Hi Fred,
Delicate balance to be struck - medical care by Fire is highly controversial and we are collectively trying to be supportive as possible.
We would expect airway and c-spine control to be a 2-person technique generally and encourage the use of LMAs to facilitate this.
Duty of care for Fire is a fairly grey area at present - generally we work well on scene and would be reluctant to see this changed.
Cheers
Anton
In message <002b01c41e67$6ebd9700$0d2c6651@hppav> fred <[log in to unmask]> writes:
> Anton
> that's my stance, from front or above but not behind, Which I consider
> DANGEROUS to teach, but where has it come from? The Medical director from
> Tyne on Weir Fire Brigade has given this technique the thumbs up to be
> taught to the FF's. So where has he got it from and why are is it being
> taught?
> It has now move to S Wales FS and god know who else next. Anton as
> continuity of Care, would you be happy to see this being done when you
> turned up at a scene of a RTA.
>
> Yes my views don't teach it, two can mange it properly
>
> What I set out to achieve is either reference for this technique, or
> professional opinion to why it should or should not be done
>
> many thanks
> Fred
>
>
>
> ----- Original Message -----
> From: [log in to unmask]
> To: [log in to unmask]
> Sent: Friday, April 09, 2004 7:43 PM
> Subject: Re: Airway technique??
>
>
> Hi fred,
>
> Been through the PHTLS manual in detail - the c-spine control and airway
> techniques are consecutive sections in the book, but not quite
> complementary - the two airway opening techniques taught are either
> positioned from above the patient or in front of the patient, but not
> directly behind.
>
> PHTLS version 5 is current medical standard for CACFOA national extrication
> challenge.
>
> For interest, most modern extrication fire teams use two medics - the second
> medic being used as a gofer for the two cutters, fifth person being the team
> leader.
>
> Quite academic for us, as rare for Fire to be on scene first - they usually
> hand over medic-side to ourselves PDQ and use their two "medics" as second
> cutting team for simultaneous cutting activity.
>
> Cheers
> Anton
>
> In message <000901c41e5b$a7314de0$0d2c6651@hppav> fred
> <[log in to unmask]> writes:
> > Robbie
> > few things first, I'm quite happy at my pre-hospital experience, that I
> was
> > not questioning for myself, Could you say that you could teach this to
> > Firemen?? Remember who is recieving this training and level of expertise!
> >
> > Secondly- where is this taught, Head position, Head tilt -chin lift and
> jaw
> > thrust laying down or in front is only ever been taught on any courses
> that
> > I've been on and know off, Any reference for this?
> >
> > Thirdly, Not ban these but to stop the teaching of this from behind, could
> > you stand up and account for your actions on an airway technique that is
> not
> > normally taught. after all, there is normally five FF's on a pump, so why
> > put it on to one person to mange the airway and try his best at twisting,
> > stretching trying to keep head in natural and list and observe the airway
> >
> > Yes we all have to make do in some extreme situations, but not the normal
> > everyday work
> >
> > Fred
> >
> >
> > ----- Original Message -----
> > From: Robbie Coull
> > To: [log in to unmask]
> > Sent: Friday, April 09, 2004 4:22 PM
> > Subject: Re: Airway technique??
> >
> >
> > > Ban or stop teaching jaw trust from rear using one person, but need
> > > reference or professional opinion to help justify this
> >
> > Fred,
> >
> > How much pre-hospital experience and training have you had?
> >
> > It is perfectly possible to hold the head in neutral alignment with the
> > thumb, index and middle fingers while using the ring and little fingers to
> > exert jaw thrust from behind (pressing forward on the jaw below the TM
> joint
> > on either side).
> >
> > In fact, this often produces less movement of the neck than a traditional
> > jaw thrust from the front (which is more common in non-trauma situations).
> >
> > Airway/breathing assessment is based on look, listen, feel. It is
> possible
> > to observe the rate of breathing, and listen for sounds of obstruction
> from
> > this position. With enough space (and safety helmets permitting!) it is
> > also possible to place your cheek close enough to their neck to feel
> > transmitted noise.
> >
> > Obviously, during an extrication the noise of the environment (usually
> dark)
> > restricts this assessment, and so sao2 and regular observation from the
> > front would be nice, but it depends on the access to the patient and the
> > number of people available to assist.
> >
> > On one occasion I have had to cradle the head of the casualty from behind
> > (with the help of a head rest) whilst attempting to use a bag and mask at
> > the same time. This was due to extreme access problems during one part of
> > the extrication.
> >
> > Although it is important that responders understand the problems and
> > limitations involved, I think it would be extremely unwise to attempt to
> > 'ban' these techniques.
> >
> > --
> > Robbie Coull
> > email: [log in to unmask] website: http://www.coull.net
> >
> > https://www.locum123.com contact locum doctors by SMS and email
|