Wednesday, June 29, 2016

EMERGENCY: The Importance of Knowing What to Do

I thought I had broken my ankle. I was doing volunteer mountain bike patrol on the Chequamegon Area Mountain Bike Association trails near Cable, WI, when my rear tire slipped on a damp tree root, and I stuck my foot out to catch myself. The place where I put my foot looked level enough, but turned out to be a depression filled with leaves. My ankle buckled inward and let out a loud “pop”, and immediately hurt like blue blazes. I also knew I was doing a number of things wrong; I was riding alone in a remote area, (something I still do) I had no means of communication, and the last riders I had seen had passed me 10 to 15 minutes earlier. 

Fortunately for me, it wasn’t a fracture but a badly sprained ankle (which never completely healed). However, in my favor, I was carrying my patrol pack with an extensive first aid kit including a cold pack. Because of my wilderness medical training, I knew what to do and did it; Rest, Ice, Compression Elevation, RICE. Then I was able to, using my bike as a crutch, make my way to my car and head into the ER in Hayward to get it checked out. 

 I have been an Emergency Medical Technician (EMT) since 1973, took my first Wilderness EMT class in 1979, and been a first aid instructor even longer since my first semester of college in 1972. I’m also a longtime advocate of carrying at least a day pack with the “10 Essentials” for the activity you are engaged in. Two of the items on that list of 10, Navigation (paper map, and compass) and First Aid Kit come with the advisory, “and know how to use them”. From my years as a ranger, and is a Search and Rescue volunteer before that, I know that too few people head into the backcountry carrying anything more than a spare pair of socks and a couple of energy bars, and if they even have a first aid kit, it is little plastic box with some Band-Aids in it and little more. 

When we formed the predecessor to what became the Backcountry Trail Patrol, and joined the National Mountain Bike Patrol in 1996, all four of our founding members were either EMTs or First Responders. That was a good thing, because at the very first event we worked as a patrol we are credited with saving the life of a young woman suffering from an acute asthma attack. Shortly after that, I took on the name of the ambulance service I had managed in Oklahoma, 20 years earlier, Emergicare, and started offering wilderness first aid training to members of local outing clubs and the bike patrol, offering the benefit of my experience in the field, as an EMT/paramedic, park ranger and a NYS licensed wilderness guide, to a variety of folks from hiking, kayaking, and mountain biking clubs in our area. 

From the very beginning people taking the classes would come up to me and ask. “How can I use this? Can I join the Bike Patrol?” Indeed, most of the senior members of the Backcountry Trail Patrol started in either a wilderness first aid or Wilderness First Responder class that I taught, and I am pleased to say that at least five lives have been saved by people I have trained. 

Since starting to do this, I have tried to keep the price of the training I offer as reasonable as possible, certainly less than many of the other, better known training providers. I do this because I feel you are more likely to take a first aid class if you can afford to take the first aid class. Even so, most of the people I have trained either are, or soon join the Trail Patrol. And the Trail Patrol cannot be everywhere all the time. Outdoors people, regardless of their activity, get hurt and sometimes, like with my ankle, they know what to do or are with someone else who does, sometimes they hobble to a trailhead and make their way to help, and sometimes it becomes a major medical rescue operation to get them to definitive care. It is the less emergent, more common occurrences that mountain bikers and other high risk outdoor activities should be prepared for, while still knowing what to do in case of a serious medical emergency, until help arrives.

Recently, BackcountryLifeline, a new organization made up of mountain bikers for mountain bikers has started teaching mountain bike–specific first aid classes in Colorado. Established in the wake of the death of the son and fianc√© of two of the founders during a mountain bike race, I like what I am seeing from them so far. They are offering affordable pre-race first-aid clinics, multi-day first aid training camps, and the thing that I believe holds the most promise, developing their own curriculum material specific to the sport. Since they are based in the same city as the IMBA/National Mountain Bike Patrol, I suggested that when they have their curriculum in place, that they take it across town with the suggestion that it become the standard for all NMBP patrollers. I’m looking forward to reviewing, and possibly utilizing the curriculum when it is completed. 
From another source, across the pond, St. John Ambulance, the leading first aid charity in Great Britain, has also come out with a First Aid for Cyclists program that includes a book,
classes and smart phone app. This is a handy source of information if needed and you have your smart phone with you, and most of it is applicable here in the US other than calling “999” instead of “911” in an emergency. The app is available for both iPhone and Android devices. 

The long and short of all this, is that I have believed for over 40 years that the more people who know first aid and CPR, the more lives are going to be saved, and non-life-threatening injuries dealt with properly. Since I started my “new” job with Team Ortho Foundation, we have had an emphasis on training as many people as possible in both full, and compression-only CPR. To date we have trained almost 40 individuals, including my first blind trainee, in Adult, Child, and Infant CPR/AED and over 75 course marshals in compression-only CPR. In Emergicare’s role as a provider of Special Transportation Service driver training, I have taught compression only CPR to well over 300 special needs transportation drivers, two of whom have saved lives with what they learned. 

There is more to be done. I would like to come up with a short course for mountain bikers, and other outdoor enthusiasts, while continuing to teach the 16 hour basic and 36 hour advanced Wilderness First Aid courses we currently teach. And as much as possible, I want to see as many people as possible know what to do if they are in a situation where they are the difference between life and death.
Emergicare Medical Training; Teaching People to be The Difference.
Proceeding on...