First Aid at Major Incidents

[OneOffDave]

You may have seen in the media there are claims that the youngest victim of the Manchester Arena attack might have survived if better first aid had been available BBC News

It does seem to overlook that standard first aid kits don't have tourniquets and no haemorrhage control agents in them. Also blast injuries aren't really covered in the standard First Aid at Work course. If the report the family instigated is correctly reported, they are also complaining that the bleeding wasn't controlled by a thoracotomy when she got to hospital. If it was bleeding that could have been stopped by tourniquets, a thoracotomy won't be much help. While horrible for the parents, it does need to be seen in the context of the over 800 people killed and injured and how it is almost impossible to give gold standard care to everyone in those situations.

I guess the debate is, should the standards for first aid be changed and should crowded places keep a stock of ballistic trauma kits suitable for similar numbers of casualties? Do we need many more members of the public trained as they will always be first on the scene? Are approaches like CitizenAid any use?

When I'm out and about I have something similar to this attached to my wheelchair mainly so that if something happens on my commute and I'm sat waiting to be evacuated I can render aid to anyone nearby mainly for my own psychological benefit. I know I have a different viewpoint due to my occupation than most members of the public but do we need more awareness?

[discovolante]

It seems like a big ask if only because general public knowledge of absolute basic first aid seems to be pretty low. I've only done a really basic first aid course (would like to do more) and dealt with 3 incidents of people falling in the street - so pretty minor stuff - and the hardest bit each time has been trying to do stuff around people who are either standing around uselessly or trying to drag the injured person around like a rag doll to make them more 'comfortable'. So tourniquets etc might be a bit of a stretch.

Having said that it seems like it would be a good thing to encourage more basic first aid training, although maybe someone will be able to say why not

On the other hand what training is available for staff who work in large venues where stuff like this is a possibility? It's obviously rare and the staff would be outnumbered, and it might be unfair to even impliedly put that level of pressure on them but is it an option?

[Martin Y]

I suppose it's always going to be a compromise about how much effort you put in to train and equip members of the public to deal with rare events. The number of people who would carry a £100 first aid kit everywhere they go and know how to use it is likely to remain fairly tiny. The number of people suffering traumatic injuries they might treat is also, fingers crossed, going to be tiny, so the chances of their coinciding will be slim.

Coincidentally I was idly thinking about superhero movies yesterday: Superheroism seems mostly to consist of an ability to punch people really hard. It occurred to me that a better superpower would be the ability to snap your fingers and everyone would know how to do CPR.

[jimbob]

You may have seen in the media there are claims that the youngest victim of the Manchester Arena attack might have survived if better first aid had been available BBC News

It does seem to overlook that standard first aid kits don't have tourniquets and no haemorrhage control agents in them. Also blast injuries aren't really covered in the standard First Aid at Work course. If the report the family instigated is correctly reported, they are also complaining that the bleeding wasn't controlled by a thoracotomy when she got to hospital. If it was bleeding that could have been stopped by tourniquets, a thoracotomy won't be much help. While horrible for the parents, it does need to be seen in the context of the over 800 people killed and injured and how it is almost impossible to give gold standard care to everyone in those situations.

I guess the debate is, should the standards for first aid be changed and should crowded places keep a stock of ballistic trauma kits suitable for similar numbers of casualties? Do we need many more members of the public trained as they will always be first on the scene? Are approaches like CitizenAid any use?

When I'm out and about I have something similar to this attached to my wheelchair mainly so that if something happens on my commute and I'm sat waiting to be evacuated I can render aid to anyone nearby mainly for my own psychological benefit. I know I have a different viewpoint due to my occupation than most members of the public but do we need more awareness?

I know that at my last first aid course, the trainer was discussing whether these should be included, especially the haemorrhage control agents.

[Martin_B]

On the other hand what training is available for staff who work in large venues where stuff like this is a possibility? It's obviously rare and the staff would be outnumbered, and it might be unfair to even impliedly put that level of pressure on them but is it an option?

I would imagine that most of the staff at a location like Manchester Arena were contract stewards; my BIL is a contract steward and the company that employs him provides stewards for Twickenham, The Stoop (Harlequins' home ground), places like that. My BIL has basic first aid training (it was on a first aid course that he met my sister!) and has taken some courses in more advanced aid; I'm not entirely sure what, but I think he mentioned that he can give injections which isn't in any first aid course I ever took.

But he's taken these courses himself - the company who employ him don't make holding a first aid certificate mandatory, mainly as large venues will have paramedics and/or St John's present anyway. The company does like having a few stewards who have first aid certificates as a back-up, but by no means would I expect all of them to have them. If you are a contract steward who is going to patrol the car park for a few quid an hour, why would you go to the bother of getting a first aid certificate at your own expense?

So I'd expect that Manchester Arena (or a similar venue), for a big concert, would have a few paramedics/high trained first responders there anyway, and the contract stewards would have a smattering of first aid certificates only.

[OneOffDave]

So I'd expect that Manchester Arena (or a similar venue), for a big concert, would have a few paramedics/high trained first responders there anyway, and the contract stewards would have a smattering of first aid certificates only.

Yes, given the standard employment practices at these big events it is asking quite a lot of people on relatively low wages and casual contracts to be expensively trained and equipped. The other complicating factor with the Manchester attack was that it happened in that that space between the venue and the station which means the event first aid teams would not regularly consider it as within their footprint. I am sure as soon as they were aware of the need they did what they could within their area of operations. We mustn't forget the confusion that was also reported with the very real belief that there was an ongoing threat both within the venue and the station area.

[OneOffDave]

I suppose it's always going to be a compromise about how much effort you put in to train and equip members of the public to deal with rare events. The number of people who would carry a £100 first aid kit everywhere they go and know how to use it is likely to remain fairly tiny. The number of people suffering traumatic injuries they might treat is also, fingers crossed, going to be tiny, so the chances of their coinciding will be slim.

Coincidentally I was idly thinking about superhero movies yesterday: Superheroism seems mostly to consist of an ability to punch people really hard. It occurred to me that a better superpower would be the ability to snap your fingers and everyone would know how to do CPR.

Yes, the cost is not insignificant and also you have to replace some elements every couple of years so there's an ongoing cost element too.

Mass CPR knowledge would make a massive difference and improved access to AEDs too. I've never used my major first aid kit elements in the 6 years I've been commuting but I have seen 4 people on the floor being given CPR in the same time which does seem to indicate the need for CPR is greater