First Do No Harm


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This includes gathering information that might indicate conditions that will warrant a No-Go decision. No-Go conditions can be difficult to replicate at a burn building e.


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But it can be done using simulation. There are several low cost alternatives. When we can get responders to a level of decision making where they realize there are alternatives AND they make their own decisions AND one of those decision options might be to dare I say it NOT go inside, then we begin to develop creative problem solvers… smart… thinking… responders. As instructors, I would encourage you to become a student of situational awareness and learn the process for how to make high-risk, high consequence decisions and begin teaching your students how to make their own decisions and Primum non nocere.

Discuss how responders are taught to make decisions in your organization. Observe how recruits are being taught in your academy better yet, observe their training, if you are able. I really enjoy getting feedback and supportive messages from fellow first responders. It gives me the energy to work harder for you. SAMatters Online Academy.

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Facebook Fan Page: www. Gassaway, spot on with this article as well. The key here is size up and situational awareness, sometimes a commander becomes overwhelmed with what they see, so the focus is on incremental pieces not the whole picture. In my career as a chief officer and instructor, I find that sometimes the education individuals receive is minimal or non-existent to the level it should be for making major decisions, and that leaves individuals to pull on their minimal knowledge. In our job, it is important to instill in our firefighters, that each step should have an educational criteria, because as we all know that one day we will be challenged, and the decisions we make may make the difference, for the better or worse.

I also agree with mentoring the individuals to make sound decisions while they are even a rookie, because if they start looking early in their career, they should continue to look at situations overtime; hence second nature and comfortableness in their decisions will make the challenges easier. Gasaway, As someone with 34 years of public safety service as both a responder and a receptionist… um I mean Telecommunicator we wish the world would recognize us as first responders with equal treatment I would like to say thank you!

Proper decision making methods should be taught prior to equipment training to apply learned skills. Keep fighting the good fight on behalf of everyone who needs or requests help. Your email address will not be published.


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Created by: Radiate. Risk versus benefit The work that first responders perform is risky. Decision making Sadly, most first responders are not taught the process for how to make a high-risk, high consequence decision. Teaching decision making So far, it all seems so simple. The lessons usually revolve around: How to stay low in smoke. How to advance the line. How to search for victims. How to maintain orientation. How to remove a victim. How to extinguish the fire.

Action items 1.

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Thanks, Email: Support RichGasaway. Leave a Comment Cancel Reply Your email address will not be published. Face distorted, squished under the mask. Gown hanging open, breasts flopped out to the sides. I will apply, for the benefit of the sick, all measures which [sic] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I took an oath.


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When are you giving up, and when are you accepting the truth? Second attempt, tube is in. Pressures maxed. Labs are back — lactate 8. Start compressions! That unmistakable sound of ribs snapping with that first push of CPR. That unforgettable feeling of cracking as you heave all your weight onto fragile bones. Press, recoil, press, recoil. The family is on the phone. My staff takes the call. Tubes and lines running in and out of every conceivable place to put one. Blood dripping from a failed IV attempt. Fragile chest skin beginning to tear from CPR.

ET tube taped to her face with pressures on the ventilator that would leave me breathless. I am not the omnipotent healer this family is asking me to be. Is it being warm, sympathetic and understanding to abide to resuscitation requests knowing that they are near to futile? How do you explain the limits of medicine to a desperate family?

The code continues.

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Morale runs low. Exhaustion, and sweat drips from the effort of chest compressions.

First do no harm - enhancing patient safety teaching in undergraduate medical education - GMC

One round, two rounds. Draw more epi. Hs and Ts. Should we lyse her? The family is still on the phone. How do you tell a year-old woman that it is time to let her daughter go? Most especially must I tread with care in matters of life and death. Perhaps the warmth, the sympathy and the understanding come not from abiding to ill-informed requests but from encouraging patients and families on their journey toward acceptance.

Love, comfort, family, friends.

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