One of my views on basic 1st aid.

1oldcoyote

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A few points of basic knowledge/skill; Basic 1st aid does not always require specialized equipment/knowledge. A layperson can often get by using common sense(Best to remain calm). Stopping bleeding; Direct pressure over the wound is best. Arterial or large vein wounds can often require extremely FIRM direct pressure. When bleeding can not be controlled/reduced by direct pressure. I would opt for a tourniquet. Either a store bought one or I would use a boot or shoe lace in a pinch. Time of tourniquet application should be noted. For either tourniquet to be useful & Life saving. It must be tight enough to stop bleeding.

As for treatment of blood volume loss/shock. I would lay the victim flat on their back & elevate their legs/feet at least 1 foot high. To keep their head & torso perfused with what is left of theirs bodies blood volume. IF... said victim is struggling to breath(due to blood & or fluid in their lungs). I would elevate their head & torso. Enough to ease their struggle to breath.

Edit to add; Any & all medical/trauma treatment views I share. Are mine alone. NOT what I suggest anyone else should ever do. I'm a retired paramedic. NOT a Doctor.
 
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CycleFishHunt

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As for treatment of blood volume loss/shock. I would lay the victim flat on their back & elevate their legs/feet at least 1 foot high.

I’m taking the NOLS WFA course this weekend and this came up toward the end of class today. The instructor said while this is an old and common belief, there is no medical evidence to support it.

There is also no evidence to say it is detrimental either.

His advice was to do it if it makes the patient more comfortable.
 
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1oldcoyote

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I’m taking the NOLS WFA course this weekend and this came up toward the end of class today. The instructor said while this is an old and common belief, there is no medical evidence to support it.

There is also no evidence to say it is detrimental either.

His advice was to do it if it makes the patient more comfortable.
I whole heartedly disagree. However, that is your instructors option to believe as they wish. I understand there are varied opinions referring to the "Trendelenburg" position for treating shock. Some say it helps, some disagree. I look at as helping to keep the brain perfused. Somewhat semilar to MAST trousers. Used by fighter pilots. To help maintain brain perfusion during G-force flight situations.
 
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1oldcoyote

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I whole heartedly disagree. However, that is your instructors option to believe as they wish. I understand there are varied opinions referring to the "Trendelenburg" position for treating shock. Some say it helps, some disagree. I look at as helping to keep the brain perfused. Somewhat semilar to MAST trousers. Used by fighter pilots. To help maintain brain perfusion during G-force flight situations. MAST Trousers are Military Anti-Shock Trousers. They are open velcro

I whole heartedly disagree. However, that is your instructors option to believe as they wish. I understand there are varied opinions referring to the "Trendelenburg" position for treating shock. Some say it helps, some disagree. I look at as helping to keep the brain perfused. Somewhat semilar to MAST trousers. Used by fighter pilots. To help maintain brain perfusion during G-force flight situations.
For those who do not know. M.A.S.T Trousers are Military Anti-Shock Trousers. Worn by fighter pilots. They are air operated pneumatic trousers. That inflate during G-force situations. To compress the lower extremities & abdomen. To assist in forcing lower extremity/abdomen blood volume. Up to the head & upper torso. To assist in maintaining consciousness vs blacking out.
 
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1oldcoyote

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City Fire Dept & County Ambulance Services I worked for. Both carried MAST Trousers as part of their EMS equipment. Mainly for the use of stabilizing pelvic /leg fractures & to assist in upper body blood volume perfusion. The only "con" that I'm aware of for the non-use of MAST Trousers. Would be for grossly broken angulated leg fractures. Those, I would "stabilize" in place. Versus try to align a broken long leg bone in the field. Paramedic manual my EMPT-P course utilized. Also shown the benefits/usage of MAST Trousers. That paramedic manual was formed/written by numerous medical/trauma Doctors. Not to mention advanced degree nurse(s) findings & or beliefs.

Myself personally, I'm not so easily swayed as per expert opinions/findings. However, when I can not or do not find proven expert disagreements. I tend to go with the flow on specific expertise on a given topic.
 

CycleFishHunt

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The instructor was not stating a belief or opinion. He was stating that medical researchers have not found evidence in the medical literature that elevating a patient’s leg can effectively be used to treat shock.

Here’s a short write up with additional references, if you’re curious.


And here’s the intro.

In World War I, Walter Cannon, an American physiologist, popularized the use of the Trendelenburg position as a treatment for shock. The Trendelenburg position involves the patient being placed with their head down and feet ele- vated. This position was promoted as a way to increase ve- nous return to the heart, increase cardiac output and im- prove vital organ perfusion. A decade later, Cannon reversed his opinion regarding the use of the Trendelen- burg position,1 but this did not deter its widespread use. The Trendelenburg position is still a pervasive treatment for shock despite numerous studies failing to show effec- tiveness.
 

1oldcoyote

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The instructor was not stating a belief or opinion. He was stating that medical researchers have not found evidence in the medical literature that elevating a patient’s leg can effectively be used to treat shock.

Here’s a short write up with additional references, if you’re curious.


And here’s the intro.
Yep I read that & some other pro & con opinions. I'm still convinced it helps with cerebral perfusion. As a side note; MAST Trousers work in relationship to cerebral perfusion/consciousness. Via depression of the body's lower arterial/venous system. Thus assisting in retaining consciousness. I view the Trendelenburg Position as assisting in doing the same. Perhaps not as helpful as MAST Trousers. But better than NOT doing anything. This perticular topic could be argued until the Sun doesn't shine? ;)
 
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