Re: Backcountry Emergency: Evaluation
Norman J. MacLeod (gaelwolf@MARLIN.SSNET.COM)
Mon, 5 Jun 1995 19:49:57 EDT
You said -
>The SAR types seemed overly cautious, but then they are the poor soles
>who have to go in and resuce people who don't get help soon enough.
>Better to err on the side of safety.
Perhaps we seem overly cautious to you, but - as you say - we are often the
ones on the pointy end of the stick when it comes to geting folks out of
trouble that goes far beyond their skills.
A good share of that caution comes from having to go out to attempt to bring
someone back to hospital, only to find that they have died primarily as the
result of the group's lack of emergency medical skills. Unfortunately, many
of the Leaders I know are rather less than capable when it comes to the
possiblity of having to deal with a serious medical emergency while out in
the bush. This goes for groups who are involved in some fairly intensive
backpacking as well as canoe trekking.
Most injuries and illnesses can be managed by a well-trained group well
enough to bring the patient out of the bush and into the hospital setting
without serious problems beyond the original injury or illness. I think it
is in every Leader's self-interest to obtain the highest level of emergency
medical training that is available in his or her community. Even more
importantly, it is in the best interests of the Scouts and Guides we work with.
>Several MD's replied and alluded to the differences in ability. What I
>have found out and been told in trainings is that an MD or a nurse is not
>necessiarly a first aider. It sounded like those who replied are well
>versed in emergency procedures, but some are not. I have encountered
>several whose practices were so removed from anything that required first
>aid that they were not as qualified as someone who had Basic Red Cross
>training. That is probably why GSUSA (or is it our concil?) requires us to
>have a certified first aider and won't allow nurses or MD's unless they
>are certified first aiders.
There is more than a grain of truth to what you say here. There are a lot of
physicians who are very uncomfortable in an outdoor setting, as well as
those who are in specialties that are far removed from emergency medicine
and surgery. Many physicians at the scen of an accident or wilderness
medical emergency will step back and follow the lead of the responding
paramedics, EMTs and SAR professionals. Taht said, I am also very comfortble
to have any type of physician around when something happens far from
hospital, since they can often provide legal authority for us to do more
medical care activities than we might otherwise be able to do. While
enabaled to work independently to a large extent, there are still some
things that we need to be in contact with a physician preceptor by radio -
and ther are places (the bottom of ravines, for instance) where we can't get
out by radio when more than a short distance from base. If we don't have a
helicopter or other aircraft to provide relay in such locations, a
doc-on-the-spot is an invaluable resource.
Terry Howerton Sakima Group, Inc. SCOUTER Magazine Kansas City