By Mary Fairchild
Alec Boyd Peshkin practices CPR with Wendy Madgwick.
When you are in the mountains, on a river, or out to sea, you need to ask yourself, "What would I do if something went wrong?"
This past week I met with 19 other people from the Midwest at the Aldo Leopold Nature Center in Black Earth, Wisconsin, for the Wilderness Advanced First Aid Course that was being provided by Wilderness Medical Associates. Half of our group was attending for recertification which is required every 3 years and the general mix included a few EMTs, a fire fighter, a search and rescue person, a physical therapist, a few youth group leaders, a whitewater rafting guide, a handful of kayak guides/kayak business related, and at least one other person like me, who likes to venture out and planned to raise their awareness of how to handle emergency situations in more remote areas.
Caitlyn, who was from Bayfield, Wisconsin, works for the National Park Service in Alaska where she spends her summers with another park staff person kayaking and camping as she patrols the campsites and the area. Part of her repertoire involves carrying a gun to protect herself and others in the case that a bear, or bears, could get out of hand.
Sherri Mertz splints Wendy Madgwick's leg.
Haris, In more remote areas you may have to stabilize and evacuate someone who is sick or injured on your own. How would you plan to do that? The answer to that question is what I would "single out" as the summary of our 4 days of training. Classroom information was put into action by acting out "scenarios" to create the experience and practice needed to gain real competance at this.
Let's say you are setting out on a paddle with a friend "on a big cold lake." When you paddle out away from the city, you begin to experience a sudden sharp pain in your abdomen like you've never felt before but it resides. As you paddle throughout the next few hours you feel hot and sweaty and begin to develop a severe headache. Then, the pain in your abdomen returns.
Your friend, who is trained in wilderness medicine, begins to ask you a series of questions to check how serious your symptoms might be while watching you more closely. Do you have any alergies? When did you eat last? What? Where you taking medication? How long have you felt this way? You soon find it hard to paddle and answer your friend and he quickly helps you brace yourself by leaning you forward in your kayak while he tows you to shore.
Good thing you were not alone on the big cold lake today...
On shore, your friend gets out his first aid kit and begins to take notes while calmly checking your pulse and breathing rate. After noting they are a little high he decides to get a t-shirt wet and tries to cool you down with it. You could be a bit anxious about the situation and the elevated pulse may not be so serious at this point.
It could be food poisoning or the flu at this point, but your friend doesn't like the pain in your abdomen and begins to feel for it. You moan in pain as he lightly presses on your spleen which feels a bit swollen. It's been five minutes since he checked your pulse so he checks it again and notes that your pulse and breathing have increased and you appear to be getting light headed. He also notes that your skin appears a little yellow.
The swollen organ combined with fever, and continued increase in pulse are considered critical and your friend calls for emergency evacuation. You are in the early stages of shock and as your body works to compensate you may soon need rescue breathing or CPR. Your friend is trained to do this for you.
Later, after you are stabilized in the hospital, you are diagnosed with the water-borne infection, Weil's disease. It is treatable by antibiotics, but it sometimes leads to organ damage and even death. It is caused by contaminated water--oralfaecal contact usually infected rat's urine in the water. The infection is commonly transmitted through unhealed breaks in the skin, the eyes, or with the mucous membranes.
Paddlers can minimize this risk by learning the infective risk of the waters they take to. Infection is logically more likely in slow-moving water where rodents are present; lakes, ponds and canals are more likely to be contaminated than fast-running streams. Weil’s disease is considered to be one of many typical paddling hazards. Paddlers should cover all cuts and abrasions; avoid splashing themselves, or swallowing potentially contaminated water; wash their hands carefully and if possible shower afterwards; and wash all equipment and clothing regularly. Anyone experiencing flu-like symptoms after contact with fresh water should see their doctor immediately.
Sawyer Alberi and John Browning of Wilderness Medical Associates demonstrate how to tie a tournicate.
Our instructor was Sawyer Alberi, a graduate of the US Coast Guard Academy, and an EMT-P who served in Iraq as a Vermont National Guard Combat Medic. Our associate instructor was John Browning, a Wilderness EMT who works in urban EMS for a private ambulance service.
Sue Gjerset, from Minnesota, splints Alec Boyd Peshkin's arm with a little consoling from Nancy Moore.
Our days were mostly dedicated to "getting experience," but you must truly understand the principles behind the procedures in order to prepare for medical emergencies...
...The vast majority of situations...are well within the capabilities of every backcountry traveler to handle. It is your right and responsibility to know, at least in general terms, how your body works and how to fix it when it's broken. (1)
David, who is on Search and Rescue in Iowa, prepares to splint Greg's arm.
Experience, thankfully, can often be difficult to come by yet we need to combine experience with our medical information in order to become competant at it.
References
1. The Outward Bound Wilderness First Aid Handbook, Jeffrey Isaac; Introduction.
2. Ibid., p. 213.
3. Ibid., p. 214.
4. First Lead
