Talk:First Aid/Head-to-toe

Children and infants don in reverse?
I've never heard this, and it's not in any FA manual I've ever seen, so unless it's referenced, I'm going to assume it's not standard. Remember that this is first aid not paramedicine. This is only to be done on ADULT or YOUNG ADULT patients! YOUNG CHILDREN and INFANTS are to be assessed in reverse. Mike.lifeguard 18:56, 3 June 2007 (UTC)
 * Actually, I heard it many times. Young children and infants (which should be held by a parent while assessing) will tend to allow you to do more and be less hesitant if you start from their feet.  By starting from their heads, they tend to be more defensive whereas when you start at their feet, they feel less vulnerable. It is in the ARC Emergency Response Book.  Mike6271 04:05, 7 July 2007 (UTC)
 * I can understand the rationale for children, though I disagree. The point of starting at the head is that those injuries would be most serious - a child's 'comfort' is less important than finding the most serious injuries first, so therefore start at the head. That rationale makes even less sense for infants. Also, the head-to-toe should be replaced by a simple "Are you hurt anywhere else?" and a visual once-over in victims that can tell you reliably whether they're hurt anywhere else or not. So a stroke victim, for example, can't tell you reliably whether they're injured anywhere else, so do a head-to-toe. An unconscious victim needs a head-to-toe. But if it's an asthma victim? Not needed - if they're hurt anywhere else, they'll be able to tell you. So any victim that gets a head-to-toe isn't going to be in any sort of condition to complain in any case. As for moving it to First Aid/Advanced Topics, I disagree - the head-to-toe is an integral part of the secondary survey, and is definitely included in Standard.  – Mike.lifeguard | talk 12:20, 7 July 2007 (UTC)

Checking for underlying causes
This entire section was in First Aid/Vitals, so I moved it to a more appropriate location. I'm wondering if it should be kept at all; it certainly goes beyond SFA standards and looks much more like something a paramedic or first responder might be doing. Mike.lifeguard 17:01, 4 July 2007 (UTC)


 * As also posted on Mike's talk page, but this is something i train my first aid teams with, partly because it helps them understand some underlying causes, partly because it gives them something to do whilst waiting for an ambulance (because let's face it, there isn't that much you can do you a 'sick person') and also because each of those diagnostic tests is very simple to perform (looking for colour, clubbing and oedema is pretty simple). Agree its not really vital signs (got carried away), and happy for it to sit here or as an extended skills module.  Owain.davies 17:14, 4 July 2007 (UTC)

Lawsuit
It should be made clear that by doing the assessment you can get a lawsuit thrown against you for sexual assault. When you are actually doing a head-to-toe assessment, you are getting awfully close to the the patient and they may feel uncomfortable, especially if you only learned to do it from Wikibook's First Aid book. Mike6271 04:05, 7 July 2007 (UTC)

Maybe this could be moved to advanced first aid. It is far from basic first aid and involves rather "touchy" parts which only a trained responder should be doing. Basic first aid should be more of a "Does this person want my help? Does this person need my help?  Is there anything I know how to do for the person that will help them?  Is there something that a medically trained individual can do for this person that I cannot?  How do I reach that person?" Mike6271 04:10, 7 July 2007 (UTC)


 * See above for reply re: moving to First Aid/Advanced Topics.
 * Legal liability is not generally a concern due to Good Samaritan legislation, where it exists. Even in jurisdiction where that legislation doesn't exist, case law will probably protect you. Victims getting a thorough head-to-toe aren't going to be in a position to complain while it's being done. As for a lawsuit after the fact... I suppose you could put in a note if you want, but I think that'd be an overreaction. First aiders should definitely give a 'running commentary' as they do it though. "I'm going to check the rest of your body for any other injuries. Do you hurt anywhere else? I'm just looking for anything out of the ordinary, and it looks like we're doing ok for now. Does this hurt? OK that's good...." and so on. So they have advance warning of what you're going to do, and they always know what you're doing. So that needs to be added as well.  – Mike.lifeguard | talk 12:26, 7 July 2007 (UTC)


 * It does mention sensitivity to gender issues in the article, but no harm in reimplying the consent issue. As for moving, definately not. This is basic first aid. Owain.davies 13:18, 9 July 2007 (UTC)


 * For checking the pelvis, for the EMT curriculum, it states that you should push them together, then only if there is no pain for that, then push down, otherwise you can cause severe bleeding by fracturing the pelvis more. After rethinking this, I still believe it should be put in Advanced Topics, as there is a lot to check for while you do this, and by just discussing it in wikibooks, more confusion can be caused on how to do it since they don't actually get to practice.  Running your hands over is a lot different than palpating.  The rapid trauma assessment is done on conscious patients too.  Also, to do it properly, the person needs to be, for the most part, completely naked to do a through exam.  Mike6271 02:52, 15 October 2007 (UTC)


 * Keep in mind that this is just a textbook - I'm not assuming (and I don't think it should be assumed) that anyone will read this and think they can do first aid - that would be totally irrational, especially considering all the warnings about getting appropriate hands-on training.
 * If you want to change the way the pelvis check is done, by all means, be bold - I see no problem with the way you've described it above. I disagree however with one of your other two points - that the head-to-toe should be moved to the advanced section. A head-to-toe is most certainly not an advanced technique (though there is a section for First Aid/Extended Assessment). If you like, add more content to the advanced section on assessment. I'm still intending to add some stuff on assessing spinals, I just haven't gotten around to it. – Mike.lifeguard  &#124; talk 00:04, 16 October 2007 (UTC)