Last Weekend: Wilderness First Aid

One of the rationales for my solo camping trip was to figure out the gaps in my wilderness knowledge, when I didn't have other people to rely on. One thing that I realized I only had minimal training in was first aid/medicine. Also, in general, basic first aid is up there on my list of "general life skills for making myself into a more useful human being" (there are loads of others on that list that I'm not making any headway on, but hey).

So I finally raised my activation energy to do something about this, and went to a two-day weekend class on Wilderness First Aid offered by SOLO School in Conway, NH:

Accidents happen. People get hurt, sick, or lost. The temperature drops, the wind picks up, and it starts to rain. Would you know what to do? Many backcountry emergencies are preventable, and even when bad things happen, sometimes the wrong care can make things worse. By learning a few basic skills, you can make the difference between a good outcome and a bad oneā€”and maybe even save a life.

The school has a great campus (a few buildings off the main road), and the instructors did a great job of mixing classroom instruction with outdoor demonstrations and "scenarios"--a portion of the class playing injured patients who we would have to diagnose and treat.

Our instructor was utterly fantastic--an outdoorsy, rock climbing, working EMT/firefighter... who was also a seriously cute blonde woman. Yep... afraid it was quite easy to pay attention in class ;). But seriously--she was a great instructor--very dynamic, funny (plenty of EMT-style black humor), and experienced. She did a good job making us realize the limitations that we will have in the backcountry--she would describe a set of circumstances that a patient might present with, and then say, with a pixieish smile, "... and then they'll die. It's sad. But there's not really anything you can do."

The course had far too much information to talk about in detail. A few interesting points:
  • They gave guidance in judging relative priorities--e.g., a patient looks like they might have suffered a neck and spine injury, and the head needs to be immobilized in the neutral/rest position... but obviously, if the airway is blocked, duh--you gotta do something, or they will die very soon... so move that head. The usual airway, breathing, circulation checks.

  • One of the priorities in wilderness first aid is that you're not going to be treating most problems out in the woods--so the priority is to figure out what is going on with the patient, record all the important information, and get that to folks who can do the medevac. Such as--judging whether there was a spinal injury (need to bring in enough rescuers to carry somebody out in a neck immobilization rig), time of injury, responsiveness, number of people in the party left at the site and their condition (cold, tired, hungry), etc.

  • New limits in personal space discomfort! One of the intial tests you ought to do is called a "chunk check"--hand-checking the head, torso (including spine), hips, and thighs for signs of major, immediately life-threatening injuries. There's the risk that if you don't go through systematically, you might be missing a major injury on the underside of a patient, if you're concentrating on that broken arm. So we needed to do a full "squeeze/prod/feel" on a partner (a complete stranger... although it made me grin when the instructor described the procedure as, "it should feel a bit like a massage.") A bit outside my personal comfort zone, but good practice for sure.

  • One of the things when doing a secondary assessment is called a, "Last In and Out"--last meal/drink, and last bowel movement. This actually has some pretty real-world applications--stories of kids in group camping trips who came down with abdominal pains serious enough to require medevac, because they were unable/unwilling to use the primitive facilities. It reminds me of a story from a David Sedaris' books on his childhood Greek-American summer camp experience:

    Camp lasted a month, during which time I never once had a bowel movement. I was used to having a semiprivate bathroom and could not bring myself to occupy one of the men's room stalls, fearful that someone might recognize my shoes or, even worse, not see my shoes at all and walk in on me. Sitting down three times a day for a heavy Greek meal became an exercise akin to packing a musket. I told myself I'd sneak off during one of our field trips, but those toilets were nothing more than a hole in the floor, a hole I could have filled with no problem whatsoever.

  • A Therm-a-Rest sleeping pad makes a pretty neat improvised splint:

    One thing the instructors suggested we pay attention to--set up the inflation valve near the person's ankle. Unless you're really comfortable with putting your mouth into their crotch and blowing.

They disabused us of any grandiose ideas of working medical miracles with a pocketknife, paracord, and a Nalgene bottle out in the backcountry--i.e., "...great, then you'll be stuck on the side of a mountain with a corpse with a few pen barrels sticking out of his throat." She sought to keep us on a realistic footing--"Mostly, you're going to see cuts, scrapes, breaks, allergic reactions... maybe hypothermia or heat stroke... stuff like that."

Most students were there to meet requirements for becoming a camp counsellor/scouting group leader, or continuing re-certification. But the folks who were there of their own accord were some pretty interesting characters. Such as an electrical generator operator at Beth Israel Deaconess hospital who is having a go at making a living working in the wilderness, instead of a 120 degree boiler room. Or a car-free woman who biked in from Portland, ME, who was in the process of bailing from a 9-to-5 job to go lead cycling tours for a living (nope, not single, in case you were about to needle me about that).

It was interesting to note that many of the topics we covered in class are things I am personally familiar with, just from my life experiences:
  • Seeing a friend go into a diabetic hypoglycemic state (and seeing how he behaved), and how they got him out of it
  • Seeing a coworker have a seizure, rolling him on his side to keep him from choking on his vomit, and then running to go summon medical help
  • Having a friend who had his neck broken (hangman's fracture), walked away only reporting a sore neck, and then had to spend six months in a halo neck brace
  • Knowing somebody whose torso was run over by a truck and lived to tell about it--they informed us that the torso can withstand 2000 lbs of compression

Anyway, if anybody has an opportunity to take this class, I'd strongly recommend it. I'm considering going back for the week-long Wilderness First Responder class. And in general, getting further down my list of "general life skills for making myself into a more useful human being" would be awesome too. Perhaps the motorcycle safety course...


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