For those of you interested in taking a Wilderness First Aid course, the Knox County Red Cross chapter offers the certification classes regularly because they are required for many of the scout troop leaders.
Later
this spring the certification requirements are changing, and CPR
training will be a pre-requisite. I wish I’d had CPR training because a
lot of the class assumed that knowledge. Breathing, as it turns out, is
the most important thing when you are trying to keep someone alive.
That, and preventing them from bleeding to death. Who knew? : )
I
actually failed one of the two (poorly designed and ridiculous)
multiple choice tests – but I still got my Wilderness First Aid
certification which is good for three years. There’s some initial
reading required, then two days of lecture, discussion, and small group
application scenario activities. Overall it was really worthwhile and I
learned a lot (despite failing the test).
The first
thing I learned that surprised me is that there are no helicopter
rescues in the Smokies. The mistaken assumption that if you get hurt
someone will just airlift you out may contribute to hikers’ cavalier
attitude toward their own safety. Right now the air force base
helicopters and personnel (who in the past have done such rescues) are
deployed overseas. The sheriff’s department doesn’t know how to use a
copter for a wilderness rescue. And, even when copters are available
there are few places in the Smokies where they can land. So, since
there is little to no cell phone reception in the Smokies, if you get
injured you’d better hope that you can walk yourself out or keep
yourself alive for the day or two it will take for someone else to hike
out, find a ranger, and for the rangers to come and get you (with
horses if you are lucky). Keep in mind that nearly every month of the
year it’s likely you’ll get hypothermia if you can’t make yourself a
shelter to stay dry and warm. As you can imagine it was a sobering
lecture.
Wilderness first aid is as much about being
prepared and anticipating the worst as it is about how to give urgent
care when help is delayed. One of the major things I came away with was
an updated gear list of what to carry:
Random reflections on hiking gear:
•
I was surprised how many in the group had never heard of the ten
essentials. There are (at minimum) ten essential gear items everyone
should have, no matter how short the dayhike. Here’s one version of the list.
•
I’m now even more convinced that, in the winter, wool underwear is key.
Our instructor fell into a river in the winter while hiking in the
Smokies, but her wool underwear helped prevent hypothermia.
•
Two bandanas are essential. Bandanas can be used for a plethora of
things while hiking, including, as it turns out, compressing wounds to
stop bleeding, making splints and making a sling for injured arms.
• Triangular bandages are lightweight and even more versatile than bandanas
•
Sanitary pads are the BEST for stopping bleeding (think about what they
are designed to do!) and they are lightweight and individually wrapped
(sanitary.)
• Our instructors recommended a straight
up Swiss army knife over a multi tool and wet wipes instead of hand
sanitizer (which all three agreed causes more harm than good).
• Having a watch in order to take the pulse of the injured person is important.
•
Here are three items that I am going to carry every time I hike,
because staying warm and dry overnight is of the utmost importance, and
everyone should hike assuming they might need to spend the night
outside:
o Emergency bivy sack which can serve as an overnight shelter
o Survival blanket
o Esbit tablets and stove for emergency fire and boiling water
• A 55 gallon contractor weight garbage bag is good to keep in your pack to use for emergency warmth and shelter.
•
Cutting up any old z-rests or non-inflatable sleeping pads into
day-pack size portions for insulation to be used in emergencies, as
well as lunch seats.
• Carry benadryl and ibuprofen,
but never administer medication to others. Your injured person can
self-medicate but you don’t want to be giving each other drugs.
• Keep your emergency/first aid supplies separated out in ziplocks to avoid everything getting wet when it’s raining.
• Relying on a GPS for navigation is stupid. However, it’s signal may help rescuers pinpoint where you are.
• Know where things are in your pack to avoid wasting precious minutes rummaging through everything.
Other hiking and safety tips
• It’s important know the basic health history of your
hiking companions, especially relevant medical conditions such as
diabetes or allergies.
• The Good Samaritan law
exists in all 50 states. It means that if you help someone in an
emergency situation, you can’t be held liable (though you can be sued). Lots of people are
afraid to help others out of fear of lawsuits.
• Don’t ever burn poison ivy – it will, indeed, get into your lungs and, well, that’s just awful.
•
The only time CPR will be useful in the backcountry is for drowning and
lightning victims. In those situations you actually have a chance to
restart their breathing and keep it going until they can breathe on their own.
•
When you are hiking with others, YOU should know where you are on the
map (and you should be carrying a map) and how to get back out to the
trailhead. Don’t rely on others to guide you – be prepared in case
something happens to your leader. If you have to send someone out for
help, be sure they can find their way back to the car (that they have
the keys!) and that they can find their way back to the injured party.
Over
the course of the weekend we learned basic first aid for a wide variety
of injuries – from impalement to chest wounds to broken bones to shock
to lightning strikes to hypothermia. Unfortunately pretty much every
lesson ended with “and evacuate as soon as possible” or, better yet,
“immediately.” Well, that’s easier said than done in the backcountry,
of course, which really brought home the seriousness of getting hurt on
the trail.
We learned how to assess the situation,
triage care, safely move the patient, and make a plan for action. The
basic first aid mantra is check – call – care, though I think in
wilderness situations it’s more like check – care – call, since you
can’t call 911. First check the scene for safety (so no one else gets hurt) and check the
patient for injuries; then prioritize care, administer urgent first
aid and protect the patient from the elements; then make a plan for
how to call for help – which means either leaving the person while you
go and get help, or waiting until the person can hike themselves out
with assistance. I would hate to leave an injured person in the woods
while I hiked back for help, but realistically no one is going to be
carrying anyone else out without putting themselves at risk. Finally,
you continue monitoring vital signs (looking for trends) until help
arrives.
In conclusion, ALWAYS hike with a minimum
of three people. That way if someone gets injured, one person can stay
with that person and the other can go for help. Oh, and only one person
is allowed to get hurt at a time, if at all. Scary stuff. But it's kind of like being prepared for the unlikely event that your house gets broken into, your car breaks down in the middle of nowhere, or your computer crashes (to steal a comparison from Kris & her friend Chris) - probably it won't happen, but when it does, if you aren't prepared, the consequences can be dire.
