Talk:First aid

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[edit] Triage

Triage should be treated, as it is a crucial step. --Fighter 18:49, 28 August 2005 (UTC)

[edit] Proposed merge of Wilderness First Aid

User:Esseye has proposed a merge of WFA into the First Aid article. I personally disagree; the two have different certifications and skill sets, both for general first aid users as well as skilled EMTs and other practicioners. The lack of equipment, additional environmental hazards (e.g. the high probability of hypothermia in a cold weather incident), and difficulties of evacuation/rescue make the two different topics entirely, although not unrelated. (As an example, in the WFA course I took, we responded to a scenario with eight trained first aiders, taking two to three hours of constant work. The incident was a single person with a broken leg (Closed fracture of the right fibula), which is barely even an emergency in the city.) Do not merge. ByeByeBaby 05:06, 31 August 2005 (UTC)

It seems the merge happened anyway. I resplit it. I agree the merge was a bad idea. St.isaac 22:00, 8 August 2006 (UTC)

[edit] What Wikipedia is Not

From the Wikipedia:What Wikipedia is not page:

"Wikipedia is not an instruction manual
While Wikipedia has descriptions of people, places, and things, Wikipedia articles should not include instruction - advice (legal, medical, or otherwise), suggestions, or contain "how-to"s. This includes tutorials, walk-throughs, instruction manuals, and recipes. Wikibooks is a Wikipedia sister-project which is better suited for such things."

I think this page is in pretty clear violation of that policy. Plus, the first aid advice is for a variety of different things that do not belong on this page; stuff should instead just link to the "bites and stings" page or whatever, and put the detail there. Otherwise you have problems with redundant material.

The part of the page on what first aid and wilderness first aid is is fine. It's the "specific conditions" section with detail about treatment of individual conditions that has a problem. It should be integrated into the bulleted "conditions that often need first aid" list with maybe a sentence after each item explaining what it is and linking to that page. There is no reason to duplicate the information here. Remember that Wikipedia is an encyclopedia.

Last, I have a concern about the quality of the medical advice being given. I think it's done in too cursory of a manner and is thus potentially dangerous. Some parts could be interpreted as advising untrained people to provide treatment that is far above their standard of care. Another example is the 'when not to give CPR' section, that is so vaguely worded that anyone could stop CPR any time by these guidelines. "When the patient is stiff and obviously dead" is wrong: no one is dead until warm and dead. Somebody following just this advice without other medical background could easily really hurt someone. This type of thing proves that wikipedia first aid page does not have enough space to be giving good medical advice. But it can link to an external page that does, like, oh, say the red cross or something. --Delldot 14:06, 21 October 2005 (UTC)

Wow- that was exactly my impression as I read this article today. The "stiff" phrase jumped right out when I skimmed the article. Take a look at Cardiopulmonary resuscitation for a better article (also see the WikiBooks link there). There is a lot of duplication, such as the info from Emergency Action Principles. This article should really be a lead for the rest of the articles in the First Aid category.
This should be cut down to:
Any other thoughts?

--Gadget850 21:13, 4 November 2005 (UTC)

I've taken out the "Specific conditions" section with specific medical advice and moved the subsections into the bulleted list under "Conditions that often require first aid". With blurbs. Useful information I moved to more appropriate pages (for example, pages on altitude sickness, bite (medical), antivenom, and heat syncope. The page still needs a lot of work. For example, encyclopedia articles do not generally address the reader in the second person or give advice. Maybe this material would be better incorporated into the wikibooks first aid project. --Delldot 01:48, 5 November 2005 (UTC)
I did a short history. Looks like there is already a lot in WikiBooks, which would be the more appropriate place for much of this. We should also have a short section on legal issues and the Good Sam laws.
Although Wikipedia is not an instruction manual, Wikibooks can be! If you find how-tos that can't stay in wp, please send them over to wikibooks:First Aid; the text has come a long way, but we still need lots of content. If you'd like to help out, please do! Mike.lifeguard 18:31, 30 June 2007 (UTC)

[edit] Scope of the First Aider

The scope of the first aider seems to have been over-estimated in some cases; and vastly under-estimated in others. I propose a major re-write of the article to reflect this. The list of conditions I think should really reflect the responsibilities of a normal first aider, and therefore shouldn't really have childbirth, toothache, cramps, or diving disorders. The section regarding antibiotic treatment for wounds is irrelevent as far as first aid goes; and heamorraghe & bleeding are the same thing so there's no need to list them twice.

The section on techniques needs to be added to; although I would strongly advise the removal of tourniquets - they are NOT a first aid measure, infact, siting a tourniquet is not even that common a procedure in the ED/ER due to its dangers.

The section on CPR is particularly worrying - "if the patient is stiff and is obviously dead". I presume this refers to rigor mortis - that's not something which a first aider is likely to see, and is certainly not something which they would immediately recognise. It should be removed. "after twenty minutes of CPR with no pulse or breathing" - again, not a recommendation I have ever taught or been made aware of (I am a first aid trainer/examiner with several large UK organisations) - we generally teach that CPR should be stopped if 1) The casualty regains signs of life 2) The rescuer becomes tired 3) The situation becomes dangerous 4) Professional Help arrives and tells you to stop.

The primary survey section is a little misleading regarding attempting CPR before calling the emergency services. The Resuscitation Council (UK) 2000 guidelines reccomend it ONLY in cases of trauma, and pre-hospital traumatic arrest is not that common (in the UK, at least, the vast majority of out of hospital cardiac arrests are medical, 2/3 alone are due to MI).

First Aiders do use the PRINCIPLES of secondary survey; but they aren't taught to follow such a strict procedure as is set out in the article. The secondary survey is only carried out by first aiders in VERY rare situations anyway, as by the time they've done a primary survey, phoned for an ambulance, and provided critical interventions (CPR, pressure on wounds, treatment for shock etc...), help will have arrived. There is no merit in a first aider carrying out a secondary survey as defined in the article in the vast majority of situations.

I'll be happy to do a re-write taking these things into consideration, if that's what people want? --John24601 22:41, 22 December 2005 (UTC)

I'd also be happy to update this page. I'm a first-aid instructor in Canada, and we don't have EMTs here...perhaps a separate EMT page is better-suited for EMT stuff? I also would like to edit the "when to stop CPR" part, as it is in a wilderness first aid context, and is incorrect for general first aiders. For example, a first aider who stops after 20 minutes is definitely vulnerable to lawsuit, from a first aid perspective. JamieJones 16:12, 25 December 2005 (UTC)

Wikibooks
Wikibooks' [[wikibooks:|]] has more about this subject:

I agree with above editors. Quite clearly, this article goes beyond the content it should contain. Instead, brief outlines of what is first aid and links to other articles would be most appropriate. Also, a very clear link to the First Aid wikibook at the top of the page would be most appropriate. On this talk page, we should also add a notice that this article is about the concept of first aid, and not the procedures of first aid, which may be found in the wikibook. Andrewjuren 22:06, 30 January 2006 (UTC)

This article should not aim to provide detail on every first aid manoeuver. What is should do is outline the principles (using a reliable WP:CITE), historical development of first aid (e.g. St John's Ambulance), popularity and accessibility of training programs and the benefits in terms of prognosis (on which studies must be present). JFW | T@lk 18:19, 31 January 2006 (UTC)

[edit] "Victim"

I'm only a volunteer driver for a small, mostly volunteer ambulance corps in the States, but how about "subject" instead of patient or victim? Very generic and nicely vague. And, as basically a lay person, with just American Red Cross basic first aid and cpr, I agree with not printing how-to's. Nobody should be encouraged to think that just reading such material will prepare them properly to handle emergency situations. Volygirl (talk) 00:34, 31 January 2008 (UTC)

I'd like to propose that we do not use the term "victim" in this article. According to wiktionary, a victim is an aggrieved or disadvantaged party in a crime or disaster. Often, in first aid, the patient is not a victim (because of self-inflicted injury or accident) and, as a rule, that word is not used in Canada to describe patients. This is generally because by being labelled a "victim", many patients will have an undesired emotional response and can become combatitive. I understand that it is commonly used in the United States (and still by police forces here). Can anyone comment on how this compares in other countries? Andrewjuren 21:49, 30 January 2006 (UTC)

Casualty seems to be the preferred term in the UK. Personally I don't like the word, but everyone here seems to use it. --John24601 22:06, 30 January 2006 (UTC)
In my US Wilderness First Responder course by NOLS we were taught not to use the word victim because a victim is dead. We were told to use the word patient instead. That being said, my urban EMT course instructors used 'victim' all the time. -- ColinLittle 03:51, 25 November 2006 (UTC)
I always use victim. First aiders, are *not* physicians. They're not nurses, and not first responders. They do not have patients. They do not diagnose disease. That is why I always use victim when teaching first aid courses. This is consistent with every first aid instructor has used in my presence, and what the literature I use reflects. As far as I know, victim is preferred over patient; Wikipedia should reflect that. It *might* be worth a mention at the top that some people use victim and patient interchangeably, but that the article will use victim. I've never heard that victim means the person is dead. Are people who are injured but not dead not considered victims of an accident or an act of violence? I think it would be more useful to make the distinction that first aiders are not healthcare personnel. Mike.lifeguard 23:19, 27 November 2006 (UTC)
And might I add that I teach in Canada. You're absolutely wrong, Andrewjuren. I've only ever heard "patient" from BC lifeguards. Never in any other province (although I'll admit that I haven't taught in all of them). You'll notice that Lifesaving Society literature (for example, Alert) doesn't use "patient". Mike.lifeguard 23:22, 27 November 2006 (UTC)
Lifeguarding though, does more often deal with people who may be "victims" (e.g. of a drowning). First aid deals with various other things as well: would you say that someone was a "victim" of a hypoglycaemia or heart attack? Patient is I agree a little pretentious, but "casualty" seems to be an acceptable word over here in the UK, and when I was teaching in Canada 5-6 years ago, it's what was used there too. --John24601 07:33, 28 November 2006 (UTC)
The first aid literature uses victim as well - its not just in lifeguarding. As for using casualty, though, I would think that is more likely to mean someone who is dead (ie a casualty of war) than victim, and should therefore be avoided. Again, I recommend putting a note at the top that these 3 things are used interchangeably, but that the article will stick to one. That consistent term should be "victim" for the reasons I've already stated. Mike.lifeguard 19:07, 5 January 2007 (UTC)
I'm a paramedic in the United States, and I have observed that people with medical training beyond simple first aid (paramedic, nurse, first responder, etc.) use the word patient, while lay people, police, and fire use "victim." When learning how to be a first aid instructor, and in all first aid classes I have taken we were told that first aiders are not medical professionals, like nurses, doctors, and paramedics, so they do not have patients, they assist victims. 65.96.38.93 (talk) 01:02, 18 April 2008 (UTC)

[edit] Red Cross image

I am an instructor for the red cross and have had numerous discussions with them about their symbol/emblem. This usage definitely is against our policies. I know you meant well, but the red cross is pretty strict on this. For more information, see "We often see the red cross emblem used as a decorative symbol on signs, in advertising or to indicate first aid stations. This may not seem like a problem, but it is wrong. Use of the emblem by commercial enterprises dilutes the impact of the symbol at home and abroad besides being against the law. No organization -- except the Canadian Red Cross and the medical corps of the armed forces during times of armed conflict -- may use the Red Cross emblem in Canada. This use is legislated by the Geneva Conventions Act, the Trade Marks Act and the Canadian Red Cross Society Act." Thanks! JamieJones talk 22:32, 31 January 2006 (UTC)

Thanks for catching that. delldot | talk 01:27, 1 February 2006 (UTC)
Oh, sorry, I didnt know about this. I always thought that 'first aid kits' had Red Cross symbols on them and they was supposed to have that, to indicate that its "health/aid/recovery/fix-injury". If the Red Cross symbol cant be used, then what symbol can I use to indicate that it is a first aid kit? TV must represent this wrong very often. Red Cross must be assiocated with first aid by alot of people. To me there is a mental connection between that two. Frap 13:40, 11 February 2006 (UTC)
Yeah, I've spoken to a number of people about this, sometimes on behalf of the red cross. I've even got them to try and compromise...but as a part of the red cross, i understand their unwavering position. It's to help protect their perceive neutrality, so that combatants don't start thinking "those guys aren't neutral...blast 'em". Makes sense. Yeah, it really annoys the red cross when the symbol is used all the time, which it is. Sometimes, a green cross is used instead. Although it maybe proprietary for a first aid company, i'm not sure. Yeah, every connect the red cross with first aid/health/etc., but it's preciously guarded. The law even says not matter what background or what colour red, whereas normal copyright you get very specific about colour, background, etc. Red cross regularly goes after corporations that misuse their image, but as you say, it happens alot so sometimes that haven't got to everyone. JamieJones talk 13:01, 10 February 2006 (UTC)
The Red Crystal is forbidden to use too in same was as Red Cross? Have Red Cross suggested any symbol to use on medikit. Maybe a red circle? I think maybe Star_of_life is good idea. Frap 13:40, 11 February 2006 (UTC)

Just curious as to how Johnson & Johnson fits in, as their first aid kits have the red cross with a registered mark. [1] --Gadget850 ( Ed) 19:17, 12 February 2006 (UTC)

Good point. I have emailed people at the Canadian National Red Cross, because either 1) they have some special understanding with red cross or 2) red cross doesn't know and will probably go after them. But you're right, it is weird, esp. for a company so well recognized. I'm on it is the best i can tell you for now. JamieJones talk 00:20, 14 February 2006 (UTC)
kudos to the national red cross for their quick answer. The answer, to me, seems unbelievable, but it comes through me directly from red cross:

"Thanks for your vigilance on the emblem use issue. There is a recently updated section of the Red Cross website that deals with emblem abuse (http://www.redcross.ca/article.asp?id+AD0-000340+ACY-tid+AD0-019) That may be helpful for you. The ICRC and IFRC web sites also have good emblem sections (www.icrc.org and www.ifrc.org respectively). Basically no-one except the Red Cross or the Canadian Armed Forces can use the Red Cross emblem in Canada. There are some companies that we authorize to use it (such as program sponsors) but we control these cases carefully. This is generally the case in any country that is signatory to the Geneva Conventions. The one exception to this rule in the United States is, interestingly, Johnson +ACY- Johnson. This is because J+ACY-J 's trade-mark was approved before the American Red Cross was able to secure the trade-mark in the US. This exception applies only in the US. If you check their web site carefully it says that the communication is intended for US visitors. J+ACY-J cannot market products in Canada with the Red Cross."

JamieJones talk 12:59, 15 February 2006 (UTC)

Thanks. I figured it was something like that, but could not find it on the J&J site. --Gadget850 ( Ed) 13:38, 15 February 2006 (UTC)

[edit] More from Red Cross

"An alternative symbol of first aid-a white cross on a green background-is recommended by the International Organization for Standardisation and used in various countries including Canada. The Standards Council of Canada can provide further information about this symbol" "Some believe that the Red Cross emblem is an internationally recognized symbol of first aid. IT IS NOT. The Society cannot grant permission for its emblem to be used at first aid or emergency locations when it has no control over the location or its personnel. Doctors, dispensaries, private clinics, pharmacies or first aid products that are not provided by the Canadian Red Cross are not entitled to display the emblem." -- from the Red Cross National Office in Canada

--> JamieJones talk 17:56, 15 February 2006 (UTC)

Since I saw what you said, I decided to make a SVG (Scalable Vector Graphics) image depicting a white cross on a green background. The image is in public domain. http://www.openclipart.org/incoming/first_aid_anonymous_01.svg -- Frap 18:26, 16 February 2006 (UTC)

[edit] Love the pics; idea

The images are great. I don't know much about the star of life so i assume it's public domain? And since many of us were confused about the red cross emblem and associated it with first aid, maybe I could put a short piece on the first aid page about it? JamieJones talk 12:46, 24 February 2006 (UTC)

I added the 2 pictures, hopefully they do the article good. The Star of Life is as far as I know public domain, the image says it was made by an US Gov employee, therefor public domain. -- Frap 14:18, 24 February 2006 (UTC)

[edit] Wilderness_first_aid links back here

Perhaps fixed already, but Wilderness_first_aid links back here. --Jidanni 2006-04-15

[edit] Proposed wikiproject on First Aid

Hey everybody. Am trying to get a wikiproject on first aid going. Please see User:John24601/Wikiprojectfirstaid if you are interested, and spread the word! --John24601 20:41, 18 May 2006 (UTC)

[edit] Wilderness First Aid split

I think we should split off the wilderness first aid article. It seems to be well written and possess none of the problems (like walkthroughs) that the rest of the article contains. The topic is complex and could be further discussed in its own article. We could leave a summary and a link. St.isaac 23:20, 7 August 2006 (UTC)

[edit] Wilderness First Aid split (agree)

We do need to spilt out wilderness first aid. It whould be seperatly expanded. All who object come forth.

K0Yaku August 7

OK, I'm doing the split. St.isaac 20:52, 8 August 2006 (UTC)
Sounds good. Some of the text just put back in also seems POV. I look forward to the split, and support it! JamieJones talk 02:38, 10 August 2006 (UTC)

[edit] External links

Sometimes, it can be hard to know which ones are spam, and which one are entered just to make profit from advertisements or if there are any bad sites or something. External links need be professional and reliable. I assumed goverment sites should be good, so I googled some and found some sites, maybe you can check if they are good and suited as link or better suited than some of the current links, I don't know. -- Frap

I cleaned up the ad sponsored sites and dirrect advertisments, and put in the CDC site and a European center for First Aid Education site. I expect the ad supported sites were added because people thought they would be useful (rather than being added by people who benefit from the money). But it's important to make sure we link to sites that have good oversite especialy for something health related. --Siobhan Hansa 16:30, 15 October 2006 (UTC)

[edit] Military First Aid

I have had the fortune of coming across the Instruction Manual for a St. John Ambulance Military First Aid course (1996 Canadian version if it makes a difference, although I could prolly get a newer version also). I wondered if inserting a paragraph about the difference is worth mentioning in the scope of this article.

  • Chemical Warfare
  • Combat Stress reaction
  • Personal Health care
  • Self-Aid
  • Exotic Locations

are the added chapters in the book that jump out at me in browsing.

What are your thoughts ? exit2dos2000 22:45, 20 February 2007 (UTC)

[edit] First aid provision by country

I propose that the details of qualifications by country are of no real relevance to this article and should be deleted. Owain.davies 17:33, 10 March 2007 (UTC)

I believe they are highly relivent and should remain.
Also I believe new additions to a TALK page should be added to the bottom of the page so as to stay in chronological order (and I have moved this to the bottom) exit2dos2000 19:58, 10 March 2007 (UTC)
Do you not think it's more relevant to talk about the types of first aid etc - the physical qualification by country doesn't seem very relevant. If you think it's needed - they should probably be on separate pages (as is currently the case with Emergency medical services) —The preceding unsigned comment was added by Owain.davies (talk • contribs) 22:26, 10 March 2007 (UTC).
I think you should first notice the previous conversation here. I myself do believe that this is exactly the place to show differences between nations. If things grow beyond a managable size, I may reconsider, but at this point this article still seems a reasonable size without subdivisions. If reference to the types of first aid are required, beyond explaing its existance and use, would a link to its entry in wikibooks not suffice? exit2dos2000 23:50, 10 March 2007 (UTC)

[edit] "Hyperbaric medicine" in "Specific first aid disciplines"

I'm not sure Hyperbaric medicine is first aid. Isn't it the final treatment? Mark.murphy 08:15, 12 May 2007 (UTC)

Whilst it is the final treatment, it certainly has a first aid specific element (no use of entonox for instance), and rescue divers are trained in the specific first aid treatment of the condition. Maybe it would be better titled 'Diving first aid', mentioning this, and that it is a pre-treatment to hyperbaric chamber decompression? Owain.davies 09:48, 12 May 2007 (UTC)

[edit] UK SJA reference removal?

Just wondering why my external link to St. John's Ambulance was removed? As someone said in their revision rollback - it needs to provide further information - of which it clearly does. For example, the Wikipedia article and subsequent external links do not provide much information at all on child first aid, where as the SJA page does. --leopheard 23:21, 29 May 2007 (UTC)

I did consider removing the link myself, but left it alone to see if anyone else did it. The link you posted was a straightforward commercial link. If you wish to link to more specific information (such as a specific paediatric first aid page), then link there, and make it clear in the descriptor that it's an information page. I think it was removed because it's just a link to an organsiation, and those are generally avoided (else we'd end up with a massive list at the end - and size is not necessarily an indicator of quality!). I suggest linking specific relevant pages (possibly as footnote refs linked to the text). I'd be happy with that, but it is a wiki, so someone else may disagree! Owain.davies 07:28, 30 May 2007 (UTC)
When I first saw it deleted, I considered putting it back, but on reflection I can see arguments both ways. On the one hand, I think it is good to have links to industry leaders, particularly those in the voluntary sector, as they are the natural places to go to for people who wish to find out more about the subject, and in addition there may be value in having some description of them in the article itself. However, it is very difficult to establish which organisations should be included (e.g. if we include SJA then at the very least we have to include the Red Cross & St Andrew's Ambulance, and possibly British Heart Foundation and Resuscitation Council (UK)). Those examples are just from the UK, and as wikipedia is a worldwide entity we'd have to include those organisations from all the other major English speaking countries, and the list would soon become unmanageable. I also share Owain's fear that we'd just be promoting a load of commercial entities, which is not what we're about. 'Tis a tough one - anybody else got any opinions?--John24601 09:21, 30 May 2007 (UTC)
How about a further reading section perhaps? Or even a separate Wiki page listing all FA organisations - or perhaps just charities as St John's Ambulance isn't a commercial one? I know some Wikipedians are against lists, but there sure are a lot of Wikipedia pages out there which appear to be nothing short of a Yellow pages directory! --leopheard 07:57, 2 June 2007 (UTC)
St John, whilst a charity, is still a profit making commercial enterprise with it's training and supplies division. This means that they operate in a commercial market, and could gain commerical advantage from the website. They are wikilinked within the article itself, and anyone interested can take the external link from there. Owain.davies 11:03, 5 June 2007 (UTC)
Saying SJA is a "profit making commercial enterprise" I think puts slightly the wrong spin on the organization. Its prolly just splitting hairs (and I do not disagree with the links removal)... but... ALL funds raised by the training and supplies are allocated towards self-sustanance (ie office space Rent, paid staff, etc) and the support of the Brigade Divisions (volunteer) supply and training. To believe that it is a company to make a profit for investors is not correct, it is a charitable organization. Exit2DOS2000•T•C•• 03:20, 7 June 2007 (UTC)

The links to BRC, SJA and SAA were all removed, and i have restored them. I believe that as sector leaders not just in the UK, but the two largest first aid training providers worldwide, they are inherently notable, and well worth a brief mention and wikilink to their own pages. Owain.davies 06:06, 11 September 2007 (UTC)

[edit] Effectiveness of First Aid Training For Laypersons

Lots of people will visit this entry with the assumption that after 8-12 hours of training, they will be capable of delivering effective first aid to an accident victim (or accident patient?).

Conceivably, this is a false assumption. Or it might be true. I wish some editor here could cite "real world" studies that address this rather straightforward medical issue, which has fundamental relevance to the entry.

In a quick Web search I've found no answer, yet the question is rather obvious.

-JS —Preceding unsigned comment added by 69.248.167.189 (talk) 03:42, 1 March 2008 (UTC)

First aid is very much in the dark ages in terms of evidence-based practice which now dominates much of the rest of healtchare! The only area of first aid which has really been subject to robust research is resuscitation - if you do a lit search in journals like "Resuscitation" you should find quite a bit on the effectiveness of different levels of protocol complexity, teaching styles, frequency of training etc as they apply to effectiveness of lay first aiders in emergency situations. There is very little clinical research into the efficacy of other areas of first aid, and so pretty much none on its teaching! I agree it's an interesting area, and one I'm interested in researching myself - I've been kicking around some ideas for a study for a while, but I never seem to get round to it!--John24601 (talk) 19:05, 1 March 2008 (UTC)

[edit] Conditions That Often Require First Aid

Shouldn't spinal injuries be in there as well? —Preceding unsigned comment added by 59.101.108.236 (talk) 08:33, 1 June 2008 (UTC)