Re: Wilderness First Aid
Timothy J O'Leary (tjo@CPTCHR.AFIP.MIL)
Mon, 12 May 1997 05:46:12 -0700
Note that I am not an ER-doc or a surgeon, but I think Jon has mostly a
very reasonable approach. Let us think about the possible injuries and
what we can or cannot do:
1. Intracranial hemorrhage - this is very bad, and I cannot do a thing
about it. I'm not going to carry high-dose steroids, which might help,
plus the IV kit to deliver them in, and I am not going to be able to
neurosurgically decompress on the trail. Remedy: Evacuate.
2. Vertebral injury, spinal cord at risk. Very bad, but worse if I move
inappropriately. I don't have a trained team, even if I had a backboard,
which I don't, and I don't want to have a bunch of 12 and 14 year olds
learning for the first time on a real injury. Remedy: Get in a team that
knows what they are doing, and evacuate.
3. Internal hemorrhage. Very bad. I don't have an OR handy, and I'm not
competent to use it. Remedy: Evacuation.
The basic message is that in this day and age, if there is the possibility
of serious injury, you need to get a trained team of EMT's in, and get the
patient out. There are only a few exceptions, such as drowning - even if
there is a spinal column injury, it won''t do to leave someone under the
There is probably no point to the splinting exercise, though, since
manipulation increases the possibility of injury. And, since shock
WILL SET IN at some point, you should be prepared to do what little we can
in a first aid situation.
Now the real question: what are your Scouts doing "bouldering." This
sounds to me like a preventable accident. Pardon the shouting, but THE
BEST FIRST AID IS THE FIRST AID YOU DON'T HAVE TO GIVE BECAUSE YOU
PREVENTED THE INJURY FROM HAPENING IN THE FIRST PLACE!!!!!
I have never seen an injury occur in Scouting which was not the result of
somebody doing something stupid. The major reason for having the adults
around in the first place is to keep an eye our for safety. One of the
reasons I started the troop my son is in is because the adults of his
previous troop weren't doing a very good job of this, and they didn't seem
to be trainable when problems were pointed out....
Timothy J. O'Leary, MD etc
CC Troop 772, Post 769, etc. NCAC
On Mon, 12 May 1997, Jonathan Dixon wrote:
> From: Steven Featherkile <madwolf@EARTHLINK.NET>
> > Here's the situation. You are 2 days from the trail head, over Hell for
> > Sure Pass (it really exists) and 10 map miles from the nearest
> > backcountry ranger station.... Two of your experienced
> > scouts are bouldering, and one falls 15 feet, sustaining multiple
> > injuries....
> I send two people to the nearest point of "civilization" to get help
> as quickly as they can ....
Terry Howerton Sakima Group, Inc. SCOUTER Magazine Kansas City