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Thread: Glock 19 of IFAKs?

  1. #21
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    Quote Originally Posted by TGS View Post
    This is the first time I've heard this.
    It is not part of lay public Stop the Bleed curriculum. I'm not sure it's even first responder level; ARC EMR states to leave wound open unless part of local protocol to use chest seals. It is part of the EMT-B and CLS curriculum.

  2. #22
    Member TGS's Avatar
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    Quote Originally Posted by Yute View Post
    It is not part of lay public Stop the Bleed curriculum.
    Neither is heat stroke.

    'Cause it's STB.

    It's taught in WFA, NAEMT TFR and LEFR, even Dark Angel Medical....all layperson classes. While not lay, it is taught in medical responder classes. It is also taught in an 8 hour class by the US Dept of State to all foreign service officers, from office managers to political officers, including family members accompanying their spouse overseas.

    It's not taught in the ASHI basic first aid, but I'm unsure if it's taught in the Adv First Aid (layperson 17 hour class). It was taught to me as a pre-pubescent boy scout...not sure if that's still taught.
    Last edited by TGS; 07-25-2020 at 11:31 PM.
    "Are you ready? Okay. Let's roll."- Last words of Todd Beamer

  3. #23
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    No argument with it getting taught as long as it's been taught right... And the risk of tension pneumothorax is properly explained.

    Edit to add: Just noticed that Texas's Stop the Bleed curriculum does include chest seals but explicitly states for medically trained personnel use only.
    Last edited by Yute; 07-25-2020 at 11:30 PM.

  4. #24
    Five years ago when I joined PF, I didn't understand half the concepts and acronyms thrown around. TDA? RDS? UOF? HST? Why doesn't anyone think my FiVE-SeVeN is badass? I should have just shut the fuck up, bought a Glock 19 and 5,000 rounds. I feel the same way now in this forum regarding first aid.

    What should a first aid noob choose before an NPA or chest seal? More quikclot gauze? A second TQ? Lots of rubbing alcohol? My most realistic scenario is a roving band of peaceful rioters accidentally fires a 7.62x39 ball round hitting a family member.

    I don't mean to sound unappreciative but you all are far ahead of me here.

  5. #25
    Site Supporter ST911's Avatar
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    No particular order/person, and for the benefit of all...

    Vented or not- Awhile back some research showed that the difference between vented and sealed in outcomes was too small to really matter due to vent volume, clogging, and all the other stuff that happens. Best treatment is application by a trained provider, monitored, and burped or needleD. 3-sided improvised and vented manufactured tend to be more legacy practice than anything. Vented is probably the best default method to teach as it might have the most desired effects.

    I went round and round and landed on "protect the wound and watch" for lay providers in very short courses.

    On the topic of "scope" (of practice), words matter and this is very local. A skill might not be typically taught, or taught within a given curriculum, but remain within scope of practice. I'd be curious to hear where application of a occlusive dressing is a regulated practice via a regulatory or statutory provision, applicable to unregulated personnel.
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  6. #26
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    Quote Originally Posted by ArgentFix View Post
    What should a first aid noob choose before an NPA or chest seal?
    First step before equipment is training- once classes resume, Stop the bleed or equivalent should be the first step. My bare minimum is a tourniquet, hemostatic gauze, packing gauze, and pressure dressing.



    In California, Title 22 codifies chest seals as scope of practice for public safety personnel (Title 22, Div 9, chap 1.5), and EMTs (Title 22, Div 9, Chap 2).

  7. #27
    I just received a large order from Chinook. I ordered a couple chest seals and the trainer. I might not have had this thread been a week or two earlier

  8. #28
    THE THIRST MUTILATOR Nephrology's Avatar
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    Quote Originally Posted by TGS View Post
    This is the first time I've heard this. It's a skill taught in layperson classes.



    Specific application to TCCC or even domestic MCIs depending on agency protocols.

    In the use of the MARCH algorithm, I can't hold a jaw trust on one patient and simultaneously move to do MA on another. NPAs are space efficient, the brain-tubing concern is more of a extremely low probability hypothetical, and NPAs allow me to perform M and A on a patient and then move on to the other patients in my vicinity before going back around and reassessing/addressing RCH.

    An unconscious casualty can still have spontaneous breathing but be in danger of losing their airway, and recovery position isn't always an option. Patient movement is a surefire portion where this can matter......you can't hold a jaw-thrust while moving somebody unless you've got a stretcher and being VERY deliberate (slow) and coordinated as a team, and most improvised patient movement techniques can induce an airway obstruction. An NPA mitigates all of this, regardless of whether you need to assist ventilations or not.

    For these reasons, NPAs have a strong place in IFAKs. I don't teach them in my lay person classes but that's a decision based 100% in liability management in 21st century America rather than any actual good reason.
    All of those sound like good reasons for EMS personnel to carry an NPA, but for the non-professional bystander, my opinion still stands. From a didactic point of view, I would prefer the layperson to focus on the mastery of a few basic skills/pieces of equipment. If you're going to include an NPA in an IFAK, you should know not just how to use one (not very difficult), but also when to use one and when not to use one (not necessarily as obvious).

    To me, that is a component of airway management, which is a related but different skillset from hemostasis/BCLS. If that's something you are going to learn then great; however, realistically, there are very few non-pros who are going to build and maintain that skillset. I don't want someone futzing with an NPA when they should be doing something else.

    I do agree the risk of harm with NPAs is low, but it is not zero. Type in "NG tube in brain" on google image search and see how many unique results you get - and those were presumably placed in the hospital, by a professional...NP tubes are squishier of course, but I never underestimate the opportunity for accidental harm.

    Just my $0.02

  9. #29
    Site Supporter ST911's Avatar
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    Quote Originally Posted by Nephrology View Post
    Just my $0.02
    When the world norms up a bit, I would encourage you to get out of your facility and spend some more time in the dirt. Grab some TCCC/TECC classes, run over to NOLS for some wilderness stuff, and spend more time with lay folks. You'd be astonished at what they're capable of. No swipe, but I think some of the circle we're spinning in here is a good example of the divide between facility and pre-hospital providers and educators.
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  10. #30
    Site Supporter 0ddl0t's Avatar
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    I'll echo ArgentFix's comments about being out of my depth with these comments and all these acronyms. I've taken the local Stop The Bleed course and (long before) Red Cross' first aid/CPR class, but are there any good web resources to learn more until such time as in person classes resume?

    And just as a point of reference, the local STB course I took a year or so back taught us to use duct tape and plastic packaging from bandages to create an improvised chest seal (tape/seal the plastic on 3 of 4 sides). They didn't give any background on the whys of chest seals, most of the time was spent practicing using the various tourniquets and stuffing dummies with gauze.

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