First Aid

[adam2]

Might I take this opportunity to suggest that all public venues should review their preparations for incidents and disasters in general.

 

Ensure that first aid kits fully meet the legal requirements, and preferably go a bit beyond the legal minimum. Remember that an attack could result in many injuries, and that the emergency services will attend first to the more serious cases, perhaps leaving the walking wounded in the care of venue staff.

 

Ensure that firefighting equipment is in good working order, and perhaps provided in excess of the minimum requirements. Explosions can start multiple fires, and remember that fire brigade attendance could be delayed by congestion.

 

Provide plenty of battery operated lanterns and torches and chemical lightsticks. Do not put your faith in fixed emergency lighting installations that may be damaged by an explosion or concealed by dust and smoke.

 

Perhaps keep a supply of blankets to provide warmth and decency to the injured whose clothing may have been ripped off by an explosion or for medical attention. Or of course for covering the deceased.

 

Recent events are very sad, but rather than ONLY saying "how terrible" please take a few minutes to consider how well your venue would cope with a major incident, not just a suicide bomb but also a mass shooting, the release of toxic materials, impact by an HGV, or a hostage or siege situation.

 

 

 

[cedd]

Indeed, most first aid kits I've come across (the statutory ones) just aren't geared up for the kind of major trauma seen in these kinds of events.

Sadly my workplace is very much a target and we've recently invested in a number of major trauma kits including pre-made tourniquets, haemostatic dressings (incredible things - have a look at the videos on YouTube) and lots and lots of dressings.

Confusingly, I was told only 4 or 5 years ago that tourniquets were bad things and shouldn't be used. Having dealt with a major car accident in my early twenties and applied one myself, which undoubtedly saved the life of the man involved, I had to disagree. Now it would appear they're back in vogue to the point where we're buying properly made ones for our kits at work (which prompted me to buy a couple for my own kit at home - save me losing another of my favourite t shirts to have to make another one like last time!).

[Jivemaster]

Tourniquets are and were bad things when used wrongly! If there is life threatening bleeding go first for the tourniquet but if there is another way to stop bleeding, USE IT. After about 30 minutes the tourniquet line starts to become the cut line.

 

Haemostatic granules and dressings are available which stop lots of bleeds where ordinary dressings just don't do it.

 

https://www.spservices.co.uk is just one of many suppliers who will trade by post.

 

Whatever first aid bits you buy remember that they tend to have a three to five year life to expiry date.

[the kid]

I had heard Tourniquets were a 15 min item depending but no more than 20 at the very most if you HAVE to. Most important is NEVER stop the pressure, medics have the drugs and the knowledge to deal with what is in essence a crush injury, even after a long time its possible to save it just needs something more.

[djw1981]

Indeed, most first aid kits I've come across (the statutory ones) just aren't geared up for the kind of major trauma seen in these kinds of events.

Sadly my workplace is very much a target and we've recently invested in a number of major trauma kits including pre-made tourniquets, haemostatic dressings (incredible things - have a look at the videos on YouTube) and lots and lots of dressings.

Confusingly, I was told only 4 or 5 years ago that tourniquets were bad things and shouldn't be used. Having dealt with a major car accident in my early twenties and applied one myself, which undoubtedly saved the life of the man involved, I had to disagree. Now it would appear they're back in vogue to the point where we're buying properly made ones for our kits at work (which prompted me to buy a couple for my own kit at home - save me losing another of my favourite t shirts to have to make another one like last time!).

A tourniquet ti stem bleeding is good - a tourniquet for a long period is bad.

 

It should be remembered that most hand / ankle/knee surgery involves a tourniquet (at defined pressure) being in place for up to 90 minutes wilth no ill effects. So a short term one to prevent bleeding which is soft (doesnt create additional damage) and doesn;t cut into the skin, and which is removed quickly once at the trauma centre will save lives.

[cedd]

Think it's worth clarifying here that the suggestion of tourniquets was in the context of a massive trauma kit, and not as a catch all for light or moderate bleeding. And of course with any new kit comes the appropriate training.

The ones we have come with a marker and label to record the time at which it was applied - only emergency services are to release or remove. We work on the assumption that in the event of something big happening we're going to have a huge turn out of emergency services with the first wave of resources arriving pretty quickly. Defibs and stopping massive bleeding are really our primary aims. Once the emergency services arrive we'll hand the major traumas on to them and we'll switch to walking wounded.

[ANDYLASER]

I am unsure about the haemostatic dressings. The chemicals they use can cause deep burns. Although in a "life and death" situation, that might be a secondary consequence.

 

Take a look at the Israeli Trauma dressings. They incorporate a very large padded dressing and an elasticated bandage that can also be used as a tourniquet. They are quick and easy to apply and have no adverse side effects.

[mark_h]

The HSE guidance on first aid requirement only covers employees not customers. In entertainment venues there can be a lot more customers than staff.

 

Trapped trying to exit building much more common killer, fear of missing bus Nottingham Lava Ignite, fear of fire Bradford, fear of missing game Liverpool. Edinburgh Empire Fire, 2 touring crew lost to smoke inhallation less than 15` from door , because it was round a corner and were unfamiliar with building.

 

Ensuring adequate escape routes are available should be a basic requirement of any venue. The advice (England and Wales), suggests a daily inspection of escape routes.

 

Provide plenty of battery operated lanterns and torches and chemical lightsticks. Do not put your faith in fixed emergency lighting installations that may be damaged by an explosion or concealed by dust and smoke.

 

Ensuring emergency lighting works is also a high priority, last years Glasgow Cineworld power failure showed the issues of evacuating a building without any lights.

 

It is a condition of Edinburgh cinema (but strangely not theatre) licences that "All attendants on duty shall wear a distinguishing uniform or armband, and shall, have in their possession an electric torch in working condition.". Both theatre and cinema licence conditions require EXIT (not running man) signs so the conditions have not been updated recently.

Edited May 30, 2017 by mark_h

[GridGirl]

I am unsure about the haemostatic dressings. The chemicals they use can cause deep burns. Although in a "life and death" situation, that might be a secondary consequence.

 

Take a look at the Israeli Trauma dressings. They incorporate a very large padded dressing and an elasticated bandage that can also be used as a tourniquet. They are quick and easy to apply and have no adverse side effects.

 

I think it's one of those things where if you bleed to death, it's not going to matter that you're not burned. Much like the situation my husband and I found ourselves in a couple of years ago where we witnessed a motorbike vs car accident and it was a choice of not take the helmet off the motorcyclist because it might be holding his brain in, or take it off to get him breathing again (I did post about it on here). Not breathing trumped possible skull injury so the helmet came off. Even with a regular tourniquet, surely losing a limb because someone stopped you bleeding out with a tourniquet is better than bleeding out.

[Jivemaster]

The haemostatic granules used to heat -but if it stops you dying... The CURRENT haemostatic dressings and granules do NOT heat in use.

 

Anywhere that says cinema has regs that date from the period of nitrate based hi-flam film. The regs haven't caught up with acetate film and digital media!

[IRW]

I am unsure about the haemostatic dressings. The chemicals they use can cause deep burns. Although in a "life and death" situation, that might be a secondary consequence.

 

Take a look at the Israeli Trauma dressings. They incorporate a very large padded dressing and an elasticated bandage that can also be used as a tourniquet. They are quick and easy to apply and have no adverse side effects.

 

I think it's one of those things where if you bleed to death, it's not going to matter that you're not burned. Much like the situation my husband and I found ourselves in a couple of years ago where we witnessed a motorbike vs car accident and it was a choice of not take the helmet off the motorcyclist because it might be holding his brain in, or take it off to get him breathing again (I did post about it on here). Not breathing trumped possible skull injury so the helmet came off. Even with a regular tourniquet, surely losing a limb because someone stopped you bleeding out with a tourniquet is better than bleeding out.

 

I may be being incorrectly pedantic, but I believe the not-taking-the-helmet off is more to do with the possibility of neck/spinal injuries rather than skull/head, but you are correct in that you have to weigh up the risks of that vs breathing problems.

[Andrew C]

I had an hour or so with the head of trauma from my local A & E on a Bikesafe day. He was very clear "Keep them alive until we get there, however you have to do it. We can do nothing if you don't because of a perceived risk of using a tourniquet. "

[paulears]

Indeed - any first aid is better than NO first aid!

[Junior8]

Indeed - any first aid is better than NO first aid!

 

Which would have been impossible to provide at a venue Mrs J8 was trading at in March. The kit - when found - did not contain a plaster fit to deal with a simple cut, or indeed much else in usable condition. Points were made...

[Jivemaster]

I recently found a "surplus" supplier of first aid kits! These are sealed ocean going vessel kits and come to me from a refurbisher of life rafts. They are all out of date but for a contribution to their tea fund I can pick up stacks of ten! I wouldn't use the medicines they have but would certainly use the dressings in emergency.