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First aid training?

As I have searched the topics on the Reflector, I find a few threads discussing what to have in a first aid kit, and many posts advising ops to carry a first aid kit. I have not seen any posts describing first aid training.

I’ve spent several decades wandering the hills and mountains in North America and, occasionally, the UK and Europe. Adding a radio to the backpack is a relatively new addition. During that time I’ve fortunately encountered few medical emergencies, but they do come up. Some notable ones in the past few years include having to stabilize a companion’s ankle after a sprain on a back-country trail so that we could walk out to the nearest town, and a hiker who stumbled and hit his head on an inconveniently located rock (in addition to facial abrasions, concerns about neurological effects had to be considered). I actually am a physician, but I retired from hands-on clinical practice years ago. Besides, being trained to be one of a team of professionals in a well-equipped emergency department is much different from finding yourself the sole care-giver in the wilderness with only what you happen to be carrying!

This past weekend I finally took a formal course in wilderness first aid. This one was offered by the National Outdoor Leadership Institute (NOLS), a US institution dedicated to teaching wilderness skills. On Friday evening I took an update for, and recertified in, cardiopulmonary resuscitation (CPR). On Saturday and Sunday, in16 hours total, we covered diverse topics including (but not limited to):

  • initial assessment of the victim in a wilderness setting
  • safely moving the victim to permit assessment and protect breathing
  • stopping bleeding
  • stabilizing fractures
  • treating dislocations
  • caring for burns
  • recognizing and treating for shock
  • recognizing neurological complications
  • emergencies from underlying medical problems (allergic, diabetic and cardiac emergencies in particular)
  • deciding when evacuation is warranted
  • composing a medical alert for radio or cell transmission.

All topics were taught in the context of what you as a responder would have available in the back country, far from clinics, pharmacies/chemists, and rapid-response ambulances.

Even with my medical background, I learned some new things related to care in the back country, and I hope to take some more advanced courses. My classmates almost all were from non-medical backgrounds and they came away with completely new insights and skills. We unanimously felt the instruction had been valuable.

What do other SOTA enthusiasts do to ensure they are prepared to use the contents of those much-discussed first aid kits, and to be prepared for medical emergencies in the hills?

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IHi Scott, you’re right in that there is generally a difference between care provided in the field and that provided by doctors. Equipment is just one of the factors. I carry a basic first aid kit and keep my first aid training up to date for work. Food, drink and protection from the elements are also important especially in the more remote areas.
However (especially as one who spends most of my walking time on my own), I think my main defences are:

  • Having a means of calling for help (mobile phone and PLB)

  • Making sure someone knows where you are going and what time you’re expected back

  • Making sure they know what to do if you don’t make contact at the expected time

A large stone or a good brandy for anesthesia ?

I also followed a first aid course, but i’m not sure to be able to help without any equipment and retraining course…
I’m mostly alone and sometimes i say to myself that i’m a bit foolish… A bad slip and i will be found eaten by wild boars if found one day !

The cellphone does mostly not work in our mountains and having a CW QRP set in the rucksack would not help a lot for calling for rescue… :grinning: , maybe SOS SOS ?

73, Patrick.

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Wilderness First Aid training is more useful than any first aid kit you can carry, and it doesn’t weigh anything! I’m due for recert, need to find a course myself.

In the US, it should be possible to find a Wilderness First Aid course. A few years ago, the Boy Scouts started requiring that training for groups going to their high adventure bases.

It is a 16 hour course and you need to recertify every two years. I first took the course about ten years ago. I was retroactively terrified that I had ever gone into the backcountry without WFA training. I have used the training a few times since then.

WFA is also excellent training for disasters. Any widespread disaster will create more medical emergencies than the first responders can get to. Skills in assessment, early treatment, and stabilization can make a huge difference in survival rates both in the backcountry and in town.

If you are curious about the contents of the course, here is a link to the current curriculum for BSA-compliant courses. The NOLS course should be similar, they are an excellent organization.

wunder

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I was the first-aider for my area at work, with two day refresher courses every two years. We covered everything on your list, though as I remember it the CPR changed every year! Having been retired for a dozen years I am not up to date but I think I would still do more good than harm even if my CPR is well out of date!

Take a sat phone, call 911, 000, 999, 112, 106 or what ever works in your country, and ask for Ambulance and follow the advice they give you. Youll get the most current advice suitable for your local conditions with out having to remember all of that stuff your self.

Make mine a double!

I have been variously 1st aid trained/qualified for well over 45 years and have had the misfortune to be present at and dealt with a number of mountain accidents. I’ve also been a tour-guide/Mountain leader on many long distance walks in the UK & Eire.

My experience is that the injuries encountered vary depending on whether a) you are on your own and/with friends, or; b) accidents involving people you don’t know very well and accidents involving others you simply encounter. The former in my experience are normally minor and the later b) can often be fatal.

Most common injury encountered? Blisters by far. Encountered in a group, if not dealt with early, can cause big problems if you need to keep a whole group together. One person can incapacitate a whole group!!. Not likely if you are an experienced walker and so are you companions.

Next most common? minor cuts & grazes but rare in my experience and can largely be ignored.

In the UK you are extremely unlikely to be beyond Mountain Rescue help for more than the time it takes you to call them and for them to reach you which may just be a a couple of hours.

Registering for this service for calling 999 (UK emergency services), increases the range of your signal. But you need to register.

https://www.ngts.org.uk/how-to-use-ngt/contact-999-using-ngt.html

1st Aid training will stop you making the wrong decisions to avoid making things worse, It will also give you confidence to deal with quite severe accidents. If you have choice choose an outdoor oriented course like Wb8icq mentions and for the same reasons and also to avoid dealing with accidents in the same way you may do at home or in the street.

Dave Perry
Robin Hood’s Bay

Just to note that dialling 112 has no advantage in the UK over dialling 999.

My 1st aid trainer even tried telling us 112 used satellites rather than the mobile (cellular) network - sigh!

what is the advantage of registering then?
Without registering can you send a text msg to 999?

I thought that a txt msg will more likely connect than a voice call if you are in a poor signal area?

Dave P

First Aid training??? ABSOLUTELY…
Our SOTA team is all seniors (around 70) and each one carries a First-Aid kit. We all have varying skills and training in: First-Aid, EMT, Survival, & Military.
We also carry a “In-Reach by Garmin” and subscribe to “GEOS”
{cell-service is unreliable in the Appellation Mountains}
Our team has been called on to help in a number of recues this past year.
Everything form a simple fall to a lost hiker in the wilderness. To say nothing about down trees, rock slides etc.
We will be taking part in refresher training during February on “Wilderness Survival” by one of the local rescue groups.
AND some of us will be taking the “Wilderness First-Aid” training by NOLS this summer…
WHY???
While you can not take everything you might need; you CAN be trained & prepared, for what might happen
73 Tom ~ W1PTS

Yes - you will be able to send a text message (this is UK only of course) which, as you say, will get through when voice does not.

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Agree with much in this thread about the value of comms, leaving a “flight plan” with someone not on the trip, and training, versus packing tons of first aid gear. Having said that, in some wilderness regions, rescue may be a long time coming and you need to think about a well-chosen first aid kit that balances effectiveness with considerations of bulk and weight. In my experience, many off-the-shelf commercial FA kits are long on supplies for minor inconveniences (band-aids and the like) and short on things that would really help, maybe even allow limited self-evacuation, like a Sam Splint and duct tape. Wilderness FA training can be helpful in suggesting such high-utility items. One of my favorites, that I learned there, and have also seen used in cave rescue training, is a small Thermarest - type inflatable seat pad. Rolls up small enough for a SOTA pack and acts as a comfortable seat in a normal activation, but can also be used to keep an injured person off cold ground, and if someone breaks or sprains an ankle, leg, arm etc. it can be wrapped around with duct tape or webbing and partially inflated, for an easily - adjustable immobilization device.


You need to register. But 999 or 112 are just the same (in UK). Ditto for emergency non-home-network access - both numbers are held in UK SIMs to allow this.

First Aid training is really useful, if nothing else it can make any conversation with the emergency services easier as you are more likely to be able to help them assess what might be wrong. I think the thermarest and a bivvi bag is an excellent idea. I have carried a casualty out as part of an MRT and even with 12 and a stretcher it isn’t easy ( 8 carrying, 2 walking behind to swop on a regular basis one navigating and the medic) so the chances of a activator getting someone off is small, but being able to keep someone warm and stop them getting worse would be good. A first aid kit is a good idea, but probably worth adding a single asprin too (Heart- again the emergency services will help for when it may be useful) We (Each tem member) also used to carry dextrose (Daibetic) and Volterol (Muscle Pain) but my MRT experise is now 15 years out of date so some advice might have changed. Training is handy as having summit brain whilst dealing with a problem is hard - it is better if the first aid is done in autopilot! Must admit the chances are you are probably more likely to come accross a casulty whien driving to the summit rather than on the hill.
Paul (G4IPB Ex Teesdale & Weardale SRT…)

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I am first aid at work trained through work and have been right through the scouts from beavers to network(used to be ventures)queen scout(eagle scout is the US equivalent) and i agree with Brian that I’m amazed at how often the CPR numbers changed. Last time i did a recert its now 30-2, 30 chest compression’s and 2 breaths but anyone not trained in CPR or not wanting to do the mouth-mouth part can leave it out and keep doing the cpr as the compression’s do compress the lungs slightly so air will be drawn in apparently.

I take a basic first aid kit but make sure someone knows where I am going, when i am due back and let them know when I am back, thats the important bit! This person is sometimes better to be someone not related to you as they can act calmer in the face of an emergency. The Scouts home contact (UK anyway) can’t be anyone related to anyone in the party, leaders or scouts/cubs etc for this reason.
I think everyone should be taught basic first aid but as long as you have something to keep yourself or injured party warm and dry and know someone will raise the alarm after no contact then the UK if you are alone then you don’t need a massive heavy first aid kit.

Thankfully in the UK we have excellent mountain rescue volunteer teams and search and rescue helicopters and our wilderness areas are nothing compared to the size of American and Australian wildernesses.

even though our areas/national parks are smaller I’m biased and say they are the best lol :slight_smile:

Thanks to all for their thoughtful comments - this post has generated more responses than anything else I’ve put up. Glad to see so many have considered this issue. The contributors have posted many other helpful tips, reminding us that a first aid kit and the skills to use it are essential but not sufficient.

The SPOT or other Personal Locator Beacon (PLB) is a great resource, but not sure it is totally reliable. See http://www.catskillmountaineer.com/reviews-winterhikingKM.html for discussion of a highly publicized mountain fatality that included a faulty location provided by the SPOT PLB. This is a different topic and I will start a new thread - please look for it and contribute!
73,
Scott

Sorry to be pedantic Scott, but there is a difference between a Spot communicator and a PLB. I fully accept that in a hiking environment a PLB does require someone to activate it (an obvious limitation for solo walkers who are incapacitated)

Edit just seen your other post and concur with Andy’s response

The Wilderness Medicine Society aka WMS offer a few different medical certification levels, and do focus on the difference in protocols related to distance/time to definitive care. I think NOLS may offer the WOFR option, but WAFA has typically served my needs.

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I give that suggestion a big thumbs up :+1: having “dealt with” my own heart attack, thankfully while at home. The 999 operator was excellent and the first thing she got me to do was to take a 300mg aspirin tablet while I waited for the paramedics and ambulance to arrive. The main thing is to stay calm and follow the instructions given, assuming of course you can get through to the emergency services. I can see that some basic training would be an advantage. How advanced you need to be in the UK is debatable.