Author Topic: Burns knowledge, 90% of people dont know how to treat burns properly  (Read 13638 times)

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Offline OzJeeper

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #25 on: October 19, 2011, 09:43:40 PM »
For those who are concerned about the legal side of offering first aid assistance (trained or untrained), google up the "Wrongs Act 1958" it's all there for you to read.
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Offline Boesman

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #26 on: October 19, 2011, 09:59:54 PM »
Sorry, I could not resist.

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Offline DeLuxHiLux

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #27 on: October 19, 2011, 10:09:48 PM »
Quote
For those who are concerned about the legal side of offering first aid assistance (trained or untrained), google up the "Wrongs Act 1958" it's all there for you to read.
You can't be sued......
 

Provided you dont do anything you aren't trained or have experience in doing..... Example: i'm sure most people here over the age of 40 have seen an episode or 2 of M*A*S*H. The example of using the Bic Biro to make an emergency Airway by cutting into the persons throat WILL land you in the soft gooey brown stuff if it goes Pear shaped and you are not trained in that skill. thats fairly simple.

By helping someone, within the scope of your knowledge and experience or what would be expected of a "reasonable person" to do, then you're all good. if however, someone specifically asks you not to do something, or withdraws their consent for you to assist them (that could be withdrawing their arm as you try to do something) and you continue to force your "help" onto that person, then the protection afforded you under various State Good Samaritan legislation and the Wrongs Act evaporate. Another First Aid trainer wrote once that First Aid is 10% knowledge, 90% Common Sense. Heed that and you cant go wrong...........
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Offline Patr80l

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #28 on: October 19, 2011, 11:37:28 PM »
I would be hesitant to put any goo on broken skin, including a burn.   Aloe Vera is unlikely to be sterile and egg protein (albumin I think, not collagen which is in connective tissue) will be an extra source of nourishment for infection.
Remember that we are talking about first aid here, which means that, unless we are in a remote area, our treatment only needs to get the patient through the first hour or so.   Cool it down to minimise the thermal damage and cover it up to minimise the chance of infection.   
As far as Glad Wrap is concerned, I don't see a problem with circumferential wrapping (around and around) rather than longitudinal.   There is not going to be much swelling in that first hour and you can monitor for that.   You don't need to apply it tightly and if you only use one or two layers it will stretch.   It is so much easier to apply circumferentially and part of first aid is being able to act quickly and look like you know what you're doing.
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Offline Mace

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #29 on: October 20, 2011, 08:38:07 AM »
Yeah, but hang on - if the patient doesnt want an Ambulance, and was in a fit state to refuse said ambulance, how does the business owner get in the poo for that?? Perhaps he was fined for failing to keep a safe workplace (either due to the lack of  forklift movement/pedestrian seperation or failing to have an appropriately trained first aider), but in the end, a person can decline an ambulance, and unless you think the person is unfit to refuse (confused, disoriented, severity of injury, effected by substances etc), all you are doing is wasting the Ambo's time if the person is just going to tell them to bugger off when they arrive!!! If the patient is making it plain they dont want an ambulance, there isn't much the ambos can do when they get there!! NOR can the business owner bundle the worker into their car and force them to go to a doctor or hospital, and force them to seek medical attention. Whilst it's sad the person in question died, but one of the benefits of being a human being is that you have the right to make decisions for yourself, and if someone relieves you of this right, that someone can be charged with assault and/or false imprisionment. Very extreme, but legally factual. You can offer, encourage, persuade and cojole, but you cant force, someone to seek medical attention.



See:  http://www1.worksafe.vic.gov.au/vwa/vwa097-002.nsf/content/LSID164706-1



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Offline Patr80l

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #30 on: October 20, 2011, 10:18:15 AM »
In Victoria, The Mental Health Act allows you to detain someone who is suffering from "a mental condition" which is not defined, and convey them to hospital for further assessment.   You will usually involve the police with this.   The Crimes Act allows you to make a citizens arrest if you witness an inditable offense.   You will always involve the police with this.
Apart from that, you dont have a power of arrest but will generally be OK if you act in good faith with the patient's interests at heart and act within your abilities or as a "reasonable person", and only limit their liberty to the minimum amount, if the patient is not capable of self care (eg drunk). .... but you might be judged later by others.

Also, you won't be criticised if you look after your own safety first.   Don't put yourself at risk if they're aggro or violent.
« Last Edit: October 20, 2011, 10:22:06 AM by Patr80l »
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Offline Mace

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #31 on: October 20, 2011, 10:36:08 AM »
It would be good if there was a decent summary of all the legislation available.

I would like to know how the "good samaritans" legislation ties in with other (say workplace health & safety) legislation in regard to provision of Workplace first Aid.

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Offline Patr80l

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #32 on: October 20, 2011, 10:51:56 AM »
I may be wrong but I think Good Sammaritan law is Common Law (ie made by judges as the cases evolve over time) rather than Statute Law which comes from Acts of Parliament.
Have a look at http://www.austlii.edu.au/ to access both.
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Offline Mace

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #33 on: October 20, 2011, 01:38:54 PM »
Found this outline of the "Good Samaritans Act" from Vic Sport.

Not quite shure how/if it applies to paid First Aiders in the Workplace, but a good starting point.

http://www.vicsport.asn.au/Assets/Files/VicSport%20Guide%20-%20The%20Good%20Samaritan%20Act%20(protecting%20Volunteers).pdf

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Offline Patr80l

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #34 on: October 20, 2011, 01:45:29 PM »
It's true.......I may be wrong.
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Offline Mace

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #35 on: October 20, 2011, 01:53:23 PM »
Nah, youre right, it arises from tort law.

If you want a real headache:

http://www.ofaat.com.au/Images/documents/good_samaritans_volunteers.pdf

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Offline Patr80l

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #36 on: October 20, 2011, 01:57:58 PM »
great reference
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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #37 on: October 20, 2011, 02:00:31 PM »
Now just need a ONE PAGE summary.
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Offline GLC

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #38 on: October 20, 2011, 02:14:56 PM »
could be 2002 but I thought it was later than that, oh well I dont study law I study OH&S and First Aid.

it is true that first aid is a stop gap, the role of a first aider is to ensure that the person is treated with respect whilst in the care of the first aider, it is also correct that the person being treated has the right to refuse treatment, where that person is unable to give the consent to being treated then they are assumed to have consented.  
What annoys me is this belief that first aiders are not trained to support a person past the initial treatment.  A good first aider can support and will support a person until other personnel are prepared to take over the legal care of the casualty.  If I was conducting first aid and a Doctor arrived on the scene and told me to move over as they are a doctor, I would not do so, they would support me until an Ambo arrived and asked to take over.  If the doctor was carrying a fully outfitted kit and was prepared to take over the legal ramifications of their actions out on the street then I would certainly be happy to move aside.  One person CLAIMS to be something the other situation the person has every aspect of being what they claim, in court I know with the second situation that the person claiming to be a Doctor can be shown by me to have represented being a doctor, in the first I cant.  Apart from that I probably know more about first aid than the Doctor does.  He is a practiconer of medicine, without his kit he can only do the same as myself.
I also want to point out that although first aid training has degenerated into something that very few seem capable of doing, it still is a skill that when taught properly trains the individual to be capable of offering very good field support to give the best possible opportunity of life being maintained.  Too often we hear instructors talk about all you need to do is do your best until an ambulance arrives, if that was true then you wouldnt need the course to begin with, the course is about teaching you to have the skills necessary to assess and manage the casualty until support arrives.

now as for the person suggesting cooking an egg on the persons arm, might I suggest that if you learnt that at a first aid course dont go back, if you didnt learn that at a first aid course then please dont teach it here as anyone practising that method is likely to be sued if something goes wrong.
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Offline Matto

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #39 on: October 20, 2011, 02:17:51 PM »
Question for the medics, if I may.

When you say "Cool the area, but don't overcool" - can you elaborate?

Example provided:
Couple of years ago we were camped out at Cobbold Gorge, 7hrs drive west of Cairns. Stupidly, I burnt my hand quite bad as we were packing up and I was putting out the camp fire. I figured it was pretty bad pretty quickly  ;D. We had one of those "instant ice packs" in the first aid, but soon discovered it was worse than useless. BurnAid worked as you were putting it on, but not for much long after that.

So we rigged up an evap cooling system using a towel draped over the hand, the 20L water cooler between my legs, and the AC vent in the car. None of said stuff sterilised. The hand stung like #$^ all the way back to Cairns (J drove the whole way, thankfully), even with big painkillers. Every half hour I had to pull my hand out for a few minutes because it was turning blue. As the cold wore off the pain came back, so it went back under the wet towel. Stayed like that for the entire trip back, and it was only right towards the end of the trip that I was able to take my hand from under the cold without the pain being unbearable.

The hand healed really well - very minor blistering and pain over the next week, and now well and truly back to 100%. I've got a couple of Aloe plants at home for just such an occasion, so kept the hand soaking in that goop for a few days. Truth be told, it healed a lot quicker and a lot better than I was expecting, with very little pain.

I'm guessing that the "turning blue" bit probably qualifies it as being overcooled. And reading about the other stuff, I'm starting to think I could have handled things better.

So my questions for next time (people who know me, know that there will be a next time regardless of how careful I am) are:
* Did I potentially do more damage by doing this,
* What should I do different next time, and,
* I should really have gone to see my Dr once I got back to town, I'm guessing? That same day, or the next day?

Obviously what's done is done, but I'd like to find out for future.

Thanks!
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Offline GLC

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #40 on: October 20, 2011, 02:20:06 PM »
legislation covering first aid is best summed up here: http://www.lawhandbook.org.au/handbook/ch18s01s04.php#
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Offline DeLuxHiLux

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #41 on: October 20, 2011, 02:27:22 PM »
Patr8ol: the Good Samaritan act is Civil law, and as you say, is influenced by precedence etc.

http://www.austlii.edu.au/au/legis/vic/consol_act/wa1958111/s31b.html

This is of course Victorian Law.

Essentially, you can do reasonable things in a  

Quote
The Wrongs Act 1958 (Vic) ("Wrongs Act") is the main legislation in Victoria governing claims for damages for personal injury (or resulting death) in Victoria, particularly in cases not involving transport accidents or work injuries.
"The Law Handbook", Fitzroy Legal Service, 2011, http://www.lawhandbook.org.au/handbook/ch18s01s04.php

and Doc, I'm with you on the gooey stuff on burns. I was always taught "Dont place goo on burns", with all sorts of "remedies" from butter to oils etc going around, i'd reckon the safest remote location treatment bet is Glad Wrap, cooling and transport to a Hospital that can deal with the situation. Upper Cumbuckta West bush nursing hospital is probably NOT that place (sorry if such a place exists..... making a point, not personally slandering anyone ;) ). Thats why the RFDS exist!!!!!

amaso57: I just read the summary of the finding by the Magistrate in the case of  VWA Vs Pressfast Industries Pty Ltd as sited. Pressfast  were charged with failing to maintain a safe workplace because they failed to keep proper seperation between forklifts and peds and not have a first aid plan (ie no currently trained first aider). the deceased was offered/encouraged to seek medical attention by staff and on lookers and declined on several occasions, although not by a first aider (not sure why  first aider would have changed the pts decision though?? ). He is quite within his rights to do so if he chooses, depsite others not thinking it smart to do so. As Patr8ol said, if he isn't a mental pt an ambulance crew can not detain him for the purposes of receiving treatment. Police will not detain a person under Sec 10 of the mental health act (Vic) on the grounds that they require medical attention and are refusing. This is not seen to fit the criteria of "a mental condition" in and of itself, although may manifest with other acute psychiatric symptoms. It is a legal right, that of Autonomy (the right to decide for one's self), and is enshirned in the Human Rights acts and charters and is a fundamental tennant of Medical practice. It is also taught in First Aid courses.

It would seem that the director of the company, in following up with the worker, and then when he  observed a deterioration in his condition made arrangments for him to be seen by a Doctor. Seeking medical attention for him was diligent, and there is no critisism (although IMHO this was inadequate, as a local GP would not have been equipped to deal with the potential injuries (no xray or CT/MRI etc), and a trained First Aider may have realised this and instead called an ambulance which could have conveyed him directly to an Emergency Department rather than to the GP, who would have then called the ambulance, thus adding in more time to the equation, which this man clearly did not have anyway

The Magistrate may have found that a "reasonable person" would consider making an appointment with a Doctor as seeking  a higher level of care than that of a Paramedic. However it does not states WHEN that appointment was made for. Was it in an hour? 2 hours? The next day? All of which would have been too late for the deceased. As the Magistrates Court does not publish Court Transcipts we cant find out.  



Quote
“This incident really brings home the importance of workplaces having a trained first aider on site at all times,” Mr Martin said.


Without accessing the entire finding it is hard to know, but it appears they did not even attempt to utilise the services of the first aider who's certificate was 20+yrs out of date.

Quote
“The only staff member with first aid training was certified in 1984, and wasn’t alerted until it was too late,”WorkSafe Victoria’s Strategic Programs Director Trevor Martin said.

In handing down his sentence, Magistrate Andrew Capell referred to the company’s decision not to seek help from the first aider, despite the expired certificate, as ‘outrageous’

“This incident really brings home the importance of workplaces having a trained first aider on site at all times,” Mr Martin said.


Hindsight always provides 20/20 vision. Its also easy to say now "oh they shuld have called an Ambulance straight away", however, depending on how the man presented, he may have still refused transport, and the Business would still have been prosectuted for failing to seperate forklifts and pedestrians anyway, and quite possibly for the failure to have a first aid plan (ie no trained first aiders). I"m pretty sure "just call 000" doesnt qualify as a valid first aid plan. A component of a plan? Yes. The whole plan? No. thats a whole other story...... but we digress......
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Offline GLC

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #42 on: October 20, 2011, 02:33:52 PM »
the fun of giving advice when your not there:)  This is not constituting advice on that situation or any other situation specifically mentioned (hope that gets me out of the crap with the lawyers;))

I think you had the right idea, what I would do if I was in a case where I had a serious burn to the hand is cool with water, keep irrigated as best as  possible allowing for the circumstances of the surroundings.  I think if I had a 20 litre Jerry can and a towel I would keep the towel cool through the use of an air conditioner or similar whilst keeping the towel wet.  Would I have bothered with glad wrap, yes I probably would have tried to keep the area sterile in case of infection (keep in mind water out of the tap isnt sterile either) but keeping it cool, then taking it out of the coolness on a regular basis until I reached hospital would have been my treatment.  I cant suggest he aloe vera plant but I do have aloe vera for my use at home.
I dont believe going by the speed at which it healed you did any damage, I would be happy with a quick healing like that.  What else could have been done. go to the doctor, they do know what they are doing despite us blokes having serious doubts about them sometimes especially when you get over 40;) any burn to the hand larger than a 20 cent piece should be checked out properly.
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Offline Patr80l

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #43 on: October 20, 2011, 02:37:12 PM »
Patr8ol: the Good Samaritan act is Civil law, and as you say, is influenced by precedence etc.


The civil/criminal law distinction is different to the common/statute distinction. Some Acts contain both civil and criminal bits (eg the Commonwealth Companies Act)
« Last Edit: October 20, 2011, 03:00:19 PM by Patr80l »
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Offline DeLuxHiLux

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #44 on: October 20, 2011, 02:41:25 PM »
Matto, the cool but dont over cool is more aimd at not cooling the whole pt so much they become hypothermic. Its hard to say if you did more harm than good, but if you had intact skin, probably not too much, but if you had actual burnt skin or popped blisters it could provide an anvenue for infection, which is one of the number 1 complications in burns, especially "minor" burns (ie not being put on a breathing machine type burns).

The pain is OFTEN a byproduct of nerves that are not normally exposed to hte air, being on cantact with the air. This is where the GLad WRap comes into its own. It provides a sterile (after you roll of a meter or so anyway)barrier that stops the raw nerve endings being in contact with the skin. It does not stick to skin so is fairly easy to remove later, and you can run cool water over it to assist with cooling. The idea of cooling is to stop any further damage from the skin cooking itself. So after 20-30 mins (20 is precibed in 1st aid texts) you are probalby ok. After that it may provide some relief from pain by cooling the area and contricting some blood vessels and reducing swelling. I would not apply an ice pack per se to a burn. The BurnAid Gel will provide short term relief for MINOR burns like sunburn etc where the skin is intact, and really isnt ideal where the skin had been compromised.

AFTER the skin has begun the heal, lotions like Vit E and aloe can apparently assist in improving skin elasticity, but the aftermath isnt my specialty.

I would seek a Dr if you had a burn that had broken skin if it was largeer than a 50c piece due to hte risk on infection, anything more significant than that is probably a hosptial job. Anything with redness and maybe an intact blister that size can usually be managed at home., If in doubt see your Doc! Any burn that invovles the entire circumfrence of a limb or digit should be seen at a hospital, preferably one that specilises in burns, but the local will refer you on if you need it, as this type of injury can have significant complications long term if not dealt with properly early on.
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Offline DeLuxHiLux

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #45 on: October 20, 2011, 02:43:30 PM »
Patr8ol: the Good Samaritan act is Civil law, and as you say, is influenced by precedence etc.
The civil/criminal law distinction is different to the common/statute distinction. Some Acts contain both civil and criminal bits (eg the Commonwealth Companies Act)


Yep. Silly me!!  :-[ Maybe thats why i';m not a Lawyer ;)
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Offline Mace

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #46 on: October 20, 2011, 02:56:32 PM »
Common Sense: So Rare, it's a SuperPower

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Offline Patr80l

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #47 on: October 20, 2011, 03:01:27 PM »
I love all this legal stuff but I fear we have gone a little off topic!
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Offline Matto

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Re: Burns knowledge, 90% of people dont know how to treat burns properly
« Reply #48 on: October 20, 2011, 04:34:38 PM »
Thanks for the feedback guys - it's great to be able to pick the brains of the many and varied experts we have around here!

If I can pick up one piece of info a day on some topic, I'll be better off  ;D.

Again, thanks!
Matto :)
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