Do no harm

Facilitator: Grace
Medics: Greg + Charis
Patients: Lisa
Time: 15 mins; 1845-1900
Actual time:
Learning Objectives:
Materials: gloves for medics

Discussion: prevention

Facilitator asks

Has anyone here used or wanted to use first aid skills? What happened (why was first aid needed)?

Facilitator asks

Could these situations have been prevented? How?

Lisa unresponsive at park: Spread safety and calm

Facilitator says

Let's start building our skillset with what street medics do all the time, whether there are patients or not. Watch -- everybody stand up and crowd around the person laying on steps.

Facilitator says

The weather is nice, the day's action was calm, she's at an action in Oklahoma City on the steps at Kerr Park.

Facilitator tells medic buddy team

standing outside circle: Hey, Lisa fell asleep on the steps. The cops said they're gonna arrest her for laying down, but she won't wake up!

Model

Buddies

talk to each other, patient, and patient's friends, but not to classroom while they demonstrate:

  • Ground, put on gloves.

  • Scene survey.

  • Decide roles (patient buddy/scene buddy)

Patient buddy

introduces pair, asks consent/checks AVPU (unresponsive), is nice, talks to her, gives bullet-point report to EMS on arrival (unresponsive since arrival; friends say diabetes, no known traumatic injury).

Scene and comms buddy

continues scene survey, gets help from crowd (Finds out she is diabetic and hasn't eaten all day and all last night. Don't know if she takes insulin), makes privacy circle, calls 911 and holds phone to lead medic's ear to transmit patient's condition.

Buddies

  • Calm, comfort, reassure. Act as a team, say what they are doing.

  • Hand-off to EMS.

Debrief

Facilitator asks

Did the medics do any first aid? Answer: no.

Facilitator asks

Was it better for Lisa that they were there? Why?

Discussion: do no harm

Facilitator says

We only do first aid within our skill level and scope of practice.

  • When faced with a situation beyond our scope or ability, we pass the patient along to appropriate equal or higher level of care.

  • Just because we're not in a hospital or EMS setting doesn't mean we provide care outside our skill level -- even in the backwoods, we can transfer care.

Facilitator says

We don't hand out meds (over-the-counter or prescription).

  • Unethical (endangers patient to get meds without record keeping and follow-up).

  • Illegal (exposes all medics and movement to additional harassment).

  • Unnecessary (make referrals or encourage self-care; patient can get OTCs at pharmacy).