First Aid Training - Beyond the Basics?

[dangerousdon]

Took a look around the site and couldn't find anything recent. I am looking to potentially take some first aid training.

In the past I have taken Red Cross First Aid courses, learned first aid in the Marine Corps (though it was a million years ago) and took an Army Combat Lifesaver class around 2004ish (I was also in the National Guard), but for some reason I feel like this might have been a tad abbreviated.

I am pretty confident that I can perform some minor to "maybe" intermediate first aid issues. But to be honest, I am woefully out of practice and I am not at all confident in my skills.

Thinking about everyday survival skills, slightly more advance first aid is at the top of my list. I work in an office building, so an active shooter situation is possible. I would like to be able to help out friends and co-workers as well as being able to take care of myself. Also I think about the worse case scenario with the world being as it is...and I NEED to be able to take care of the family if things go bad. It doesn't do me any good to collect all the supplies I can if I can' treat my wife and kid.

I'm in the Baton Rouge area, and was wondering if anyone knows of...and can recommend...a more advance first aid class. I know FRC does a Hemorrhage Training Seminar that is two -three hours. I wouldn't mind doing another Combat Life Saver class. If I had the time and money...I might even take an EMT course...but that isn't likely.

Anyway...looking for your thoughts.

 

[hkump]

As long as you know basic CPR and know how to use a tourniquet, that's good enough for the real world. For more serious issues, you're going to need IV access, meds, etc, so that would be up to the professionals. As long as you can get the heart beating and keep the person stabilized, that's doing pretty damn good already. For arms and legs, just know how to stop the bleeders with a tourniquet and you'll be good. For all the other trauma, leave it to the pros.

 

[dangerousdon]

As long as you know basic CPR and know how to use a tourniquet, that's good enough for the real world. For more serious issues, you're going to need IV access, meds, etc, so that would be up to the professionals. As long as you can get the heart beating and keep the person stabilized, that's doing pretty damn good already. For arms and legs, just know how to stop the bleeders with a tourniquet and you'll be good. For all the other trauma, leave it to the pros.

I appreciate the comment. The problem is that I am not confident in my skills. I'm in the process of taking classes on more basic skills to refresh what I already know. And while I agree that in most situations basic first aid and CPR is what I will need, I don't think that is quite good enough. In this day and age when first responders are hampered and often times blocked from getting to where they need to go...do you really want to wait for EMS if your buddy has a sucking chest wound from a gunshot to the chest? I remember being trained on it in the military...but honestly I don't think I can help someone out right now if the need be. And yes, I understand that I would need access to IV and other things. Oddly enough, I believe I can administer an IV if I had to...that part of the training stuck with me for some reason. Just trying to be prepared and not have to rely on first responders in the event that first responders can't get to me. I think the past 20 years or so have demonstrated the need for these skills... 9/11, Katrina, 2016 Flood, Riots, other civil unrest. Call me paranoid...I just think I can wholeheartedly rely on these services anymore.

 

[dwr461]

Duplicate post.

 

[dwr461]

Good afternoon,

I’m a paramedic with over twenty years of field experience most of which was in East Baton Rouge Parish. Currently I’m a training officer, state instructor, and training center faculty for the American Heart Association.

I would recommend the first aid course from AHA for those that want to learn first aid. It also teaches CPR which is very important. In fact is it is the most important skill to have for a medical cardiac arrest.

“Sucking chest wounds” rarely happen even with penetrating chest trauma. In fact I never remember encountering one in the field. An open pneumothorax is far more common to occur. If they do occur please leave the treatment to the professionals.

A tourniquet is useful but must be applied correctly to prevent further harm.

Dave


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[dangerousdon]

Good afternoon,

I’m a paramedic with over twenty years of field experience most of which was in East Baton Rouge Parish. Currently I’m a training officer, state instructor, and training center faculty for the American Heart Association.

I would recommend the first aid course from AHA for those that want to learn first aid. It also teaches CPR which is very important. In fact is it is the most important skill to have for a medical cardiac arrest.

*Sucking chest wounds* rarely happen even with penetrating chest trauma. In fact I never remember encountering one in the field. An open pneumothorax is far more common to occur. If they do occur please leave the treatment to the professionals.

A tourniquet is useful but must be applied correctly to prevent further harm.

Dave


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The sucking chest wound was a bit of an example.

But seriously, are you guys telling me it's better to not be prepared for a situation than to be prepared?

I work on the 10th floor of a building. My organization is a bit high profile and occasionally attracts crazies. The building has some security. Sure it is likely, that I will never see an active shooter. Does that mean I shouldn't have a trauma kit? Does that mean I shouldn't have a plan? Does that mean I shouldn't have the knowledge to help my buddy, or God forbid, myself if the need arises? It takes first responders 8 to 10 minutes to arrive on the scene...in the best of situations. In an active shooter situation, it could be much longer. And the best answer I get is, "let the professionals handle it."

Yeah, that's okay...

 

[dwr461]

I’m sorry if I came off as flippant to your concerns. That was not my intention.

Please take a first aid course and keep a first aid kit handy. But for serious trauma do your best to stop the bleeding and call 911. What they need is a surgeon and blood products. The time to get to a hospital that has those services is the most important factor at that moment. That’s just as true for us as it is for you.

Unfortunately if someone has a GSW to the torso you and us will not be able to stop the bleeding due to it being internal.

I recommended calling the professional because Paramedics training is two years long and is about 2,500 hours. We also get additional training on Pre Hospital Trauma Life Support etc. We also do this for a living. Treating a GSW is a normal day for us. Emergency care is what we do and will therefore be better at it than most people.

Dave


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[dangerousdon]

I’m sorry if I came off as flippant to your concerns. That was not my intention.

Please take a first aid course and keep a first aid kit handy. But for serious trauma do your best to stop the bleeding and call 911. What they need is a surgeon and blood products. The time to get to a hospital that has those services is the most important factor at that moment. That’s just as true for us as it is for you.

Unfortunately if someone has a GSW to the torso you and us will not be able to stop the bleeding due to it being internal.

I recommended calling the professional because Paramedics training is two years long and is about 2,500 hours. We also get additional training on Pre Hospital Trauma Life Support etc. We also do this for a living. Treating a GSW is a normal day for us. Emergency care is what we do and will therefore be better at it than most people.

Dave


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Umm...yeah...this post wasn't any better. It seems that you are assuming that I won't call 911 in a bad situation and that I would prefer to treat the victim instead of getting him to a hospital. And your answer is that if something bad happens just let your buddy be and let's hope and pray that he gets help. Wow!

I'm not looking to do Open Heart surgery. I am not looking to take forceps and remove a bullet from someone. What I am looking for is something a bit more than just what your standard everyday first aid class offers. I have taken a few of those. And I will likely take one again...and soon. But I am looking for something that kind of bridges the gap between standard first aid and EMT. In the military they have this. Evidently, as a civilian, you are just supposed to hope you can get treatment.

 

[DAVE_M]

What you're looking for is a Stop the Bleed type course.

You can find out if there are classes near you by going through their website, here: https://www.stopthebleed.org/training
Looks like there are two Stop the Bleed courses coming up in Metairie. They are not extensive, but they are free.

Aside from Advantage Group's medical course that has been taught in the past and Stop the Bleed courses, I'm unware of any TECC/TCCC type courses that are publicly available.

You may also want to look into Dark Angel Medical. They have held courses in Mississippi in the past, but the closest upcoming course is in Texas.

In the past, VATA Training Center has held TECC/TCCC type courses. I'm unware if Phobos or Advantage Group has anything coming up. FRC does have short classes, but I don't see any available and I believe they are similar to Stop the Bleed courses.

To be honest, there isn't much available to civilians (non-LEO, Mil, or Medical professionals). However, there is a fair amount of information online if you look for it.

 

[dwr461]

Seriously I'm not trying to come across that way. We just have a communication gap. I know part of the problem was trying to answer on my phone. I'm at a PC now and will try to explain myself better. I'm happy that want to learn more first aid skills and wish more people would do so.

It seems that you are assuming that I won't call 911 in a bad situation and that I would prefer to treat the victim instead of getting him to a hospital.

No not what I was saying at all. But I can see how you read that.

There's nothing anyone outside of a surgical suite is going to do stop the bleeding if it's internal. There's no short class that's going to teach you how to stop internal bleeding because you and EMS systems can't. I said to call 911 because the time to get them into surgery is the most important factor that affects mortality rates. As the length of time to get to the surgeon goes up so does the mortality. This is true regardless of treatment rendered pre hospital. The hospital will give the blood products to replace what they lost and the surgeon will stop the bleeding. Of course I'm discussing hits to the torso in this previous paragraph.

You can make a difference in serious trauma with extremity injuries. Tourniquets or pressure dressings are great tools. You can absolutely make save a life by controlling a gross external hemorrhage. I mention pressure dressing because they're cheaper than tourniquets and can be equally effective depending on the nature of the injury. For example if were work a MCI (Mass Casualty Incident) I might only have five CAT tourniquets on my truck. Not every GSW to an extremity requires a tourniquet so might use pressure dressing for those if time and scene safety allows.

In discussing internal hemorrhages again, Yes you could start an IV for example but that is a mixed bag. IV fluids are not blood. By that I mean they don't carry oxygen or have the ability to clot. In fact large quantities of crystalloid IV solutions decrease the body's ability to clot by both diluting the platelets and by reducing the body temperature. EMS systems do not routinely give IV bolus of Saline or Ringers, or D5W for this reason. When we do mortality rates go up. We've known this for more twenty years now.

So when I say call 911 and try to stop the bleeding that's exactly what you should do. Because numerous medical studies conducted world wide have proven that this reduces mortality rates. Once EMS arrives they should try to stop the bleeding and everything else enroute to the hospital. Because this reduces mortality rates. Enough medical studies have been done to prove that this it is no longer a debated subject and is treated as fact.

But I am looking for something that kind of bridges the gap between standard first aid and EMT.

I understand now you don't want a First Aid course. I suggested it because it's a one day course that also contains CPR. Statistically you'll be far more likely to use CPR to save a life than in a serious trauma. CPR is simply the most important thing that can be done except for rapid AED use to reduce mortality in medical cardiac arrests. I recommend everyone take a CPR course.

However if don't want that course you may also consider an EMR (Emergency Medical Responder) course if you wish. That is a 48 hour long course which covers far more than trauma but is less than an EMT. I do know numerous course you could take if you were an EMR. TECC (Tactical Emergency Casualty Care) for first responders is great course taught by the (NAEMT) National Association of EMT's. I used to be an instructor for this and it is a great course.

I'm never going to recommend a course that hasn't been approved by a medically accredited and governing body. These courses have research and studies to back up why they teach what they teach.

Evidently, as a civilian, you are just supposed to hope you can get treatment.

No you wouldn't hope. The EMS system and Fire Department near you will come. That's what we do. I know you didn't intend to insult my profession with that statement so no big deal.

I sincerely hope this helps you understand my point. I strongly encourage you to get more first aid training it'll come in handy more often than you know.

With peace and respect,

Dave

 

[dwr461]

What you're looking for is a Stop the Bleed type course.

You can find out if there are classes near you by going through their website, here: https://www.stopthebleed.org/training
Looks like there are two Stop the Bleed courses coming up in Metairie. They are not extensive, but they are free.

Aside from Advantage Group's medical course that has been taught in the past and Stop the Bleed courses, I'm unware of any TECC/TCCC type courses that are publicly available.

You may also want to look into Dark Angel Medical. They have held courses in Mississippi in the past, but the closest upcoming course is in Texas.

In the past, VATA Training Center has held TECC/TCCC type courses. I'm unware if Phobos or Advantage Group has anything coming up. FRC does have short classes, but I don't see any available and I believe they are similar to Stop the Bleed courses.

To be honest, there isn't much available to civilians (non-LEO, Mil, or Medical professionals). However, there is a fair amount of information online if you look for it.

Darn I totally forgot about the Stop the Bleed course. That's a good one.

Thanks Dave M

 

[Fugum]

Darn I totally forgot about the Stop the Bleed course. That's a good one.

Thanks Dave M

I agree with Dave, the stop the bleed class wasn't very extensive, but they did show proper application of a tourniquet and packing a wound with combat gauze or hemostatic dressing. The one I attended last year actually taught the proper application of a chest seal.

 

[dangerousdon]

What you're looking for is a Stop the Bleed type course.

You can find out if there are classes near you by going through their website, here: https://www.stopthebleed.org/training
Looks like there are two Stop the Bleed courses coming up in Metairie. They are not extensive, but they are free.

Aside from Advantage Group's medical course that has been taught in the past and Stop the Bleed courses, I'm unware of any TECC/TCCC type courses that are publicly available.

You may also want to look into Dark Angel Medical. They have held courses in Mississippi in the past, but the closest upcoming course is in Texas.

In the past, VATA Training Center has held TECC/TCCC type courses. I'm unware if Phobos or Advantage Group has anything coming up. FRC does have short classes, but I don't see any available and I believe they are similar to Stop the Bleed courses.

To be honest, there isn't much available to civilians (non-LEO, Mil, or Medical professionals). However, there is a fair amount of information online if you look for it.

Thank you! This was very helpful

Seriously I'm not trying to come across that way. We just have a communication gap. I know part of the problem was trying to answer on my phone. I'm at a PC now and will try to explain myself better. I'm happy that want to learn more first aid skills and wish more people would do so.

It seems that you are assuming that I won't call 911 in a bad situation and that I would prefer to treat the victim instead of getting him to a hospital.

No not what I was saying at all. But I can see how you read that.

There's nothing anyone outside of a surgical suite is going to do stop the bleeding if it's internal. There's no short class that's going to teach you how to stop internal bleeding because you and EMS systems can't. I said to call 911 because the time to get them into surgery is the most important factor that affects mortality rates. As the length of time to get to the surgeon goes up so does the mortality. This is true regardless of treatment rendered pre hospital. The hospital will give the blood products to replace what they lost and the surgeon will stop the bleeding. Of course I'm discussing hits to the torso in this previous paragraph.

You can make a difference in serious trauma with extremity injuries. Tourniquets or pressure dressings are great tools. You can absolutely make save a life by controlling a gross external hemorrhage. I mention pressure dressing because they're cheaper than tourniquets and can be equally effective depending on the nature of the injury. For example if were work a MCI (Mass Casualty Incident) I might only have five CAT tourniquets on my truck. Not every GSW to an extremity requires a tourniquet so might use pressure dressing for those if time and scene safety allows.

In discussing internal hemorrhages again, Yes you could start an IV for example but that is a mixed bag. IV fluids are not blood. By that I mean they don't carry oxygen or have the ability to clot. In fact large quantities of crystalloid IV solutions decrease the body's ability to clot by both diluting the platelets and by reducing the body temperature. EMS systems do not routinely give IV bolus of Saline or Ringers, or D5W for this reason. When we do mortality rates go up. We've known this for more twenty years now.

So when I say call 911 and try to stop the bleeding that's exactly what you should do. Because numerous medical studies conducted world wide have proven that this reduces mortality rates. Once EMS arrives they should try to stop the bleeding and everything else enroute to the hospital. Because this reduces mortality rates. Enough medical studies have been done to prove that this it is no longer a debated subject and is treated as fact.

But I am looking for something that kind of bridges the gap between standard first aid and EMT.

I understand now you don't want a First Aid course. I suggested it because it's a one day course that also contains CPR. Statistically you'll be far more likely to use CPR to save a life than in a serious trauma. CPR is simply the most important thing that can be done except for rapid AED use to reduce mortality in medical cardiac arrests. I recommend everyone take a CPR course.

However if don't want that course you may also consider an EMR (Emergency Medical Responder) course if you wish. That is a 48 hour long course which covers far more than trauma but is less than an EMT. I do know numerous course you could take if you were an EMR. TECC (Tactical Emergency Casualty Care) for first responders is great course taught by the (NAEMT) National Association of EMT's. I used to be an instructor for this and it is a great course.

I'm never going to recommend a course that hasn't been approved by a medically accredited and governing body. These courses have research and studies to back up why they teach what they teach.

Evidently, as a civilian, you are just supposed to hope you can get treatment.

No you wouldn't hope. The EMS system and Fire Department near you will come. That's what we do. I know you didn't intend to insult my profession with that statement so no big deal.

I sincerely hope this helps you understand my point. I strongly encourage you to get more first aid training it'll come in handy more often than you know.

With peace and respect,

Dave

Look...I don't doubt you are good at what you do (and my wife would like you for being a Penns fan), and of course I know and trust that first responders would come if I need them to come. What I meant is that what if first responders can't get to you in time. What happens if first responders are being blocked by a protest, what if you are hiking in a remote area, what happens if you are in any situation where EMS can't get to you in that 8 - 12 minutes or if you can't call for 911. And please do not get hung up on sucking chest wound...there are a lot more trauma rated injuries out there than a gun shot wound. And before you tell me that these situations can't happen...really think about it. In 2016 during the floods we had here and AT&T switch went down leaving thousands of people without cell service. What if several of these went down at the same time? During natural disasters, first responders are stretched thin, over worked and extremely tired...you guys can't be everywhere all the time. In these types of situations...I want to be prepared. And yes...I understand that basic first aid and CPR are what is most likely to be used. But as I indicated (a couple of times I think), I have plans on doing refresher courses of these...as I have had numerous first aid classes and CPR classes in the past. I need to refresh these skills. So it's not that I don't want them...I just want something more.


@DAVE_M Thanks again for the recommendation...I will definitely look into Stop the Bleed as well some of the other stuff you mentioned.

 

[AustinBR]

Advanced first aid is also something on my list of things that I'd like to do. Dave, thank you for sharing the Stop the Bleed course. I am going to sign up for one ASAP and try to take more advanced courses if available.

 

[dwr461]

Thank you for your kind words, I've been trying to be helpful. I failed. But there you go.

I teach that providers should spend their careers looking for horses because they'll miss them looking for unicorns. The horses in this metaphor is the most likely stuff you're likely to see and unicorns are things that almost never happen.

I worked the entire weekend of the 2016 Floods. They sucked. I've every major disaster since 1997 in Louisiana. Shootings usually go way down during disasters. So I wouldn't worry about it. But I get your broader point, what if EMS can't get to you for [insert reason here.]

Well I'm not sure what you want me to say here, I thought it was pretty clear. If you're having an internal hemorrhage that is uncontrolled and you can't get to a surgical team and blood products? You die. Packing a wound? it can potentially help and certainly won't hurt. So the stop the bleed class is good.

Like Dave M said there are not a lot of classes from sources that I would recommend that cover material in that specific spot that you're looking to cover. I'm sure there are tactical type medical classes being put on from various sources. But I won't recommend them without looking at the curriculums. Most of those classes I've looked at the past were of questionable value to say the least and way to expensive to say the most. I will absolutely not mention any names or classes.


I

Dave

 

[AustinBR]

Thank you for your kind words, I've been trying to be helpful. I failed. But there you go.

I teach that providers should spend their careers looking for horses because they'll miss them looking for unicorns. The horses in this metaphor is the most likely stuff you're likely to see and unicorns are things that almost never happen.

I worked the entire weekend of the 2016 Floods. They sucked. I've every major disaster since 1997 in Louisiana. Shootings usually go way down during disasters. So I wouldn't worry about it. But I get your broader point, what if EMS can't get to you for [insert reason here.]

Well I'm not sure what you want me to say here, I thought it was pretty clear. If you're having an internal hemorrhage that is uncontrolled and you can't get to a surgical team and blood products? You die. Packing a wound? it can potentially help and certainly won't hurt. So the stop the bleed class is good.

Like Dave M said there are not a lot of classes from sources that I would recommend that cover material in that specific spot that you're looking to cover. I'm sure there are tactical type medical classes being put on from various sources. But I won't recommend them without looking at the curriculums. Most of those classes I've looked at the past were of questionable value to say the least and way to expensive to say the most. I will absolutely not mention any names or classes.


I

Dave

Hypothetical question: Let's say someone is shot or poked or somehow has a hole opened up on their midsection. We have a few folks around, one of which has taken stop the bleed classes and is carrying a TQ and wound packing material. 911 is immediately called.

Option a) Pack the wound and compress. Maintain pressure till EMS arrives.
Option b) Wait till EMS arrives.

Let's say that EMS arrives in 8 minutes.

Option a only happens because someone took a few classes and knows a bit about bleeding, but is no paramedic.

Which option is better?

I don't think anyone here is arguing that EMS will be replaced, but are arguing that simply having a bit of know-how and trauma tools (basic IFAK stuff) can probably help if someone has their pipes leaking.

If someone has a serious bleed from an appendage, don't pretty much all studies show that throwing on a TQ + applying pressure while waiting for EMS are a hell of a lot better than not? If a TQ is applied and EMS shows up 10 minutes later, they can decide to keep it, reapply another one, take it off, or apply alternate wound care, right?

 

[DAVE_M]

Stop the Bleed courses will cover tourniquet application, pressure dressings, and hemostatic gauze. I don’t think anyone here is advocating civilians do nothing, but there is only so much you can do until EMS arrives.

CPR and using pressure dressings will probably be the most common thing you need to do, if anything at all. Not everything is a gunshot wound. I’ve used my booboo kit more than anything. Ironically, it’s been used the most in New Orleans from myself and others tripping/slipping around town.

Classes are a good idea to teach people what to do and what not to do. I don’t want to think of how many people are walking around with a decompression needle in their kits, because they saw it on YouTube.

 

[mct601]

Invasive skills are hard to learn, harder to perform, and even harder to maintain. In the critical care transport world, clinicians with extensive initial training still screw up chest decompression and even IVs. Those are people with a much high frequency and exposure than a layperson will ever have to include cadaver lab training in many instances. I do not recommend seeking out training on this because even if you do get presented with the opportunity to use it, it's likely you'll cause more harm than good. Tearing up IV sites and striking nerves and blood vessels with a 10/12/14ga decomp needle in the chest will make it harder for professionals to treat the patient. Please do not put us in this position.

Aside from all that, you're referencing natural disasters where response is prolonged. Any worthwhile skill you'll learn is a bridge to a surgeon or other definitive care. Your needle in the chest will likely kink or occlude not long after insertion and require more pokes to maintain decompression. That's one example and unless you have extensive wilderness training you won't be able to maintain a very sick medical or trauma alone unless luck just so happens to be on your side.


Please. Do. Not. Buy. Decomp. Needles.

 

[dwr461]

At East Baton Rouge EMS our providers have an option between NCD (needle chest decompression) and simple thoracostomy for tension pneumothorax. They have to re-certify both skills regularly. They are not for laymen but are for professionals.

Dave


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[Xeon64]

I agree with the stop bleeding and call 911 or go to ER as fast as possible. I am and Eagle Scout and we where taught many many life saving courses. All of which where methods to maintain life until the professionals arrived. This training was decades ago for me but I did have to use it once. I had to apply a tourniquet when a friend fell through plate glass in a drunken stupor. I remember there was timing that had to be recorded once a tourniquet was applied and I can no remember any of that today. Like said best to take a CPR and prep course to maintain life until the pros arrive.