It’s interesting to see how differently first aid is taught across countries. Eg the last training I did in the US (California), I was surprised by two things that I had not encountered when I was trained in France:
- a big concern around pathogens - always have gloves with you and put them on when administering first aid especially if the person is bleeding; use a mouth dam for mouth to mouth and if you don’t have one don’t do mouth to mouth, just chest compressions, etc
- training first aid responders around what to do when a person needing medical attention tells them not to help because they don’t have health insurance (this point was repeated numerous times by the EMT training us, saying it was routine for them to have to deal with it)
Can you expand on your second point, if you have a moment?
I knew someone (in California) who crashed his bicycle on a curb in front of a number of people. He picked himself up and had a bloody but minor wound on his arm. But overall he was unharmed, just some surface bleeding.
"Of course" multiple people called 911, and an ambulance arrived in short order. He had insurance, but he wasn't interested in getting in an ambulance, he wanted to look after his bike while wrapping up his light wound, and then treating it later.
I'm told the exchange was awkward to say the least.
Interesting. I'm an American, and once sustained a bloody but minor scrape of my knee when playing basketball in China. I went to the campus clinic/dispensary to obtain some bandages, since I couldn't find any that were the right size at the nearby convenience store; there, the staff practically tried to admit me, telling me that I had sustained a very serious injury and that I needed to take it seriously and start a course of antibiotics. After an awkward conversation concerning my refusal to take antibiotics without (what I deemed to be) sufficient cause (being mindful and wary of the resistance risks of an unnecessary course), and their belief that I was being disrespectful of their medical expertise, I left with a bottle of antibiotic pills that I never took. My knee was as good as new in a week or so.
Point being, medical cultures can differ quite a lot, even from locality to locality, and the differences can be seen even in the handling of minor scrapes.
Correct me if I'm wrong: I think that a wound that is bleeding is a wound that's, at least in part, being protected from infection by 'internal positive pressure'.
My grandpa taught me that; to let wounds bleed freely for a while, if possible, to reduce the chance of infection.
The most surprising things I was taught when taking classes in Germany (which went beyond the mandatory classes you have to take to get a driver's license) are the following. Well, not really surprising once you think about it...
- Mouth-to-nose is usually better than mouth-to-mouth, at least when there is no obstructions (like bleeding, broken nose, snot, etc).
- If you're doing chest compressions, expect a high probability of breaking a few ribs. Don't stop, as it is highly unlikely the ribs will break "inwards" and puncture a lung, and a broken rib is still better than being dead.
- Remove all clothing from the chest area you're working during CPR. Yes, that includes bras, specifically. The reason being that any clothes will hurt your hands/rip your gloves (if you have some)/shave the skin off your hand especially when you have to do CPR for 15mins. Bras in particular often have wires etc in them that will hurt your hands even worse. As one of the EMTs training us put it: "Don't be shy, no time for false modesty, it may cost a life."
- Don't forget to breath when giving mouth-to-*. Also, don't forget to actually lift your head when you breath. Else you will just breath in the spent air again that you and the person you're helping just exhaled. Given that CPR is very physically taxing, according to the EMTs it is quite common for people giving the CPR to faint themselves if they breath incorrectly.
- It is more important to call for help than to do CPR. Always call first, if you're alone. And stay on the phone until you're being told you can get off the line. Apparently a lot of people either do not call, or call, scream some stuff into the phone, then hang up to administer help, often forgetting to tell crucial details like their location because it is such a high stress situation.
- Defibrillators do not actually restart hearts that stopped beating. They essentially stop the heart in order to reboot it in hopes it will restart with a proper pace/rhythm.
It's not usually taught, I think, because if you dony have a knife (which is what professional rescuers will use if they need to do this), removing clothes tends to add delay and also involve moving the subject, both of which are strongly contraindicated in most circumstances where a lay rescuers needs to use CPR in the first place.
The man has a pretty good explanation in that case, iff there was a good reason to administer CPR. So what would it cost the rescuer, exactly? Unless you start undressing every unconscious woman you encounter, even if they seem to have no other problems...
People have been sued for injuries caused while performing CPR, so I could certainly imagine someone being sued for undressing a person (without their consent, obviously) to perform CPR.
You can sue anyone for just about anything. But it doesn't seem like a very winnable case to me. Maybe in some crazy jurisdictions. Many places have 'good Samaritan' laws that protect people who are not medical professionals when they cause injuries during a good faith attempt to safe someone's life. I would assume injuries to someone's modesty are included...
At the end of the day, would you rather let a woman in need of CPR die because you are afraid of maybe getting sued, with an even smaller chance of a conviction?
There's also the court of public opinion to consider, in which actual legal standing is irrelevant. Small comfort if you successfully rebuff a suit but lose your reputation in the process.
In Germany not performing what we call "lebensrettende Sofortmaßnahmen" (stable side position, clearing airways, CPR) is (at least technically) criminally liable to § 323c StGB. I shall also point out that first responders have some legal protections and insurance.
Do you have a link for that? Every time I look into one of these/similar stories it is a shitty insurance company either heavily encouraging or basically forcing the suit if the person wants to be covered for their injuries at all.
This should not happen. Another rule is that you must not to put yourself on top of the victim or walk crossing over the body of other people. Is disrespectful and can be dangerous also. You have to sidestep it and approach from one of the sides.
I understand how social rules about touching other people can differ in different cultures, but a side position looks clearly different to a "riding" position to me in this sense.
People feel often ashamed, can feel humiliated, violated, happy, sad, or anything their want, but they have to understand that CPR means that 1) you life is at risk and 2) some stranger(s) will put their mouth in yours and their hands near your breasts for some time. Period of time that can last for many minutes or even hours. Often longer than the duration of most violations. There is often a legal obligation to do it for some people. To pass and quit the area is not an option.
Sorry but there is no time to find a young sexually acceptable partner for you to happily wake up in her/his arms and upload your booze adventure to instagram, forever-happy style. Deal with it. There is nothing sexually arousing in the experience for the rescuers about your vomit taste or about your body leaking different kinds of fluids over yourself. Not even remotely.
If the person is able to tell you that they have no insurance, this by itself means they're able to talk reasonably, this means they are conscious and can breathe and so (absent heavy ongoing bleeding e.g. from a gunshot wound) they aren't dying right now - so urgent emergency healthcare isn't really required.
If they can move on their own, then they can get to the clinic of their choice themselves if and when they choose to; if they can't (which can be caused by anything from a sprained ankle to a fractured hip) then they still may prefer to be delivered to the hospital by family&friends or a taxi instead of paying thousands for an ambulance delivery.
good point about using that as an assessment of the persons state of being. they still could be bleeding however which needs to be stopped unless it's just surface scratches, or have broken bones that need temporary stabilizing.
it seems other than for the first point the question only becomes relevant after any relevant first-aid actions are completed.
i have been in a situation where a guy fell out of his wheelchair. he wasn't injured, he just could not get back into his wheelchair and he was to heavy for any of us to help him without us risking to drop him in the process which might have then actually risked an injury. he looked like the kind of person who might not have had insurance. though he didn't make any statement about that and no-one even considered that to be an issue. we saw no choice but to call 911, which sent an ambulance with people who could help (and they knew him too).
i wonder now how we would have reacted if he had told us that he has no insurance. we might have been looking for alternative help with an outcome that could have been good or bad.
with that in mind i'd think other than for the reasons you mentioned the statement should be ignored.
- a big concern around pathogens - always have gloves with you and put them on when administering first aid especially if the person is bleeding; use a mouth dam for mouth to mouth and if you don’t have one don’t do mouth to mouth, just chest compressions, etc
- training first aid responders around what to do when a person needing medical attention tells them not to help because they don’t have health insurance (this point was repeated numerous times by the EMT training us, saying it was routine for them to have to deal with it)