First Aid

Gareth LittleMay 3, 1:08pmHi all,

Just a few points I observed last night while giving Aidan Blighe and hand with the first aid.

With most of the LL races there are always going to be substantial numbers involved so in my view I think there is definitely a need for two first aiders at LL races. So what if it is not a busy race for the first aiders and they end up sitting around, one of them can always be put to an other use. Last night for example there was quite a queue forming behind Aidan and the runners in need of attention were starting to get cold as Aidan could not work any faster.

Second thing I noticed was that there was a sever lack of medical gloves and sterile wipes in the first aid kit as these are the bread and butter items you need for a hill race medical kit. If a runner has cut knees and hands you need lots of wipes and that's just for one runner so you can see how it all adds up. As for the medical gloves, you can only use one pair per runner so a good stock of them is required. I suggest at least 50 wipes and 25 sets of gloves with these levels being monitored each race by the first aider. It would then be his or her duty to post here with what needs to be replaced after each race.

And lastly, it's really important to have a large bottle of water (4L) to wash the mud and dirt from wounds before then can be cleaned and bandaged up properly. I think this needs to be added to the mandatory first aid items.

Please let me know what you think?


Mick HanneyMay 3, 1:56pmValid suggestions. However, we had a problem historically even just getting 1 First Aider to volunteer for races. We've done the training now and gotten the
commitment for 1 per race which is great.

We also just about filled a class for first aid recently. 12 volunteers was all we got.

We have general agreement amongst the first aid trained people that if they see a queue building up with the appointed first aider for an event that they should chip in and assist. I don't agree that 2 first aiders are needed - not formally at least. On balance there should be someone else in the race who can help the first aider out.

I had the opposite experience in Bray. No first aid incidents whatsoever.

Most people only need a wipe for grazes. In such events they can self medicate so the 1st aider can focus on anyone requiring more attention. This cuts down on the need for gloves.

At the first aid course we agreed that the first aider would bring water for cleaning wounds etc. At least then from race to race the water would be refreshed.
Jeff FitzsimonsMay 3, 2:37pmLoosely related, I've a set of crutches in the car for ages now which I put in there as I remembered seeing something about crutches going missing from the IMRA kit.

If they are wanted I'll leave them in the car and give them to someone at the next race, if not I'll find an alternate home for them.
Aidan BligheMay 3, 3:10pmHi,
That was some introduction to imra first aid, I cant remember seeing so many wounded at a race before.

Definitely a few lessons learned for me & future first aiders.

I never brought water. I agree with Gareth that most injuries require cleaning so several litres of water should be brought to every race.

Most people were able to get clothing to stay warm but for the lads who couldn't i should have handed out some foil blankets.

With regards to the kit there were very few plasters & antiseptic wipes. There were only 3 or 4 wound dressings, 1 triangular bandage & 1 pair of gloves. After the first pair got bloodied I was using my bare hands which is not great practice. At the first aid course we done we came up with a kit requirement list. Does anyone have that list? I think it might be useful to put that list on the website & in the kit. We need a system where the last person or next person to use the kit stocks it according to the
List. Alternatively maybe 1 or 2 people could be in charge of stocking it every few weeks. Any thoughts? Either way I need a copy of that list if possible as I need to stock it before next week.

On the volunteers, I wonder could we look at a running volunteer as the second first aider? Possibly just for rocky courses – 3rock, tibradden, sugar loaf. I note there are 2 down for next week which is odd as its one of the least hilly races.

On the plus side I can say it was a great race to learn & hone my new skills. Special thanks to Gareth whose mountain rescue skills were a great help and I can say provided me with a better lesson in first aid than any classroom can give. Also thanks Gareth for allowing us to use your own personal kit. Let me know what items need replacing and I can get them when re-stocking the imra kit.

Thanks also to Peter & everyone else who helped out & provided water to the wounded.

Great race overall
Dermot MurphyMay 3, 3:13pmJeff, that would be great if you could give us those crutches, will are still without any.
Paul SmythMay 3, 4:16pmPersonally I feel that best practice would be for each first aider to take responsibility for ensuring in advance that the kit they will use on the night is sufficiently stocked. It's been suggested that people post messages here stating that levels of a particular item have run low etc. Apart from adding to the 'noise' (i.e. mailings that most people aren't interested in) on the forums, I think that's a recipe for mistakes to occur. My suggestion is to be more proactive.

First Aiders should:

1. Obtain an IMRA First Aid kit in advance of the event they will be on duty at, usually by collecting it at the previous event. (We should probably have two such kits). If they can't arrange to pick it up then they should contact whoever will bring it on the night and check the contents with them.

2. They should purchase whatever is necessary to bring the number of items (swabs, dressings, gloves etc.) up to the required level. They should be reimbursed on the night in return for providing a receipt.
Paul SmythMay 3, 4:24pmOn the subject of people being cold.

I find foil blankets to be all but useless in anything other than quite mild weather. It would be better to have several real full-size blankets (fleece blankets are easily and cheaply available) in the first aid kit instead. Doubly important in the event of a case of hypothermia. In the event of a hypothermia case a couple of SOL Heatsheets Emergency Bivy Bags are very good and also very affordable and compact.
Mick HanneyMay 3, 6:56pm@Aiden, sounds like you had a baptism of fire, but you'll be all the better for it!

The first aider for next week should either ensure Jimmy is restocking or restock it themselves.

Here is a list I posted a few weeks back. After races the first aider should advise the safety officer what was used, what is missing etc. and should leave the kit as they would expect to find it.

• Triangular bandages
• Assorted bandage rolls
• Safety pins
• Swabs
• Gloves
• Small rubbish bags (sealable lunch bags would suit)
• Antiseptic wipes (lots of)
• Ice packs
• Compression pads
• Medical tape
• Allsorted pre-cut plasters
• Compeed plasters (for blister care)
• Plaster roll
• Scissors
• Tweezers
• Scissors (small & large)
• Antiseptic spray
• Antibiotic ointment
• Foil Blanket
• Sam splint
• Water (for wound irrigation) [1st aider should bring their own]
• Syringe – good for wound irrigation
• Midge spray – good for evening summer races
• Kissu (emergency shelter) (optional)
• Crutches (optional)
Mick HanneyMay 3, 8:51pmA 2nd fully equiped first aid kit mightn't be a bad idea. Or, have a backup kit bag stocked up with the usual first aid bits that tend to get used more often, so the main bag can be re-stocked at any stage, say during the race when the first aider has prep time on their hands.
Aidan BligheMay 3, 10:01pmThanks for the list Mick. I can go get it re-stocked and bring a reciept for next Wed. Charles Lyons is down for next weeks race, he is on hols at the minute but as he is a neighbour and mate of mine we can arrange handover of the kit when he gets back early next week.

This will save Jimmy doing it if thats ok with you Jimmy? On that note do imra have a prefered supplier or can we purchase stock whereever is handy?

Paul it is definitely a good idea to try get the kit in advance of the race in order to check it. I guess as we have 12 newly trained first aiders we will experience some teething problems but i would imagine we should sort all those out as the season moves on. Ideally from now going forward maybe the person handing over & the person recieving it can both check it & decide between them whether new items are needed or not.
Mick HanneyMay 3, 10:51pmSounds good Aidan. Any stockist should do. I believe there is a dedicated first aid supplier in Wicklow town near the Murrough that Jimmy uses (don't know the name of it offhand) but that is out of the way for Dublin based people. The bigger stockists like that would tend to work out that bit cheaper but probably not significantly so.

Diarmuid O'ColmainMay 4, 4:52pmAgree with a lot of what is being said here - there should be two first aiders, but experience is that we're lucky to have one. I was first aider at the Sugarloaf last year and there were at least two of us busy with injuries. Not sure what would have happened if I was really on my own - long queue or maybe people would have gone away and looked after themselves

And the first aider should bring a few litres of water for washing.

On the subject of equipment, there is no mention in the comments so far of ice packs. There were about 5 or 6 people at the sugarloaf with sprained ankles (visible swelling) to a greater or lesser extent, and I think we had 2 or 3 icepacks (I had a couple more personal packs). So, not knowwing how many ankle sprains there would be, I was making a judgement of the relative severity of the sprain to decide if I would give an icepack or not to reduce swelling. In hindsight, I feel we should have enough of them to be able to dish them out fairly liberally - they only cost a couple of euro each, not much in the context of a race fee of €7, and people would feel they were being well looked after. If a stock of 10 was kept in the kit there would be no issue.
Diarmuid O'ColmainMay 8, 8:48amOn mature reflection, however, we need also to keep the First Aid pack to a manageable size, so I'm not quite so sure about the number of ice packs to be held in it!

One further thought before I retreat from this discussion - almost all inujuries get treated at the race finish, rather than on the race route. Perhaps we should recommend to all participants that they keep with their change of clothes, an ice pack, a 2 litre bottle of water, a warm jacket/blanket, and some jellies/chocolate. If anyone needs First Aid, they can turn up to the First Aid person at least partly equipped to wait and to be treated.
Bernard MenthonMay 8, 10:44amIf we did away with the website we should be able to afford a couple of St. Bernards to patrol the hills, maybe get Skippy out to be ready to alert the authorities to any danger.....
Mark Needham NeedhamAug 15, 12:10amHi lads,

Only new to this site and just reviewed your first aid kit list.
Very good but You shoul add some electro lite powders or solution to it and also Celox. Compeed dont alwsys do the trick so mole skin and benzoid tincture is a safer bet. I would also stick in 2 Eppi pens just to be on the safe side. And simple soap and water rather than antiseptic wipes is more effective for cleaning wounds.

If i can be of any furthur assistance please let me know.

Mark Needham
Wilderness Medic @ Remote Medicine Ireland.
Diarmuid O'ColmainAug 18, 9:56amSorry everyone, it's me again! Just a couple of small points.

Firstly, IMRA is not intending to offer a primary healthcare service at the end of a race, just enough to get people home or to a hospital.

I'd be all for encouraging people to wash any wound out themselves with water as far as possible. Having eliminated most of the grit and muck they could be given cotton swabs and antispetic swabs to continue the job. Depending on the location of the wounds they might need the first aider to finish the job and put on bandages or plasters, but the more the casualty can do themselves the better.

Of course there will be cases where the injury is too painful or awkward, or the casualty is squeamish when the first aider should look after the situation fully - but these cases are comparatively rare.

Casualties may occasionally need to be advised to get professional medical help.

I agree with Paul about the foil blankets but surely all participants should have the sense to have some warm clothing with them at an event?

Re Epipen, my understanding was that under no circumstances should you use an epipen on anyone, unless it is their own prescribed epipen (for anaphylactic shock). But I'm no expert - any other views on this.
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