Gardai as medical responders

ScubaDave · 30-09-2008 07:44PM #1

Hey Gang,

Its that time of training for me when a dissertation has to be written! I want to look at members of An Garda Siochana in remote areas providing first aid/defib/first responder type care to injured persons while waiting for more qualified assistance.

I just want to ask you lot a few questions:

1. Have many of you personal experience of providing care to injured persons while on duty?

2. How would you feel about the above happening?

3. Are any of you aware of any defib schemes operated either by, or in partnership with AGS?

4. Metman, what kind of system is in place in the UK?

5. Any of you any ideas of an area worth exploring - please let me know!

Thanks for any input you may provide folks. It is appreciated.

Regards,

Dave

ScubaDave · 30-09-2008 07:47PM

Also, if there are any paramedics reading this, how do you feel about this?

What are your experiences with members of AGS at incidents where they are first on scene?

Would you support the above idea?

All feedback appreciated!

metman · 30-09-2008 09:48PM

Dave, in London all officers are ELS (emergency life support trained) and refresh every couple of years. I've had to use it a couple of times in more serious circs (male collapsed with a heart attack, basic cpr given, but he later died in hospital which was rough, and also during the events of 7/7 where I also had to use the basic skills I have) and numerous times on a weekend night shift patching up the glassed/bottled/punched chavs that forever get glassed/bottled/punched etc on a saturday night! :rolleyes:

All vehicles carry basic first aid kits, while armed response vehicles carry defibs, as some of their crews are trained to a higher level (EMT), and carry additional kit and supplies for dealing with gunshot wounds etc.

Custody suites now stock defibs too. Generally speaking you're never waiting too long for an ambulance in the smoke, unless its on a saturday night.

Fyr.Fytr · 30-09-2008 10:09PM

Cars in blanch and kilkenny (i think its kilkenny open to correction) have defibs on board officers trained in their usage.

Not sure wether they have been used or not. I'm sure someone will confirm or deny this.

I think this is a very good idea, the more people trained to provide emergency care the better. The pt normally doesnt care who is treating them aslong as someone is and they're doing it right.

Statistics show for ever minute lapsed from the pt going into cardiac arrest and recieving cpr the changes of survival drop by 10%

The chain of survival is

early access
early cpr
early defib
early advanced care

If gardai can provide the first three it hugely increases the chances of survival

JonAnderton · 30-09-2008 10:41PM

metman wrote: »

Dave, in London all officers are ELS (emergency life support trained) and refresh every couple of years. I've had to use it a couple of times in more serious circs (male collapsed with a heart attack, basic cpr given, but he later died in hospital which was rough, and also during the events of 7/7 where I also had to use the basic skills I have) and numerous times on a weekend night shift patching up the glassed/bottled/punched chavs that forever get glassed/bottled/punched etc on a saturday night! :rolleyes:

All vehicles carry basic first aid kits, while armed response vehicles carry defibs, as some of their crews are trained to a higher level (EMT), and carry additional kit and supplies for dealing with gunshot wounds etc.

Custody suites now stock defibs too. Generally speaking you're never waiting too long for an ambulance in the smoke, unless its on a saturday night.

We're all going to be Defib eventually. It's an easy bit of kit to use (turn it on, listen to what the machine tells you to do) and a great idea.

Sadly, the DFibs in the cars are supposed to be going. City of London ARV's started out the idea and they found that LAS were begining to rely on their (CP) cars to supply defibs. While my opinion is whoever's the best placed (as long as properly equipped) to deal should deal, I can see how the headsheds weren't keen on this at all... Our car's were supposed to be loosing the DFIBS as well and I know our departments had there's removed.

bear in mind, in the rural areas, a passing car, or one based in a nearby village, would be of great benefit. But would the Supt. be keen on one of his cars being dispatched to a possibly death in garda custody(cos in theory, thats what it might be considered to be if the patient, having been worked on by Gardai. granted, not like a shooting or prisoner in a cell)would be.. or is the definition different over there. What constitutes a death in custody?

deadwood · 30-09-2008 10:53PM

We got cpr training in Templemore but no refresher training. Although best practices may have changed i've no up-to-date training. (I hear this penecillin is mighty stuff)

Defibs were introduced in a couple of pilot schemes (did we have a pilot pilot scheme for the Air Support Unit?) but Fyr ftr has all the data on that.:D

I know some local groups have approached gardai and offered to provide training and equipment to be carried in patrol cars, as they will often be the first responders in rural areas. I don't know if many took it on though.

There is a fear of litigation but a barrister specialising in medical issues informed a group I work with that a person acting competently and in good faith has nothing to fear from the courts.

metman · 30-09-2008 10:56PM

deadwood wrote: »

a barrister specialising in medical issues informed a group I work with that a person acting competently and in good faith has nothing to fear from the courts.

Good advice there from the spokesman for InjuryLawyers4You!

Fyr.Fytr · 30-09-2008 10:56PM

http://www.mhb.ie/mhb/News/2006News/March2006/d9037.HTML.html

http://fire.kilkennycoco.ie/News/2006/Automated_External_Defibrillator_Pilot_Project/

More info for you there.

Deadwood is correct cpr has changed alot in the last few years as more focus is put on the AED (defib) and compressions rather then breaths. So refresher training is essential

JonAnderton · 30-09-2008 10:57PM

The defibs are pretty fool proof... They show you where to stick the pads, it tells you what to press and when.... They are even clever enough that they wont shock if they detect a pulse.

Fyr.Fytr · 30-09-2008 10:59PM

Yep some even beep to tell you when to compress the chest, not only will it not shock if it detects a pulse but it wont shock if it detects a rhythm other then v-fib

eroo · 30-09-2008 10:59PM

Aren't AGS still running a pilot programme on having Defibrillators placed in the boot of patrol cars?

I think ALL Gardai should be trained in the ES equivalent of 'Occupational First Aid' or higher level, and in use of Defib. I have myself enrolled in a Defib course, and plan on enrolling in a Practical First Aid Course, simply because I believe it is vital that everybody has some knowledge of administering basic emergency medical care, whether your in ES or not(as in my case).

If I'm not mistaken training in first aid and Defib is carried out at the Garda College as part of Phase 1. That's all well and good, but what is the point of being trained in use of Defib if you don't have access to one?

deadwood · 30-09-2008 11:04PM

metman wrote: »

Good advice there from the spokesman for InjuryLawyers4You!

"I stuck this rusty spike up my baloon knot at work because there was no sign telling me not to. I got £3,000!"

Paulzx · 30-09-2008 11:04PM

I think there is a greater arguement for Garda cars carrying defibs in rural areas than in the cities where ambulance response times are much better. All Garda stations should definetly have them. I have had plenty of arrests in the cells of Garda stations due to the clientele that frequent them( drugs etc.).

The reality is that even with our reasonably quick response times in Dublin we deliver a lot more dead ones to A&E than people that still have a chance. To be honest you generally don't get too many back. Thats not to say that defibs shouldn't be more widespread and strategically placed.

deadwood · 30-09-2008 11:05PM

JonAnderton wrote: »

The defibs are pretty fool proof... They show you where to stick the pads, it tells you what to press and when.... They are even clever enough that they wont shock if they detect a pulse.

Red=positive, black=negative, or is it the other way around?

JonAnderton · 30-09-2008 11:05PM

deadwood wrote: »

"I stuck this rusty spike up my baloon knot at work because there was no sign telling me not to. I got £3,000!"

And they replaced the sign saying 'No rusty spikes to enter your ballon knots' which made it all worthwhile"

Paulzx · 30-09-2008 11:08PM

JonAnderton wrote: »

The defibs are pretty fool proof... They show you where to stick the pads, it tells you what to press and when.... They are even clever enough that they wont shock if they detect a pulse.

You'd want to be a cabbage not to be able to use them. The most difficult part is turning it on:P

Eru · 30-09-2008 11:11PM

Short and sweet. Stationed in city, enroute to work man has a heart attack, park car, ask questions (just like they trained us if you can believe that, even scene safe), listen to snotty answers from assholes, do cpr, DFB arrive and take over. Then go to shop, get water and rinse mouth thoroughly (****ers made me pay!), go to station and put a ventaid in the glovebox.

I was later informed by the DFB guys that were there that he made a full recovery and yes, I do get a warm feeling telling you this story

BTW, excuse my ignorance but exactly what are Gardai based on the training we get? Is it even full first aid level? and did anyone hear the story about the rookie medic in the US that shocked his colleague while she was driving as a joke? Was sent away for manslaughter

deadwood · 30-09-2008 11:14PM

JonAnderton wrote: »

And they replaced the sign saying 'No rusty spikes to enter your ballon knots' which made it all worthwhile"

Yes. A lesson learned. And it didn't cost me any hidden charges!

metman · 30-09-2008 11:16PM

deadwood wrote: »

Red=positive, black=negative, or is it the other way around?

Always cut the blue wire!

Sorry wrong SOP.

But grab the cat anyway

JonAnderton · 30-09-2008 11:19PM

metman wrote: »

Always cut the blue wire!

Sorry wrong SOP.

But grab the cat anyway

A minute ago you said redddd...

I'm too old for this s**t!

pa990 · 01-10-2008 12:29AM

OK.. a lot wont agree with my opinion.. but a lot will

I would be reluctant to offer medical assistance to anyone injured, i can just see a claim coming in should i do something wrong.

Even if we get training, it will be from inservice (or CPD, whatever they call themselves these days) who haven't a fu©king monkeys anyway, with no refresher course.

I have also refused to carry someone to the hospital in the back of the patrol car, when all the ambo's were busy. NO WAY was i explaining how someone died in the back of the car, while technically they were in our custody.

Its cruel i know, but i have a mortgage and bills to pay, and as someone much wiser told me once,
"The code was written to inform the reader and protect the writer"

(i am awaiting the onslaught of critisism )

deadwood · 01-10-2008 12:34AM

pa990 wrote: »

"The code was written to inform the reader and protect the writer"
(i am awaiting the onslaught of critisism )

An understandable position. I think if we we received regular training we would have a better idea what to do, or maybe more importantly, what not to do.

TheNog · 01-10-2008 12:38AM

I all for defib training but could see any training that requires refresher could present a problem.

I used my first aid skills for the first time last weekend. Twas funny when I put the bandage on it was upside down. Made a total eejit of meself but the wounded lad was laughing.

CLADA · 01-10-2008 12:39AM

"Protect life" It was in the oath you took gentlemen:mad:

deadwood · 01-10-2008 12:41AM

CLADA wrote: »

"Protect life" It was in the oath you took gentlemen:mad:

Let's not turn this into an abortion discussion.

TheNog · 01-10-2008 12:41AM

pa990 wrote: »

OK.. a lot wont agree with my opinion.. but a lot will

I would be reluctant to offer medical assistance to anyone injured, i can just see a claim coming in should i do something wrong.

Even if we get training, it will be from inservice (or CPD, whatever they call themselves these days) who haven't a fu©king monkeys anyway, with no refresher course.

I have also refused to carry someone to the hospital in the back of the patrol car, when all the ambo's were busy. NO WAY was i explaining how someone died in the back of the car, while technically they were in our custody.

Its cruel i know, but i have a mortgage and bills to pay, and as someone much wiser told me once,
"The code was written to inform the reader and protect the writer"

(i am awaiting the onslaught of critisism )

If ye did carry a person to hospital in the back of the car would ye not be protected by "Protect Life"?

Eru · 01-10-2008 02:11AM

CLADA wrote: »

"Protect life" It was in the oath you took gentlemen:mad:

Have to agree, acting in good faith to protect life, etc. Have also carried injured persons in the car which you are covered for without them being in custody. Hell you can bring old ladies home if you think they are vulnerable (may or may not include the frozen food melting

)

ScubaDave · 01-10-2008 04:39AM

Thought i should mention,

my background is that ive been involved with the civil defence for touching 7 years. Through this is got my advanced first aid (old title), bls/aed healthcare provider (includes defib), and a scatter of other little certs.

I have already found this training useful on numberous occasions hence why i think this topic is worth a stab.

Dave

PS

Metman, what is covered in your ELS training?

dredre · 01-10-2008 06:33AM

Fyr.Fytr wrote: »

Yep some even beep to tell you when to compress the chest, not only will it not shock if it detects a pulse but it wont shock if it detects a rhythm other then v-fib

Defibrillators do not detect a pulse.

Defibrillators will shock either VFib or VTach

Being qualified to use one doesn't qualify you to instruct others

I've said it already, I think you should take a break from here. For your own sake.

Fyr.Fytr · 01-10-2008 08:51AM

dredre wrote: »

Defibrillators do not detect a pulse.

Defibrillators will shock either VFib or VTach

Being qualified to use one doesn't qualify you to instruct others

I've said it already, I think you should take a break from here. For your own sake.

I've just done my phecc cfr refresher and all of the note slides etc only mentioned vFib, no mention of vTach. Maybe that is just the AED's im sure more complicated machinces detect other rhythms.

I never instructed anyone just gave my opinion.

JonAnderton · 01-10-2008 09:14AM

dredre wrote: »

Defibrillators do not detect a pulse.

Defibrillators will shock either VFib or VTach

Being qualified to use one doesn't qualify you to instruct others

I've said it already, I think you should take a break from here. For your own sake.

Appologies.. I think we've confused detect a pulse with detect a shockable heart rythum... We were told it wont shock a beating heart.. is that correct?

Gardai as medical responders

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