It’s been three years since I joined St John Ambulance, so this week I was dispatched to the wilds of North London on my day off for a refresher first aid course. People imagine that as a Johnny you are treating casualties all the time, but it’s not actually like that. A lot of it is standing around in the rain watching rubbish football teams waiting for something to happen, and when something does happen, all the Johnnies swoop like vultures on the poor patient and fight over who he is going to treat him or her. It can get very silly. Anyway, as a result our first aid gets a bit rusty and we have to requalify every three years to prove we still know what we are doing. The course is called First Aid at Work and as the name suggests, it is intended for people who are the appointed first aider in their workplace. I was the only one on the course doing it for another reason.

The St John first aid course was largely very good. Our instructor was very knowledgeable and my sling making improved immeasurably during the course. There was one thing about the course that was absolutely terrible, though, and that was the instructions about calling for ambulances. My initial first aid qualification was done before I got the job with the LAS, so I didn’t pick up on this before. It seems to me that St John and the ambulance service have never, ever got together and talked about this.

Things I didn’t like:

* There was no discussion whatsoever of when you should call an ambulance, and sending a bystander to call an ambulance was part of every scenario, even nosebleeds and cut hands! The trainer did explain that she wanted to get everyone into the habit of sending for help at the correct point (after you know what the problem is, and she did make a point of getting us to tell the bystander why we needed an ambulance, which is something) so I might just let her off this one.

* The trainer told us that you would never have to wait more than 15 minutes for an ambulance! I almost fell off my chair laughing and felt at this point I had to butt in. The trainer also did not know that 999 calls were prioritised or that we could respond with a call back from Telephone Advice for green calls – she had thought that the differing response times depended on the area you lived in.

* In every scenario, a bystander was sent away to call an ambulance. You should never send someone away to call an ambulance unless it’s absolutely necessary (you have no phone, or you need to find a landline to call from because you don’t know where you are and you need the call to be traceable). All the scenarios happened in the workplace, where the bystander would almost certainly have been able to ring whilst standing next to the patient.

* The bystander was always asked to find how long the ambulance will take. The ambulance service are not allowed to give you this information.

* The trainer did not seem to know what information the ambulance service would ask for. In fact, there was nothing about them asking questions at all, it was all “you must tell them this, this and this”. Nothing gets our back up faster than callers who start giving you information, some of it relevant, some of it not, without letting you get a word in edgeways. According to our assessor, the most important information you need to give (after “what’s wrong”) is what position you’ve left the casualty in and what your name is and that you are a first aider. This is not right!

* Absolutely no mention of getting a good location to give to the ambulance service, which really is the clincher in my book.

I am not blaming our trainer for this – St John people rarely have to call 999 as they usually have their own ambulance on duties, so I guess they just don’t know how the system works. I do think St John and the ambulance service should have got their heads together on this one though. I know it’s a first aid course and not a dialling 999 course, but it would only take five minutes to give a few pointers on ambulance calling which would make life so much easier for us and the first aiders, and there is certainly no excuse for giving people information that is actually wrong (“send someone off to call and find out how long it will be”).

I hope they’ve fixed it by the time my next requalification is due, or I will not be very impressed!

Published Mar 22, 2007 - 49 Comments and counting

49 Comments on “First Aid Courses”
  1. katie Says:

    I went on a first aid course on Saturday – it was First Response which is the slightly downgraded, but child-oriented, first aid course for Guide/Scout leaders. I was impressed, after reading you and Random Acts quite a bit, that the trainer didn’t say “call an ambulance” for every single thing – the main reasons given were loss of consciousness, chest pain (there are a lot of v. overweight older Guiders/Scouters), and broken lower limbs, and we were given tips for getting the patient safely to hospital with a broken upper limb.

    As many Guide/Scout incidents happen on camp in fields where it’s hard to get an ambulance, and which are a long way from anywhere, I thought the advice was sensible. One thing the trainer (who was a nurse in a GP practice) didn’t say though was about stating location – which would be important with an incident in a field. But one would hope that the Guider/Scouter would know which field they were in…

  2. Martin Says:

    I think the key factor here is the First Aid at *Work* part. If you are acting for the company, you basically cannot do anything. A sticky plaster is pushing it. It’s all about responsibility – if you ring 999, the Ambulance service will take the can if the patient explodes. One of the main things companies don’t like is getting sued.

    I can understand your views about the unnecessary information – but isn’t it better to know that someone is conciousness, not breathing, that someone saying ‘yeah, someone’s hurt, but I dunno what’s wrong’. I think those protocols are built from ASHICE – which isn’t really relevant when calling 999.

    Also, technically in the ICHD book, there is no mention of priorities. That’s what happens in the real world, but in the shiny world of government every call will be there in under 8 minutes. Nosebleed, whatever.

    I do agree with you that your experience sounded pretty unreal. But I think it is a mixture of unreal expectations, strict compliance with the H&S act, and arse-covering. Hey ho.

  3. Martin Says:

    My bad. I meant unconscious. I blame the cold weather.

  4. Steve W Says:

    Did you find that since the last time you did your St. John, they’ve made it, well, far too easy? I did my refresher at the beginning of last year, and the first thing I noticed was how dumbed-down it had become since the time previous.

    I’m struggling to think of specific examples now, but I do remember at one point asking why a procedure had changed for something which to my mind was simpler yet less-effective.

    “Oh, some people just didn’t get it,” was the response.

    Well, boo-f*cking-hoo. It SHOULD be difficult enough that some people don’t get it. But no, the focus now seems to be on ensuring that the stupidest person on the course is able to pass with relative ease, instead of making it challenging enough to ensure a bare minimum standard of competence. We’re trying to save people’s lives here, FFS!

  5. tjwood Says:

    Mark… I know FAW is probably a bit of a lost cause, but maybe you could volunteer to run a session for your unit or something about how the 999 system actually works? Maybe you could even invite some of the trainers to come and learn ;-) I’m sure people would value hearing about how it works from someone who knows what they’re talking about…

  6. tjwood Says:

    Steve… that’s not St John, it’s the HSE, who seem to enjoy dumbing-down FAW. I’ve heard stories from people who have been on FAW courses run by private training companies which are even worse…

    (SJA are trying to move away from FAW as the basic course for members for this reason).

  7. John C. Kirk Says:

    Following up on tjwood’s first comment, I’ve been helping out with the training for my division of SJA recently, and I was thinking about this same issue. Would you (or any of your colleagues) be willing to come along as a guest speaker at one of our class nights, to talk about how all of this works? (Basically, the same type of thing you’ve been saying in your blog for ages.) I’m not sure whether there’s a better channel for this, but I didn’t want to call 999 to arrange an interview :)

  8. Mark Myers Says:

    Martin, what I meant was that the ambulance service should be asking the questions and the caller should be answering. Even if the information they give is relevant, they might be giving it at the wrong time and too quickly (don’t forget it all has to go into the computer) and it gives us a real headache!

    Steve, yes, I do find the courses are getting easier. I find the whole notion of “dumbing down” quite irritating. The whole “Plain English Campaign” thing has gone too far too, if you ask me. Added to the fact that there’s less and less a first aider can do for a fear of being sued, at this rate the first aid course will last about five seconds and only cover plasters.

    tjwood/John – I’ve actually done a presentation at my own St John division about this before and I would be happy to bring it to any other divisions nearby (I am in North East London) – I am a bit of a rubbish public speaker though! Email me if you want to borrow me for a training night.

  9. Eddie Says:

    When I did my Scout First Response a couple of years ago, the trainer went to great lengths to stress that not every call to 999 would result in the immediate appearence of an ambulance with sirens and lights. but that calls were prioritised.

    I think that this is probably a useful thing to emphasise as first aiders ought to be aware that calling 999 does not mean that the first aid incident will be over 5 mins later…..

  10. uphilldowndale Says:

    Steve W
    Did you find that since the last time you did your St. John, they’ve made it, well, far too easy? I did my refresher at the beginning of last year, and the first thing I noticed was how dumbed-down it had become since the time previous

    Absolutely.; raise the bar, toughen up standards; and make them do 20 min’s of vigorous CPR (I didn’t get enough sleep last I am feeling a tad sadistic! Can you tell?) And recognise that sometimes you have to say ‘sorry you don’t make the grade’

    Mike M
    Added to the fact that there’s less and less a first aider can do for a fear of being sued,

    Is the ‘sued first aid person’ for real, or is it an urban myth; a hypothesis that is getting in the way of people being compassionate to their fellow man?

  11. Steve W Says:

    “…raise the bar [of FAW], toughen up standards; and make them do 20 min’s of vigorous CPR…And recognise that sometimes you have to say ‘sorry you don’t make the grade’”

    The problem lies I think with the “no-one fails” culture which has crept into these courses. A company which sends a couple of employees on the FAW course does not want to see hundreds of pounds go to waste should those people not pass. And SJA doesn’t want to have to deal with several irate bosses after the end of each course (each wondering why the Hell their guy failed), or face the potential loss of future business to other organisations. So those who are struggling are instead “pointed in the right direction” by the trainers and examiners in order to see them pass. Anything for an easy life.

    I’m not calling for a return to the multiple-choice written test (which was pathetically easy even when the practical exam was not), but the First Aid at Work course is in danger of becoming nothing more than a meaningless paperwork exercise for companies looking to comply with minimum HSE requirements.

  12. Petrolhead Says:

    I’ve not had to phone 999 for an ambulance yet, but even though at St John it was drummed into us to do the whole ASHICE thing, I’m not sure I’d do that when the time came! I’d let the call-taker take the lead because they know what information they need.

  13. bob Says:

    I’m not sure who is demonstrating the most waltish behaviour here

    A phone gimp who wants to be a paramedic or the st johns hobbyists

    All very scary

  14. bob Says:

    FAW is a box ticking, Hse arse covering bit of legislation. A golden goose for medical “training companies” to coin in and more often than not taught by “Intructors” that have no actual real time experience

  15. TheBunslinger Says:

    I did my FAW in November and it was just the same.

    You can actually fail assesments for not sending someone to call an ambulance. “But the patient doesn’t need one” “ring anyway”.

    They were staggered to hear that it’s a good idea to use a landline if you’re not sure of your location too.

    In fairness the trainers just didn’t know – we have a bloke in our division who is a mnager in Control and he would have mentioned it had he been around.

    I didn’t like the way FAW was taught to be honest – now I’m progressing a bit there are clearly holes in my knowledge which I don’t like.

    Heh, maybe I’m too dumb to “get” the dumbed-down FAW.. that’s a worry!

  16. Mark Myers Says:

    I have now found ‘waltish’ in a slang dictionary. It’s quite a good word. Bob, however, is a prat.

  17. Leila Says:

    Ok, being a lowly ‘ordinary person’ (with a bit of first aid training) is it better to phone from a mobile, not knowing exactly where you are, or to try and find a land line?? I’ve never had to call an ambulance, but it would be nice to know! As to the rest of it, I can’t believe that people really call ambulances for things that can go in cars / buses!! Amazing – don’t they get embarrassed?

  18. Funky Mango Says:

    I’d be interested to know whether you were on a Brigade course or a Commercial course. My experience (as a Johnnie and trainer) is that many of the commercial trainers have never made a 999 call in anger in their lives. Brigade trainers, on the other hand, are or were active first aiders. Certainly when I’m training I go on about location, tell them to send a spare person outside to show the ambulance the location, explain that there’s no point phoning until you know (for instance) whether the casualty is conscious and breathing or not, and probably a few things I’ve forgotten about!

  19. Trooper Man Says:

    Hi all in blog land

    As a jonner myself I can speak from personal reference calling 999 for assistance from the ambulance service.

    Every weekend I am out with my fellow jonners, it is rare I don’t have to call for help for a serious injuriy whilst on duty. This varies from concussion to open fractures. Unlike some, my ambulance isn’t due till later this year!!

    I wait for the call to be answered, and follow the prompts the ambulance service give me. I never interrupt as this causes delays and we don’t need those.

    I always have to hand the following information:-

    Duty address in full including the post code.
    Six figure grid reference (OS maps are brilliant for these) just incase the budgie ambulance is sent.
    Contact number for myself (this pops up on thier screens as Mark can confirm.
    The obviously all the patient details that patient confidentiality allows me to give.

    I now train first aid to the public and because of my experieinces alway tell my students what to expect when they dial 999 (112).

    On several occasions I have been asked to hang up and wait for a return call. This is rarely more than 30 seconds away.

    As a foot note, if any of out there are still using those big books with preety pictures of the British Isles in them, then if you look at the horizontal and vertical grid lines you will see they are numbered. By a bit of guess work and knowing roughly where you are, you can give the ambulance service a preety good grid ref. I do give lessons if anyone out there is interest.

    Regards to you all
    TM

  20. Leila Says:

    Hi Funky Mango,

    It was a commercial course and normally, I would expect to be somewhere I vaguely know. However, I also suffered from the ‘call for help = call an ambulance’! during training. Thanks for the reply, hopefully, I’ll never need the information!

  21. Trooper Man Says:

    Hi all

    I have read the above comments on the ‘dumbing down’ of the all time favourite FAW course.

    It may appear to be easier but I have been on full and requal courses where students have been referred (failed for want of a better word).

    The HSE will take a dim view if anyone who passes students to ‘keep the bosses happy, and reatin future lucrative business’.

    Try looking at things from this side of the fence.

    I was on my first course way back in 1997 and two guys
    who were taking it were there because of thier employers. In both cases they had been told if they failed then there jobs were on the line (one was actually told not to come back to work!!) Now, there is an incentive.

    The course was of the ‘old’ standard with the 25 multiple choice question paper at the end.

    That in itself wasn’t so bad, but one poor guy was dyslexic and had a big problem.

    I spent the four days with him helping understand all what to do and mentioned this missed fact to the trainer. Once this was known a third party sat with this guy to write the answers down as he thought correct. Not by helping him but by reading the questions and ticking the box that coresponed with his answer. He got 21 out of 25 and kept his job.

    I still meet up with him 9 years on at the requals and he always thanks me for helping him out.

    Believ me, you can be ‘failed’ if the assessor believes you you are unsafe!! even on the new dumbed down FAW.

    Trooper Man

  22. Trooper Man Says:

    Hi all: Ref the FAW

    I have read the above comments on the ‘dumbing down’ of the all time favourite FAW course.

    It may appear to be easier but I have been on full and requal courses where students have been referred (failed for want of a better word).

    The HSE will take a dim view if anyone who passes students to ‘keep the bosses happy, and reatin future lucrative business’.

    Try looking at things from this side of the fence.

    I was on my first course way back in 1997 and two guys
    who were taking it were there because of thier employers. In both cases they had been told if they failed then there jobs were on the line (one was actually told not to come back to work!!) Now, there is an incentive.

    The course was of the ‘old’ standard with the 25 multiple choice question paper at the end.

    That in itself wasn’t so bad, but one poor guy was dyslexic and had a big problem.

    I spent the four days with him helping understand all what to do and mentioned this missed fact to the trainer. Once this was known a third party sat with this guy to write the answers down as he thought correct. Not by helping him but by reading the questions and ticking the box that coresponed with his answer. He got 21 out of 25 and kept his job.

    I still meet up with him 9 years on at the requals and he always thanks me for helping him out.

    Believ me, you can be ‘failed’ if the assessor believes you you are unsafe!! even on the new dumbed down FAW.

    Trooper Man

  23. David Says:

    FAW as I understand it has been altered to make it more suitable for the average [read:office] environment. Through my St John hobby, I may well see an open fracture at a football tournament, but the likelihood of this in my level-floored office is rather less, and the course is supposed to be for the workplace. I think another idea is that it’s better to have someone pounding away doing effective CPR than having someone attempting CPR whilst also trying to remember the intricacies of the human circulatory system, hence the removal of the A&P elements. A pity, but the motto seems to be ‘don’t think, just follow the flowchart’.
    As for the ‘send someone away and get the to tell you how long the ambulance will be’, this has two causes. The sending someone away to call 999 is a hangover from when mobiles weren’t commonplace and you might not be next to a phone. Asking them to come back and tell you how long the ambulance will be in coming ensures that they come back to provide further help if needed.
    Two classic trainer/assessor jokes:
    “Call me an ambulance!”
    “You’re an ambulance”
    “How long will the ambulance be?”
    “About 20ft”

    The old ones are the best!

  24. Jac Says:

    I was a Tech then Commercial Training Officer (FAW, Paeds, Sports etc) and I know my collegues would not hesitate to fail anyone not deemed ‘safe’. As a trainer I would have the experience to pick up on any weaknesses and give additional training.

    My first FAW course was with St John (before I joined the service) and I thought it was great and really enjoyed it. Now I realise that until you’ve done the job you really can’t give advice about calling for a van, recovery position – you’ll know what I mean – etc. It really worries me that private companies are running these courses. Having said that plenty of my ex work mates are Jonners and do really excellent work in their own time.

    If you want a course call your local NHS Trust.

  25. tjwood Says:

    Jac – I hope you’re not lumping SJA in with the “private companies”.

    SJA has been around a very long time – was around way before the NHS – and SJA “invented” First Aid…

    ;-)

  26. Funky Mango Says:

    Seconding tjwood’s comments…I used to go into NHS trusts to teach BLS to nursing staff. It was VERY scary thinking some of them were let loose on the public as “professionals”!

  27. Hannah Says:

    Sorry just had to post ,
    recognise this scenario 100% as a st.john ambulance member myself .. its crap the way were taught to get ambulances and doing it on the field is very different to the method you mentioned which is the way we have to do it in out exams!

    I think letters need to be sent from the ambulance service to EVERY st John main headquaters .. not just London (‘cus there probably lose your letter anyway)

    H xx

  28. tc Says:

    I have just taken FAW with St John and it was very different for me. The trainers were at great pains to get us NOT to call ambulances willy nilly but to use our common sense – which was a huge relief as I am also a Neighbourhood Responder and hate being called out to someone with a mild nosebleed or bit of a tummy ache when I am in the middle of this week’s Desperate Housewives. But my local division has a fair sprinkling of controllers who are also NFRs so maybe the feedback is better.

    Sending the bystander off is part of the training to make sure you can cope on your own if you have to – in real life of course you would get them to do all the dirty work!

    And did they tell you to call 999 or 112? we were told to favour 112. Do you have a preference/POV?

  29. susz Says:

    As an ex-Johnnie who did their FAW trainer course (but have never actually taught FAW as I moved about 3 months later), I’m pretty unimpressed by the “call for every tiny little thing” attitude – you should be able to decide whether an ambulance is required or not. Having said that, they need to show that they would get help in the test, so you often build most/all of the scenarios so that an ambulance is a good idea. This is also why bystanders are always sent away – the test time is limited (although good trainers always mention the usefulness of mobiles). The whole legal issue is a red herring – if you act within your training and in good faith, no court in the land will find against you.
    I always explain about the priority system in the sense that if you need to send someone away to call 999, they absolutely need to remember to say the words “chest pain” or “not breathing” if that’s what’s wrong, as then the call handler will be able to prioritise the call appropriately.
    The list I now teach people to tell their bystander is “Go and find a phone, call 999 and ask for an ambulance. Tell them that there is someone who is (unconscious/not breathing/suffering from chest pain) at (detailed description of wherever I am holding the course, eg. the Red Lion Pub, South Street, Oxford) and then come back and tell me you’ve done that”. Yes, I know the call taker will ask them a whole load of other questions, but in the worst case, we get the vital info to you. In most real situations, the phone call will be made within shouting distance of the casualty, allowing them to be answered.
    The whole “come back with how long the ambulance will be” has evolved from “come back and tell me you’ve done it”. This is just because once that person has left your eyeline, you really need to know that an ambulance is on the way, and not that they’ve run off in terror. I know it’s unlikely, but it can happen, and there’s nothing more comforting when you’ve got a rapidly deteriorating patient in front of you than someone returning from the phone with the words “they’re on the way”. Apart from them actually arriving of course.
    In an ideal world we would always be able to call from beside the patient, but my experience suggests that patients invariably collapse in the centre of mobile phone blackspots without any landlines…

  30. Barry Salter Says:

    Having done a St. John FAAW course recently as well, our Trainers emphasised about only calling for an ambo if it was necessary, sending folks in a cab for less serious things.

    They also said about favouring 112 if you’re calling from a mobile, reason being that if you can’t get a signal on your *own* network, but can on another, your call will still get through, which isn’t 100% guaranteed if you dial 999.

  31. Tom The Tech Says:

    I agree Mark, Bob does sound like a prat, although I’d add ‘ignorant’ as well.

  32. Matt Says:

    I think Mark’s 10 Commandments (somewhere else in this blog) is a very useful tool.

    I also find a duty info sheet from SJA to be useful when calling an Ambi (as it also list the ACCESS ROUTE for SJA/Ambi vehicles…)

  33. Sarah Says:

    I did a Red Cross First Aid course for my Scout Warrant, and did wonder whether the chap instructing had ever called an ambulance. As was said above, we were told “you must tell them” rather than “they will ask” and that you would be told how long an ambulance would take.

    We were told nothing about how to hand over to the crew once an ambulance had arrived. More of a “hurrah the ambulance is here we can stop now” sort of thing.

    (I thought about pointing him to your blog, but chickened out.)

  34. Jac Says:

    tjwood – sorry if I sounded disprespectful about SJA – it wasn’t intended. I’d far rather have trained Jonners there than private companies. x

  35. Red Barron Says:

    I train for RedX in Scotland and have taught folk about the questions control ask ever since they changed over. Don’t remember ever being told to do this ‘officially’. Don’t know if I do it beacuse of my general interest in ambulance related matters or because our group has been to the Scottish AS control centre three times now and watched the process from call arrival to ambulance arriving on seen happening live!

    Certainly opens yours eyes!

  36. C M Says:

    I’m having a lot of issues with SJA(Avon) at the mo, gone to a diff company and will be handing kit in soon. the reason? i’m epileptic and have been told i cant work as a level 2 tech, i’m 3 years clear and aloud to drive again but can only 3rd crew with sja? sod that! the crews in Avon all have the god thing going and are a bunch of c****. Glad to be leaving

  37. James Says:

    The first aid training I got in school back in the mid 1990s wasn’t impressive either. CPR, recovery position and the Heimlich Manoeuvre. All very useful as far as they go, but I got no instruction in school about dealing with broken bones, burns or anything of that sort. I was relatively fortunate in that I got somewhat better instruction from the Scouts, but nobody else in my class got any of that. As for calling an ambulance, I don’t think we ever got any guidance at all. This is something that needs to be addressed, and urgently.

    And as an aside, I shudder now at the memory of being shown an instructional video in the use of the recovery position after a cyclist had been hit by a car. That is the very last thing you should do unless you’re very, very certain there’s no possibility of a spinal injury.

  38. Lola Says:

    As a soon-to-be SJA trainer, the whole bit about telling the person to come back to let you know how long the ambulance will be, is a bit of a ploy to, a) make sure they come back, in case you need any help, and b) make sure they actually call an ambulance. Some of our old hand trainers have some delightful stories about sending someone to call an ambulance and then waiting, and waiting, and then getting someone else to call an ambulance. Turns out the first person never bothered to call for the ambulance in the first place. If they have to come back again, they’ll feel obliged (for want of a better word) to phone, and if they don’t come back then we can assume they haven’t called.

    Some of the other points you mentioned, like giving a good location are actually covered in our courses up here, maybe the trainer forgot about that bit?

  39. Jo Says:

    As someone who has trained with Red Cross (volunteer 1st Aider) and SJA (FAW), this is a brilliant post!

    I have (fortunately) never had to call an ambulance in anger (and only been in one situation where it might have been necessary, but my colleague requested that I didn’t…), and had always thought that it would have been similar to the way it was done on my courses … (although I was told about the “how long will the ambulance be / 20 meters” one with the Red Cross)

    However, I do have a comment about the FAW being easier to pass. When I first took the course, I was taking it with a security guard colleague from work. He was coming up to retirement age, and not the ideal person to be shifting heavy bodies around… He also couldn’t remember the basic ABC – he never once got it right in class, and struggled on other basic things (bandaging etc). However, he still managed to pass the exam. Now, whether that was just luck on the day, or whether the examiners were kind, I don’t know. It just made me a little bit scared to think that he could one day be responsible for my life…! Fortunately, even in an office of 400 people, the chances of someone having a major emergency are very low…

  40. Chris Says:

    Hi there,
    it’s interesting to hear the differences. I’m a St. John brigade member in British Columbia Canada, and we aren’t allowed to transport patients. We have Ambulances on nearly every event, but due to legalities we can only use them as stationary first aid posts, and are required to call BC Ambulance Service for transport. It’s definatly true that the Brigaders have to endure long periods of sheer boredom, followed by breif periods of excitment. But, with that being said, within my area, we don’t have a whole lot of members, so as a result, our first aid skills are definatly high, due to the fact we get alot of practise in the field. Anyways I love your blog, just wanted to drop a line and say howdy!
    Bye For Now
    -C

  41. Kettle Tester Says:

    Now I do feel terribly smug, because I am a FAW instructor and I do teach my students about the different categories of call, AMPDS (including the ‘script’ for a casualty who has arrested), the difference between a BT operator, ambulance service calltaker and despatcher and that the calltaker will not give an ETA. Unfortunately none of this is part of the protocol in my training organisation’s training package, who insist on teaching all the bad habits you mention. I’m not sure what the source of this problem is, but I guess it’s down to the FAW training organisations being rather remote from the ambulance service.

    Now, smugness aside, what is particularly difficult to teach, is when to call an ambulance. Bare in mind the huge range of abilities and experiences of our students, the fact that we have three and a half days to set them up for any scenario they might come across in their diverse workplaces over the next three years, and, the fear that seems to grip the nation, of getting sued, or worse, ending up in the papers. What is also particularly tricky in the workplace, especially where the public are involved, is what do you do with a ‘casualty’, who is ill or injured and needs treatment but is not bad enough to warrant an ambulance but has no transport of their own?

    Please excuse the essay, and the smugness, but it would be interesting to know the views of the various ambulance service contributors on what they would regard as a ‘legitimate’ call, and some quick and easy guidelines on what signs/symptoms/history should get an ambulance.

    KT

  42. Mark Myers Says:

    Kettle Tester, your smugness is justified! I wish there were more instructors like you.

    In answer to your question about whether you should call an ambulance, there’s no hard and fast rules, but I would ask myself the following questions:

    1) Is it a life threatening emergency?
    2) Is the patient’s condition likely to deteriorate significantly if they do not get to hospital straight away?
    3) Is the patient unable to get to hospital any other way for a medical (not financial!) reason?

    If the answer is ‘no’ to all, then don’t call. If the answer is no to 1 and 2, but yes to 3, then call, but be prepared to wait.

    The four things you should always call an ambulance for are unconscious people, breathing problems, severe bleeding and chest pain. In any other situation, you should use your own judgement.

  43. Rob Says:

    I am involved in training Air Cadets up to the SJA Young Lifesaver Plus award and can certainly recognize many of the comments and scenarios already mentioned. After the first course I ran I became acutely aware that I didn’t know how to role-play the ambulance call with any level of authenticity and my cadets were not going to feel confident with the ambulance calling bit if it is necessary.

    I took the liberty of taking one of your posts from a year or so ago where you wrote up an example of how an emergency call might go and I made it into a handout. Now each of my students gets this at the end of the course and are hopefully better equipped to be a useful caller. What would be more useful still is one or more recordings of actual calls (or actual training calls anyway)

    The main reason I got into first aid and took my FAW qualification around 8 years ago now was because I saw myself being that panicky person who was forever calling ambulances. The course taught me to be more relaxed about these medical “emergencies” and to have the confidence to do a little triage but it is never easy. I hope that the courses I teach are helping to build that same confidence in the cadets and I have seen positive results already.

  44. babeestars Says:

    what you described really does sound like st. johns,
    i know im only part of the school first aid team, but having taken part in the competitions they set up i really can relate to what you are saying,
    with every scinario you had to send someone of to phone the ambulance, but most of the time i have a mobile on me so i dont see the point in sending them away.
    ive been part of other first aid youth groups and they have never made these mistakes. you can usualy have the caller stand next to you and ask you questions id your stuck
    i think learning both ways should be done not one or the other.

    babeestars-(not real name obviosly)

  45. Willco Says:

    Hmm,
    I did a first aid course many years ago when all you need do was protect the situation from getting worse and summon professional help (999) – today I think I’d only practice it on friends or family but for strangers I’d look more towards ‘securing the scene’ As for ‘making it easier’ to pass exams maybe all should get a certificate but graded say 1 – 5 where ’1′ is ‘this person achieved a perfect score’ and ’5′ well anyone with a 5 could make sure the ‘accident’ sign does not get nicked.

  46. Roy Lalor Says:

    We run Occupational First Aid (Workplace) training in Ireland and are also an Irish Heart Foundation Training Site. I think it depends on whether you are at work or not.
    I called numerous ambulances in Dublin when I was teaching on a Sports Management course and looking after teams because it was the organisation’s policy. I was comfortable with that and the response crews never minded and were never less than helpful.

    Roy Lalor
    LTS First Aid Specialists
    http://www.lalortraining.ie

  47. mark Says:

    i know that all people hav there own opinions but i am a johnnie myself an they don’t tell you how to call for an ambulance because they are not there 4 that the are there 2 teach first aid at work

  48. ichd - StartTags.com Says:

    [...] having wide … College / University Website: http://www.ichd.kannuruniversity.ac.in/ Jaipur National …Nee Naw – First Aid CoursesPeople imagine that as a Johnny you are treating casualties all the time, but it’s not … Also, [...]

  49. Kris Says:

    As an experienced CFR and nurse, I had a direct line to Ambulance Control: a number for routine calls and a number for emergency calls.

    If I came across something, it is so easy to ring up and say, "Ruraltown Responder here; ambulance required to 123 High Street, 28yo female with difficulty in breathing, am on scene." And I'd get one, just like that, whereas if I ring 999 and go through it that way, I've found it so much more time-consuming when I could be providing reassurance to my casualty or carrying out obs, such as BP monitoring, or running through the full SAMPLER history. I had one recently to a lady who was blatantly having cardiac trouble (presented with shortness of breath and heart palpitations, amongst other things and had history of said complaint) and instead of keeping her calm I had to deal with an irate call taker who insisted on taking me through the questions for meningitis (which I'd already asked the casualty anyway). She eventually asked if she could just talk to the patient (who was short of breath!)

    Any feedback would be greatly appreciated…I've been reading from your final post to here so far!

    Nee Naw
    Nee Naw was a blog about life in the London Ambulance Service control room. It was written by Suzi Brent from 2005 to 2010. The blog is no longer being updated, but the archives will remain here.
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