Accident to Disaster in 6 simple steps!

How to  muck it up

1 Have a flat battery on your phone, or no network service
2 Fail to call the ambulance or be slow/late calling them
3  Don't get any one to help, just struggle on, on your own while your colleagues watch
4  Stand and watch your friends broken arm slowly bend, whilst he struggles to breath
5  Can't concentrate or hear because people are still sawing close by
6  Have people standing around not doing anything, while everyone gets cold

Disastrous first aid or first aid for disasters  - where are you?

We are atrocious at communication –
There are more studies then we can shake a stick to say how poor we are at calling for help. The Ambulance services spend a huge amount of time and effort trying to dissuade us from using them. When it comes to an emergency, people hesitate to dial 999/112. The majority of simple first aid incidents we will sort out without complication. However, the boundary between simple and cockup is vanishingly small!

Have effective communication system –

Make sure when you leave for work your phone is fully charged, have you got a network where you are working. That is less important for the initial 112 call as your phone can cross network dial, however you will not be able to get a call back from them, I have an old phone will a payg EE sim in it for the odd time when I need to speak to WMAS and I have no network. 

Call the ambulance service/fire & rescue early.
If you panic and call them early, then later discover that you have overreacted, ring them back and stand them down! Not a problem, someone bleeding and you not stopping it is a very big problem! If the situation changes, ring them back and tell them.

Get colleagues to help early,
Get all your team involved. There is plenty to do. Someone to meet the ambulance, keeping the patient warm, sorting out evacuation etc.

We become fixated on one issue –

We are often overwhelmed by the situation and obsess over one thing.
People see blood and panic, or see a broken arm and panic. We see the first part and then stop looking, we frequently see this people in all walks of life, we miss obvious things (including doctors) because we are overwhelmed by the circumstances. If we have been injured in one place on our bodies, why not anywhere else. Have a damn good look.

We are overwhelmed by noise/alarms/people.
Turn the saws off!!!!! Noise is extremely distracting. I frequently go into peoples house and they still have their telly on, someone is dying, but the telly is still on! I turn it off.

Step back – check situation, is everthing happening that should be? If you are team leader, have you got it all going? someone on the phone, one or more doing first aid, access/egress, meeting the ambulance, keeping warm etc.

Delegate someone to be situationally aware. Last week I was dealing with a collapsed lady in the street. A bus touched my arm, I had not heard or seen it, scared me! I moved my car to close off the carriageway. The motorway is extremely dangerous, a number of people are killed every year just stepping onto the live carriageway. Trees and chainsaws will be the same, in the accident situation.

Distribute workload-

Crew resourse management, one person one job 

Each crew member carries out their specific role, tree surgeons are expert at this. Apply it to the emergency situation. We loose many of the above skills when overloaded with functions, therefore, one person needs to take overall charge and delegate, this avoids many of the above faults by checking that functions are being done. Move people around to stop them becoming tired.

You should have learned all about this on your first aid training course, I teach it on all of mine. We can be contacted at www.axiomtraining.com there are links there to other blogs, facebook etc.

Communication is vital – to the patient, to the team, to ambulance control!

By Martin Bennett
Director, Axiom Training Ltd

The Anatomy of a Disaster part 1

The anatomy of a disaster.

First Aid Training for disasters

Shit happens, (Forrest Gump), and when it does, the actions that the people involved take, significantly affect the outcome of the event. Generally we think of disasters as affecting lots of people. Many people dead and injured. On a personal basis, you falling from a height, breaking your leg and consequently not being able to pay your mortgage is a disaster!

This is about how quality first aid training and the applied skills alters the outcome of an accident

The points below are about what makes a bad situation worse, the mistakes that we make when faced with a very challenging situation. A lot of what is here comes from a short film about the Costa Concordia disaster-

http://lifeinthefastlane.com/crisis-crewmanship-crm/

http://vimeo.com/85691977

People become disoriented in their environment – map references

The captain had turned off the autopilot, and thus did not know where they were!

You plan your days work, the address of where you are working. what about your journey to and from work? The "Devon Air Ambulance Trust App" locates us within a few seconds with a six figure map reference, plots where you are and has a box to dial 999/112 straight off! It works on all smart phones.

Plan for access and egress. How does the ambulance get to you, off the road. If you are a long way off the road, does Ambulance control need to send Helimed? only you can tell them!

Know where your equipment is - first aid kit etc. its no good in the front of the van, half a mile away!

Know where your colleagues/help are!

We fail to anticipate or plan –

The training and planning that the crew of the Costa Concordia was atrocious, they failed to train their staff in most of the procedures necessary, as well as failing to tell the passengers how to evacuate. Afterall its never going to sink is it!

First aid training:- a lot of the training we receive is not fit for purpose (some is, I hasten to point out). It is up to you, the purchaser to exercise "due diligence" when organising your first aid courses. Choose companies that are experienced with Tree Surgeons and understand your needs.

Rehersal of incidents, one afternoon, when everyone is tired and wants to go home, imagine how you would all respond to severe burns after a saw catches fire whilst filling it up!

Have you got your burn gel dressings do you know how to use them!

“Failing to plan is planning to fail”

First aid training, understanding how thinking around and planning for a situation going pear shaped makes a huge difference to the outcome!

The next part of this disaster blog, will be next week.

I welcome any comments about this and everything else I write. Please comment about this post, or give me ideas about new subject areas to write about!

For dates and more information about our courses look at www.axiomtraining.com or our google+ page. There is a link from the main website www.axiomtraining.com or directly at axiomtraining112

By Martin Bennett

Director Axiom Training Ltd

Mountain or remote first Aid Part 1

Mountain First Aid or remote/wilderness first aid.


Mountain first aid, first aid in the remote areas and wilderness places of the world present us with an interesting and demanding challenge. Help is often a long way away and the reason we are in the wilderness is do interesting and challenging activities. We like rock climbing, caving, kayaking, mountain walking and the like. I have enjoyed these activities since I was 9 years old

On Tryfan looking down towards Llyn Ogwen

The mountain first aid course must meet all of these challenges. If one is a member of a mountain rescue team, you will spend half your waking life learning about first aid for the wilderness. That afterall will be your area of operation. I found very early on in my career, that the people involved in mountain rescue had hearts of gold and legs of steel, but were often misled by out of date ideas and dogma when it came to patient care. Interestingly this was easy to change, because of the nature of the people themselves, open to new ideas and quality training.
It is a different matter in the wide world of wilderness and remote first aid training. Some of the very old ideas are very firmly embedded. The idea of not removing the boot, i do not know where it came from, but its a problem

This is actually a RTC victim, note that he has trench foot as well:-

Can you imagine trying to treat this, or even work out what is wrong without removing the boot. The risk of the patient loosing their foot would be enormous!

I believe that a good quality patient head to toe and a structured history will elicit most of what is wrong, with your patient. This must be done, as the injury above would be terribly painful and give significant masking pain.

If you don't look, you wont find!

There is an almost an infinite amount to write about this subject, more to follow
By Martin Bennett

This is my very first blog.
I have chosen to write about Tree Surgeons or Arborists and Utility Arb. Tree Surgeon and Arborist are largely the same person, except maybe the arborist has done a bit more theoretical training. Utility Arb is the arm of tree surgery that deals with the Utlities, such as electricity cables and so forth.

As far as I can ascertain the practitioner is only required to hold an Emergency First Aid at Work Certificate, although, some have the three day First Aid at Work qualification. Three days training would seem eminently more sensible for people who are working in quite a high risk industry, which is quite unique - the point of me writing!
It would seem that enormous numbers of tree surgeon/arborists attend standard first aid courses that do not, and perhaps cannot cater for such a specialist industry. The people who I have spoken to about this complain that the training they receive is not relevant to their industry! It is their most serious complaint. The other complaints often levied, are poor quality training, or just plain boring, and out of date techniques.

I am a professional first aid trainer, I have BSc honours in PreHospital Care, plus a bunch of other stuff, First Responder for WMAS etc. I believe that anyone who comes on one of my courses must get training that is pertinent to their working environment. To this end I have detailed the subject matter that I think should be covered on an arborists first aid course.

The obvious things are head injuries, bleeding, allergies/asthma/fitting and so forth, a bit of CPR. I say a bit because resuscitation secondary to trauma is one of the greater challenges of the medical world! I think its essential to include life threatening haemorrhage, and the CABC protocol. the use of pressure bandages, packing and finally tourniquets. A brief understanding of suspension trauma is a good idea too! Disaster management together with situational awareness and CRM training would be life critical. As will electric shock treatment.
Other subjects will be "thorn strike" and general splinter removal, eye irrigation, bit on burns etc.

If anyone ever reads this, please add subjects to be covered, correct anything I have got wrong, its my very first blog!

Martin