I view the world of medicine thru 3 windows. First is the window thru which I am currently employed. It is the world where one has an entire hospital to back you up. It is the place where a higher level of medical care is only a shout away. This is where guidelines like "Do not remove impaled object from the patient", or "Keep the C collar on until the Doctor clears the spine" should be followed. It is the window that is available to you thru a Red Cross First Aid and CPR course. It relies upon the idea that there is an EMS truck around every corner. In this world, guidelines from your training should be followed to the letter.

The second window is a wilderness setting. Back in 1999, I took a Wilderness First Responder course. I highly recomend that anyone preparing to survive be trained to this level. This course, as well as this world, is different than the first. Higher levels of medical can be hours to days away. The situation is often ruled not only by the injury, but also the weather, the terrain, and the distance that must be crossed to get to a hospital. It relies upon the idea that help is available, but it is going to take more effort than just dialing 911.
Guidelines are still there, but they are a little looser. Impaled object can be removed under certain conditions and you are taught to clear a spine for example.

The third window is a survival setting. This whole world is defined by you, as only you are in the situation. As a result only you can make the choices, and you will have to live with the results, what ever they may be. Do you follow the guidelines of your training or do you toss them to the side? Do you attempt a procedure that you have only read about, or do you stick to your scope of practice? Does the patient survive? This is a very gray area. Doing nothing in some cases may be better than something, in other cases it may be worse.

Bottom line is that haveing some training under your belt is a good idea. Know yourself, and be prepared to do what you think you need to when the time comes. Others may judge you later, some for doing nothing, others for doing the wrong thing, but only you know what was the right thing.

My two cents.
Phishi