Wednesday, 28 May 2014

Mountain or remote first Aid Part 1

Mountain First Aid or remote/wilderness first aid.

Mountain first aid, first aid in the remote areas and wilderness places of the world present us with an interesting and demanding challenge. Help is often a long way away and the reason we are in the wilderness is do interesting and challenging activities. We like rock climbing, caving, kayaking, mountain walking and the like. I have enjoyed these activities since I was 9 years old

On Tryfan looking down towards Llyn Ogwen

The mountain first aid course must meet all of these challenges. If one is a member of a mountain rescue team, you will spend half your waking life learning about first aid for the wilderness. That afterall will be your area of operation. I found very early on in my career, that the people involved in mountain rescue had hearts of gold and legs of steel, but were often misled by out of date ideas and dogma when it came to patient care. Interestingly this was easy to change, because of the nature of the people themselves, open to new ideas and quality training.
It is a different matter in the wide world of wilderness and remote first aid training. Some of the very old ideas are very firmly embedded. The idea of not removing the boot, i do not know where it came from, but its a problem

This is actually a RTC victim, note that he has trench foot as well:-

Can you imagine trying to treat this, or even work out what is wrong without removing the boot. The risk of the patient loosing their foot would be enormous!

I believe that a good quality patient head to toe and a structured history will elicit most of what is wrong, with your patient. This must be done, as the injury above would be terribly painful and give significant masking pain.

If you don't look, you wont find!

There is an almost an infinite amount to write about this subject, more to follow
By Martin Bennett

Tuesday, 27 May 2014

This is my very first blog.
I have chosen to write about Tree Surgeons or Arborists and Utility Arb. Tree Surgeon and Arborist are largely the same person, except maybe the arborist has done a bit more theoretical training. Utility Arb is the arm of tree surgery that deals with the Utlities, such as electricity cables and so forth.

As far as I can ascertain the practitioner is only required to hold an Emergency First Aid at Work Certificate, although, some have the three day First Aid at Work qualification. Three days training would seem eminently more sensible for people who are working in quite a high risk industry, which is quite unique - the point of me writing!
It would seem that enormous numbers of tree surgeon/arborists attend standard first aid courses that do not, and perhaps cannot cater for such a specialist industry. The people who I have spoken to about this complain that the training they receive is not relevant to their industry! It is their most serious complaint. The other complaints often levied, are poor quality training, or just plain boring, and out of date techniques.

I am a professional first aid trainer, I have BSc honours in PreHospital Care, plus a bunch of other stuff, First Responder for WMAS etc. I believe that anyone who comes on one of my courses must get training that is pertinent to their working environment. To this end I have detailed the subject matter that I think should be covered on an arborists first aid course.

The obvious things are head injuries, bleeding, allergies/asthma/fitting and so forth, a bit of CPR. I say a bit because resuscitation secondary to trauma is one of the greater challenges of the medical world! I think its essential to include life threatening haemorrhage, and the CABC protocol. the use of pressure bandages, packing and finally tourniquets. A brief understanding of suspension trauma is a good idea too! Disaster management together with situational awareness and CRM training would be life critical. As will electric shock treatment.
Other subjects will be "thorn strike" and general splinter removal, eye irrigation, bit on burns etc.

If anyone ever reads this, please add subjects to be covered, correct anything I have got wrong, its my very first blog!