To Treat, or not to Treat

There is a thing about first aid that some people get straight away, others catch on eventually, and still more never really understand:

You can’t treat everyone.

It is a fact that some people who don’t need treatment will demand it, and others that really need treatment won’t accept it.

The former are very easy to spot, and easy to deal with.  You just have to follow someone like Brian Kellett (né Tom Reynolds) on Twitter (@Reynolds) or read one of his books (which I highly recommend) to get a feel for the number of patients who turn up to A&E or call an ambulance for things that really don’t need emergency care.  I’ve had plenty of this sort of patient, but let’s be honest, these are the people who should be coming to someone like me. I can patch them up and send them on their merry way without consuming the time of a professional who has better things to be dealing with.

The latter group is more difficult.  These are the people who would really benefit from help, but don’t want to be a bother, or don’t want to waste your time.  Their heart is in the right place, but they don’t realise that they are themselves in the group they think we should be spending our time on.  I thankfully don’t see many of these, and the few times I have we’ve managed to reach an agreement that perhaps, may be, it would be worthwhile getting a nice paramedic come out and for them to have a chat.

Finally, there is a third class of person.  I’ve deliberately not called them patients, because most of the time, they’re not.  Often, these are the people who are most likely drunk who stagger past you at a stupid-o’clock in the evening while you’re waiting for a bus.  They are the people determinedly limping past your first aid post on the half marathon.  The might benefit from treatment, but they don’t really need it.

It is tempting to walk over, offer treatment, persuade them to stop.  It’s easy to go charging over, first aid kit in hand, and cure their ills.  Except they won’t appreciate it, and they’ll argue, and to be honest, they’re not interested.  Just because you can fix something, doesn’t mean you have to.  Just because you can act doesn’t mean you should.

You have to be realistic.  That drunk person you want to approach in the street.  Say they actually accept your help and don’t wallop you one for your trouble.  What you are you going to do?  They are conscious, mobile and still with it enough to make their way from A to B.  If you call an ambulance, they’ll take them in (assuming the patient is still around when the ambulance arrives), and they’ll sleep it off in A&E.  What would they do if you weren’t around?  They’d go home, and sleep it off in their own bed.  Yes, in A&E, they will be monitored by the staff and cared for.  But do they need it?  Perhaps it isn’t our call to make, but again, what would happen if you weren’t around?

The same goes for when I’m on duty. You see someone heading towards your post.  You think about going to intercept them.  Except, what if they’re headed past your post?  And even if they are headed your way, what does this gain you? They still need to come to your post if you plan to treat them properly, so you’ve just had to walk too and fro to meet your patient a few seconds earlier, and gained what?

I was the same.  To be honest, I have to watch myself to make sure I don’t revert.  It is very tempting to think that you can go in and solve any problem.  I enjoy looking after people. I think everyone in the Organisation does.  But I think, slowly, I’ve learned when to get involved, and when to just stand back, watch, and wait until I’m needed.

I’m not advocating walking on by every time.  Sometimes you do need to stop and asses.  But you must be reasonable.  Assess the situation from a distance, first. Will you getting involved achieve anything? Are you putting yourself at risk? What are you about to go charging in to?

Sometimes it’s experience.  Sometimes its a judgement call.  It’s not easy, but it is important.  Running in to the rescue may be exciting, but when you get it wrong you just look like an idiot.  And that is not fun…

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About The WalkingPlasterDispenser

So who is the Walking Plaster Dispenser? Well, I'm a volunteer First Aider, working with a well-known First Aid charity to help out random people I've never met before (or, more usually, when) they hurt themselves. This typically involves walking briskly (never run...) around after people who are silly enough to do sports or some other suitably daft activity in their free time. In my spare time, I am a graduate engineer, working my way through a graduate scheme with a big engineering company.

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