May 7th, 2008 by Carl
With the summer season just around the corner, a few tips on some basic First Aid might be helpful. In this simulation, you can see my friend and Wilderness First Responder, Lisa, stabilizing the patient’s (Jason) neck. Stabilizing a patients spine is super-important in critical care for all patients who have suffered major trauma, or where the mechanism of injury is unknown. In other words, when the rescuer doesn’t know what happened, and why the patient is suffering. The best position for a patient whose may have a spine injury is flat on their back, with a rescuer holding their head in what’s called ‘anatomical position’ – basically, as straight as possible. Moving the head, or allowing the spine to flop around, can easily cause the spinal cord to be ruptured, or severed, causing permanent disabilities to the patient.
One of the things about spinal injuries is that it’s quite possible for someone to be up and walking around even if they’ve suffered spinal injuries – including a broken back. It’s critical to carefully get the patient into a stable position, where the spine is supported and stable before any harm can be done to the spinal cord. In this simulation, Lisa and her partner found the patient lying in a pool of water, which meant a few things:
a) they needed to get him out of the water, out of his wet clothes, and dry as quickly as possible, and
b) they needed to get him into a spine stable position.
The foam pad underneath the patient helps immensely in keeping him warm. Up to 15% of heat loss is due to conduction, with water being 25% more conductive than air, concrete or stone is approximately 100 times more conductive, and the ground lies somewhere between water and stone, depending on its composition. So keeping the patient off the ground really makes a big difference to keeping them warm.
This simulation eventually required packing Jason up and placing him in a litter (a newer fancier backboard) and carrying him out of the field. That situation will require a number of people and assistants. The critical part, however, is the initial treatment. Once he’s warm and dry and stable, we can keep him there until further help arrives (assuming no further injuries such as increasing intra-cranial pressure or internal bleeding, etc).
If you haven’t taken any wilderness first aid courses, or have only a rudimentary understanding and knowledge of basic first aid, I’d highly recommend taking a course. There are some elementary differences between general first aid and wilderness first aid protocols, so it might be wise to look into a class framed for the backcountry. If that’s not possible, any first aid class is better than none (in general). The bigger critical care situations, such as this one with Jason and Lisa, can happen anywhere but are, fortunately, uncommon. But stuff like blisters, aching muscles, abrasions and bruises, allergies, etc, are very common, and it’s a good idea to be comfortable with them before you get back out in the woods.
Most places that teach these kinds of courses offer a Wilderness First Aid course, a Wilderness Advanced First Aid course, a Wilderness First Responder course, and a Wilderness EMT course. A basic Wilderness First Aid course is probably a great place to start, and get some understanding of how to deal with situations in the backcountry.