Crash scene -what do you do?

[PrincessBandit]

Never mind safeguarding your bike - think of yourself first.

It makes sense that you need to think in terms of your own safety when dealing with any injury to others, whether it be simple cuts/grazes etc. or at the other end of the scale full-on triage scenario. But I would go more for personal safety by ensuring that you remain in a condition yourself to be of assistance e.g. doing your best to stay out of the line of fire regarding bypassing vehicles etc. In terms of protection against infection or blood borne disease, maybe surgical gloves could be a handy compact item to keep in our pack/pocket/medical kit when we're on the road. I never really thought about it till now, although we do have some in our first aid kit in the bathroom [not much use there if you come across an accident on the road though]. As for mouth to mouth, well, you are either moved sufficiently by the victim's plight to do it if you consider it necessary or not. We should all give serious thought to what we should/could do (especially those of us who are not medically trained) as in the heat of the moment we might be less likely to dither or procrastinate. Another good reason for carrying (charged ) phone - never know when it might be needed, and not necessarily for yourself!

[discotex]

This is turning into a novel sized discussion..

Just checked in so excuse late reply. Can't agree that stigma is promoted by the post. Tho mighta been better to highlight as you did that this is not going to be a factor most cases. I just think it is best to be as safe as possible - and most responsible. In no way did I suggest people should not do CPR on others. It is possible to have a win win and no worries -

Ok fair call that you didn't actually say don't do it but you certainly made it sound like helping someone in need is an extremely a risky thing to do which is not actually the case (aside from the moving cars and petrol etc)

?Billion to one odds of transmission you say - now thats going to the extreme -if it were not a fair concern they why did our qualified CPR instructors always cover this and recommend masks?

Most likely that they're expecting professionals to encounter many incidents where they would risk exposure - ambos, firemen, police, etc. I imagine they then use the same standard training material for corporate courses.

And can you back up your odds comparisons?
I'd doubt it - as the numbers of tattoos done would allow good ballpark estimates of odds of catching a bbv - but the infrequency of CPR would make sure no good stats can be gathered on this possible mode of transmission.

We could do some basic guessing... Canadian OSH stats there is a 0.3% chance of a needlestick/direct-cut-contact resulting in an HIV infection. Hep C as 1.8%.

I'm sure someone so inclined could do the maths and work out:

1) the odds of the particular victim having HIV or Hep C
2) the odds of yourself having an open wound and getting infected blood in it (largely a guess but very low unless you were in the crash yourself)
3) add the percent chance above

I'm sure there are a number of other factors that all reduce the likelihood. Personally I do think it'll be in the 1:million to 1:billion range.

I'd be interested to know (I looked but couldn't find) what the number of non needle-stick blood exposure related HCV or HIV infections per decade is in NZ. I'm willing to bet it doesn't make an average of 5 per decade.

I'd agree it is not a huge risk but its a lot higher than billion to one - for one the main risk group (iv users) is at greater risk of serious crashing than most of those outside the risk group. At about double the risk (IMMORTAL study). Some risk of dealing with someone with a bbv is therefore there. A risk that can be eliminated is worth considering.

You make a big assumption (incorrectly) that it's mainly druggies that:

a) crash - as although risk of crash is higher number is still very low as there are very few iv drugs users compared with the general population - 2x10 is still lower than 1x1000 for example.
b) have Hep C - Although new cases are largely iv users as far as I know the majority of Hep C sufferers in NZ are hemophiliacs that were given infected clotting agent before blood screening came in in the early 90's.

When you have had a needle stick injury and months of worry as a result of attending to someones healthcare without employing sufficient self care techniques, I think maybe you'll relate to the safety first principle. It cant hurt anyone, so whats the issue .

In a nutshell....

If a life isn't saved because someone doesn't have a mask that's doing a lot more harm than infecting someone with Hep C. Hep C is hardly a life-ending disease anyway (although shortening in a percent of cases).

There's nothing wrong with considering it as one of a whole host of things in life that are a risk. That said I think you overstate the risk at the risk of scaring someone into inaction.

My other issue is with the tone of your post (largely the quoted bits). It comes across to me as very negative towards people with blood borne diseases (in other words it comes across that you're saying "they're all gay druggies so watch out" but more politely). I'm sure that's not what you mean to convey but.....

[candor]

This is turning into a novel sized discussion..

Most likely that they're expecting professionals to encounter many incidents where they would risk exposure - ambos, firemen, police, etc. I imagine they then use the same standard training material for corporate courses.

I'd be interested to know (I looked but couldn't find) what the number of non needle-stick blood exposure related HCV or HIV infections per decade is in NZ. I'm willing to bet it doesn't make an average of 5 per decade.

You make a big assumption (incorrectly) that it's mainly druggies that:

a) crash - as although risk of crash is higher number is still very low as there are very few iv drugs users compared with the general population - 2x10 is still lower than 1x1000 for example.
b) have Hep C - Although new cases are largely iv users as far as I know the majority of Hep C sufferers in NZ are hemophiliacs that were given infected clotting agent before blood screening came in in the early 90's.

My other issue is with the tone of your post (largely the quoted bits). It comes across to me as very negative towards people with blood borne diseases (in other words it comes across that you're saying "they're all gay druggies so watch out" but more politely). I'm sure that's not what you mean to convey but.....

Tone is hard to convey I once had a partner with it and he was often ill and care both sides prevented transmission. So rest assured I'm far from "judgmental" - just aware its best avoided if you like eating fish n chips without a nausea response (:

No most crashers are not drug users but they are still shown in many studies to crash way more than others so that would up the odds. A quarter or less of IV users are in treatment programs and in NZ they are tested showing a 70% prevalence. Current IV users being 1% of population the sometime users would be more. At a guess 2%. If they crash twice as often as studies siggest that makes 4% of crash victims with the iv user status risk factor and a 7/10 chance of a bbv so back to 3% again. And much much lower for hiv. I'd call a one in 30 chance would make precautions worth considering - maybe not if it was a one in 3000 tho. Everyone would have diff risk acceptance I guess.

Yep my CPR training was prolly directed to people with higher risk exposure (hospital staff). A cursory fact finding look at the hep c website in response to someone saying hardly anyone has it, saw only iv users not haemophiliacs mentioned. The numbers weren't insubstantial and an awareness ad I just on telly the first time a few minutes ago said there are 30g diagnosed, with large numbers also not.

As for the number of non needle stick blood exposure caught bbv in a decade I can assure you it is much higher than 5 a decade. I have 2 friends who got hiv thru sex, and my mother worked as an hiv specialist nurse for 20 years and dealt with many cases of hiv caught by both sexes through partners they thought were faithful. Thats how one of my mates got it - did not make for a harmonioos relationship the few years after diagnosis tho they are OK now. Nuff said by me - hopefully .