Wednesday, 25 June 2008

Two Day Equine Specific First Aid Course - ESFAC

My last two days were spent on doing cardiopulmonary resuscitation (hard work this one!!!), putting casualties of various accidents and with variety of horrific injuries in recovery positions (or half-recovery positions if pelvis was broken), decreasing blood loss when dealing with minor and major bleeds, dealing with dehydration, hypothermia, using Epi-pen on Anaphylaxis casualties, splinting broken limbs, wrapping protruding intestines in a cling film (to stop them from drying out and dying in the process!), dealing with burns and electric shocks, assessing head and spinal injuries, recognising Angina and Myocardial Infarction (or Heart Attack for short!), performing abdominal thrust and back blows, coping with an unconscious casualty with suspected spinal injuries fallen off on a cross-country course into a ditch, helping patients with hyperventilation to regain normal breathing and many many more.
All this thanks to fantastic team of First Aid trainers at Pro Medical. It was an intensive course starting at 9am and running until 5.30pm on the first day, homework, then second day again 9am to 5.45pm.

Thankfully...everything was in theory only and using these fellows:

The content of the ESFAC course as delivered over the last two days can be found on here:

I found it very useful, run with a sense of humour yet seriously in the same time. I learnt loads and feel much more comfortable to deal with riding accidents, no matter how freaky they may be. I would definitely recommend attending an ESFAC course and Jon Coe at Pro Medical certainly made the tough subject of saving lives very approachable.

It was a tiring First Aid marathon. After arriving home at 9.30pm I spent a couple of hours writing down my First Aid homework - answers to questions on 5 accident scenarios - then 6.30am start to the day the next morning, back into classroom, whole day lecturing and practising again, then final multiple choice test.

Now I just have to wait for my SAE to return to me and check whether I passed and am a qualified First Aider :)

Random Facts You Won't Find in the Downloads and Which I Noted Down (well, I made more notes but I though I might as well share some:):
  • As an Instructor you take 80% responsibility for what happens to your pupil;
  • "Have you seen what those Eventers do? They break collar bones, whole arm strapped to the torso and what do they do? They DRIVE their HGV lorries...good idea eh? NO! You wouldn't be admitted to do your driving licence with broken bones, would you?"
  • "First Aid kit in a yard's office isn't of much use if you have a rider needing it 6 miles away on the cross country course. Yards need to have First Aid kits available at various locations".
  • 3 minutes without breathing and your brain starts to die.
  • On Using First Aid Manikins: Clicker device gives audible confirmation of adequate compression depth - do not expect your real casualty to click; if the ydo, you most likely broke their ribs.
  • Don't take Bute yourself (yes, some people do!) - it's been banned for human use. It's an equine any other equine drugs/medicines/creams etc
  • Chocolate is an official drug. Swiss Olympic Dressage Team lost their silver medal because one of the riders gave her horse a half of a Mars bar as a treat. DO NOT FEED chocolate to horses.
  • Average speed of a falling rider is 60 miles/hour hence riding hats with British Standards Kitemark are tested to save lives during falls up to that speed. It does not matter how expensive your hat is. If it has BSI Kitemark it will be of the same safety standard whether it costs £50 or £150. Materials might be different of course.
  • "If you see someone with an intestine hanging out don't run and poke it back, don't cover it with clothing! Use cling film and wrap it up to keep it moist. Call 999."
  • DO NOT ALLOW CHILDREN to eat while wearing a body protector. It is designed to disperse and absorb energy. If a child starts choking all the back blows you do will be useless - in other words it is impossible to deliver an effective First Aid to a choking patient wearing a Body Protector.
  • "Rugby shirts were designed for Rugby - not to be worn over Body Protectors; they don't tear, are very hard wearing and you can only take them off over the head. Not the greatest qualities when you want to get through to the injured area on a patient with suspected spinal injuries (most common on a cross country course). Someone needs to design safe XC wear which unzips at the front."
  • "Do not collect someone's blood loss by sticking your hands under casualty's injured area - when treating open cuts/heavily bleeding wounds - why on earth would you do that??? - seen on a video).
  • Best ways to cool down babies and small children is to make them wear socks and gloves - the heat is then created in extremities while organs are being cooled down. babies CANNOT regulate their own temperature. They don't sweat and don't shiver.
  • "Head of a person in Anaphylactic shock can swell until it reaches the width of the shoulders; eyes bulge out, the neck swells enormously".
  • DO NOT put anything in the mouth of a person having epileptic spasms. Never.
  • Recycle your old rugs - cut the buckles off, wash the rugs well and store them near arenas in case you need to insulate a fallen rider or transport them away from danger without unnecessary movement.
  • Do one puff at a time when using Asthma inhalers - you are not helping yourself by taking two quickly at the same time - exactly opposite!
  • Use a paper bag for victims of Hyperventilation.
  • Sugar eats away your tissues.
  • Many accidents could be avoided if riders maintained their sugar levels by avoiding chocolate bars and sweet carbonated drinks (like Coke). Sugar imbalances affect co-ordination an reflex.
  • Sparkling water re hydrates you faster due to CO2 content.
  • "Avoid going to competitions on your own - if you do there is nobody there to confirm what are "normal" readings for you like let's say speech or facial expressions; you may have a wonky smile but a First Aider will treat you as a casualty with partial facial paralysis....Seriously though, have someone with you! "
  • Landing on your feet - NOT SO GOOD! Great danger of back injuries especially in lumbar area.
  • Head injuries can manifest themselves up to 28 days after the initial trauma.
  • Head Injury - ask Short-Term Memory questions only!! Best question: "So what happened there?". Concussed patients often loose STM but have perfectly functionable Long Term Memory (LTM).
  • Bruising behind the ears and on the nape of the neck comes up instantly when the skull is fractured.
  • More riders should wear Gum Shields - they are there to minimise the impact.
  • Pelvic fracture - if aorta breaks (which is very likely in these fractures) all the blood is emptied into pelvis area in just below 1 minute causing death very quickly.
  • Femur Fracture - extremely dangerous, don't try to weight bear as you may end up with your knee up your hip bone!
  • Pneumothorax casualties - "the faster they breathe the faster they die" - regulate their breathing!
  • Don't try to apply butter on burns - useless. Put under cold running water.
And on a More Serious Note:

CPR Audio File
CPR For Babies Audio File
Breathing But Unconscious Audio File
Dealing With Burns Audio File
Wounds and Bleeding

All downloads from:


Argument Winning Award:

ESFAC student: "Should we not write down that we need to treat this case as 'this and that' [when discussing the assessment of a casualty in one of our homework's scenarios].
Jon Coe, The First Aid Trainer (after heated discussion): "Of course you can write it like that. It's your own opinion. You are entitled to your own opinion. I am only telling you the truth"...

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