sometimes carry when I don't have the room for the Fr2+ are rare to find and at £2.5k plus VAT, not at all competitive. Also the batttery and pads are extortion personified as well. The commonly available ones in the UK are either Hearstart, Medtronic Physiocontrol, Powerheart G3 or on rare occasions, Zoll AED Plus. Each operate differently - you have to turn the FR or LP machines on, the G3/Zoll turn themselves on. Some have the pads already connected, others do not. With some it doesn't matter which way the pads are placed, others it does. Give someone a set of Zoll Stat Padz and the first thing they will do is hold them up for a better look and get confused. All the while these unskilled operators are looking at the pads and the machine, someone has got hold of the patients hand - sometimes they know them, sometimes they are just some stranger who always appears out of any given crowd, along with the busibody, the town drunk and the local loony.

For any of us here who have regularly defibrillated in public areas, you will know thatat least 20 percent of the time you have to withhold the shock until people actually break contact with the patient who have failed to hear/reused to comply. It is for this reason that allowing MOP's access to a taser is not a good idea unless is is failsafe. In some areas I teach, AED's are placed in wall cabinets around the workplace and can only be accessed by keyholders - a keyholder being a full FAW with an AED ticket - hence the term used at one site "I got my key today" - aka I passed my AED assessment. They are allowed to give anyonw their key to retrieve the defib for a job, but may never delegate keyholding because they are absent or busy. But, I am afraid I have read some tosh on this thread, and there is no point backing people into a corner and actually asking them outright if they are professionally experienced and have actually used one of these machines live, because it will result in a predictable answer and a slanging match! It therefore reverts back to earlier in the thread where for many of us, HSE approval means not a lot, and out clients use us because of the quality of the experienced educators we use.
medicdog Offline
#53 Posted : 11 December 2011 20:15:39(UTC)
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On second thoughts,Not worth it!
PrivAmb Offline
#54 Posted : 11 December 2011 20:44:33(UTC)
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No, probably its not.
FATC Offline
#55 Posted : 11 December 2011 21:49:18(UTC)
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privamb



you obviously feel very strongly about this issue



for specialist first aid then perhaps your undoubted unique experience is of high repute and brings clients back to you



for Mr Average and Mrs Miggins (her again!!) who need a certificate so they can apply a plaster, restock hold someones hand whilst they wait for an ambulance after breakign their leg and perhaps deal with the odd cut, HSE acceditation is quite sufficient and does what it needs to



like any provider, corners can and I am sure will be cut my some and will only come to light when there is a complaint
yogi760 Offline
#60 Posted : 12 December 2011 17:17:43(UTC)
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I just heard that Big Mac is using an AED, BVM, O2 and can intubate blind. Next week he is teaching the local TFU how to use tazer as an AED adjunct.... Amazing, apparently Charlie taught him.....
PrivAmb Offline
#61 Posted : 12 December 2011 17:20:59(UTC)
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He's better not be. He's teaching me on my ALS Requal next week. Apparently he's never missed a tube in all his life as a jolly Geordie porter and as I have missed several in my time, I need a masterclass!
yogi760 Offline
#62 Posted : 12 December 2011 17:28:34(UTC)
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I know someone who could facilitate that if she's not busy looking after her children.... re the tube.... don't blame it on the sunshine.... blame it on the bougie
FATC Offline
#63 Posted : 12 December 2011 17:31:57(UTC)
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It woudl appear that PrivAmb is in a league of all his

I suggest we don't get involved in heated discussions

after all this is a first aid forum

let privAmb teach his courses on how to save your mate with only a chainsaw and a toothpick whilst swimming with sharks whilst the rest of us carryon teaching mediocar first aid- we obviously not skilled enough to even be in the same room as him(?) never mind touch his coat

I just hope he sticks to what he knows so much about and doesnt foray into say Food safety or h&S unless he is qualified and extensively experienced in those too
PrivAmb Offline
#65 Posted : 12 December 2011 17:40:43(UTC)
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I can safely say that I would never venture out into the side orders of Food Safety because I have no training and never so much as worked in a commercial kitchen. I do have NEBOSH, but it was pre-European six pack 92 so it would be a bit like an SEN telling an RGN what to do. Old knowledge. There was something I chose to keep current, and thank you for pointing out that by default, my students are not medicore and are in a league of their own. That is why they work where they do. We did not choose them. Their employers chose us to teach them. As for your quip about the chainsaw, some of our students do work with chainsaws and came to use because we can teach them what to do with regards to amputation at 20 feet in the air, and suspension trauma after waiting for those trained in rope rescue to bring them down. I am afraid that the most serious patients some people have treated are those they invented in scearios in the classroom.
yogi760 Offline
#64 Posted : 12 December 2011 17:46:08(UTC)
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Originally Posted by: FATC Go to Quoted Post
It woudl appear that PrivAmb is in a league of all his



I suggest we don't get involved in heated discussions



after all this is a first aid forum



let privAmb teach his courses on how to save your mate with only a chainsaw and a toothpick whilst swimming with sharks whilst the rest of us carryon teaching mediocar first aid- we obviously not skilled enough to even be in the same room as him(?) never mind touch his coat



I just hope he sticks to what he knows so much about and doesnt foray into say Food safety or h&S unless he is qualified and extensively experienced in those too





FATC I find your personal attack on PrivAmb offensive!



After some of the rubbish I have read by people blowing trumpets on here, it is refreshing to read something by someone who DOES KNOW what they are talking about.



I'm in the same room/camp as PrivAmb so feel free to have a pop at me too....
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