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Old 09-19-2010, 09:27 PM   #1 (permalink)
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First aid on the trail, how much training?

hey all, I've been wheeling for a few years and have seen a fair amount of roll overs. Luckily no one was majorly hurt but seeing a roll over this past weekend got me thinking, how much first aid knowledge should one have?
I want to take a basic first aid class, but should I stop there? I want to be as best prepared for what ever happens on the trail and I know I don't need to be a full on doctor but it seems like the basics might not be enough. Besides a well stocked medical supply bag, what do you all think or do?
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Old 09-19-2010, 09:46 PM   #2 (permalink)
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A basic first aid course and CPR is a great start. Being a former EMT has come in handy more times then I care to admit, both on the trail and just out and about. Knowing how to keep your buddies alive out in a remora area is a handy skill to have.
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Old 09-19-2010, 09:48 PM   #3 (permalink)
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If you know what you're doing, a well stocked bag might help. It doesn't matter if you're a nobody or a doctor...if you don't have access to the equipment it's not going to matter.

Most of the time on the trail, you'll only run into minor injuries. Small-medium cuts, abrasions, and maybe a sprained ankle or two. That's really the jist of what most can handle. As far as big cuts or broken bones, learn how to slow the bleeding, stabilize, and have a way to get some advanced help. In the case of a head/neck injury, spinal immobiliation is great, but it's difficult with limited equipment (no back board/collar).

My bag has some basic bleeding control items, as well as some saline, a few misc items and a collar. I recently added a few suture kits, but for legal reasons I wouldn't use them on anyone but myself or my kids. The way I see it is on the trail, you're really at the mercy of fate. Most injuries can be handled, or at least held off until you can get to a hospital. If it's really bad, ie arterial bleeding or sigificant head/neck injury, just give it your best!!!

Hopefully, you'll never have to deal with anything that requires more than a band-aid!!!

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Old 09-19-2010, 09:58 PM   #4 (permalink)
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Hoping to have a first aid class on the lakebed this year in Hammertown.
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Old 09-19-2010, 10:09 PM   #5 (permalink)
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I took a two day wilderness first responder training class that was pretty good. It was put on by a local fire station and the Department of Natural Resources. There were alot of hikers, hunters and ORV people in the class. The local Search and Rescue people offer in depth wilderness first aid training too.

Yesterday I was working on an ORV trail unloading 1000lb boulders out of my trailer, the guy helping me was using a 6' prybar, it slipped and hit me in my head. It started gushing blood, I used a shirt to hold pressure on the 3" cut, we finished unloading the rocks and I went to the hospital that was an hour away where I got 6 sutures. You never know when something will happen.
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Old 09-19-2010, 10:11 PM   #6 (permalink)
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Thanks for info guys, I guess I'd rather be over prepared and not use it. I'm going to check into EMT training
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Old 09-19-2010, 11:56 PM   #7 (permalink)
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Thanks for info guys, I guess I'd rather be over prepared and not use it. I'm going to check into EMT training
Unless you plan on pursuing a career as a firefighter or ambulance drive that is going to be way more advanced then you need. A first responder course will be more then most will ever need.

Also being an emt carries some legal Downside. As a first responder or basic first aid you are legally covered under the good sameratian act.
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Old 09-20-2010, 07:45 AM   #8 (permalink)
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an EMT has minimal legal implications as it is a certification, and all skills are still basic. EMT;s fall under the samaritan act as well, and really, any medical professional does, as long as they act with in reason and prudently. Meaning, as a medic, you 'shouldnt' start IV's and give cardiac meds if someone has a cardiac issue while wheeling the rubicon. EMT is a 6 month class, normally, and able to be had at many JC', but as camo said, CPR and first aid is prolly all you 'need', and much shorter.


I would recomend a wilderness first aid class, as its a little more "mcgyver" than standard FA
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Old 09-20-2010, 07:53 AM   #9 (permalink)
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I would talk to John Hunt at Big Dogs Offroad. He teaches survival training but he he also manages the wheeling events and competitions at the Cove in Gore, VA. If anyone can help you with everything you need and nothing you don't i think he would be the one to ask.
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Old 09-20-2010, 07:59 AM   #10 (permalink)
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Unless you plan on pursuing a career as a firefighter or ambulance drive that is going to be way more advanced then you need. A first responder course will be more then most will ever need.
Also being an emt carries some legal Downside. As a first responder or basic first aid you are legally covered under the good sameratian act.
X2 ^^^

I was a EMT before I went in the Army. While in the Army I took a "Combat life saver" course (intense first responder with some extra stuff).

All I carry in the rig is a good first-aid kit, with some extra gauze, tape and butterfly bandages thrown in... almost anything else can be improvised if needed.
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Old 09-20-2010, 08:00 AM   #11 (permalink)
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I agree with Camo.

I would reccomend trying to get yourself in a wilderness first aid class. The knowledge will be much more applicable than your typical EMT training. It will be directed at dealing with stabilization and evacuation taking a greater amount of time and dealing with injuries with less than optimal equipment and supplies.
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Old 09-20-2010, 09:36 AM   #12 (permalink)
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Old 09-20-2010, 10:04 AM   #13 (permalink)
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Hoping to have a first aid class on the lakebed this year in Hammertown.
Jeff, I have helped teach the wilderness medicine course in Colorado and Montana, let me know if you need any slides or handouts.
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Old 09-20-2010, 12:25 PM   #14 (permalink)
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Super Glue and Duct Tape will fix anything!
^
That's what I thought too, well that and watching re-runs of ER (which is where I've gotten all my medical knowledge so far )
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Old 09-20-2010, 03:22 PM   #15 (permalink)
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i carry O2 and a venti mask and a bagger, suture kit, antibiotics, Asa (stroke/mI), benzos (seizure), bronco dilators, and various stuff for airway management. Sometimes i take the AED from my office on club runs

All the ER's within 50 miles of my mountains are on speed dial. I have direct access to the chopper

But the best 2 items in my kit are:
1. Narcotics-makes it all better
2. a recently purchased 2M radio. This is probably the best piece of first aid I have. with it I can be miles into the mountains and still bounce a signal home and to help

And you cant treat stupid but you can tell them not to drink and wheel

and wilderness medicine would be a sweet course for anyone

As far as giving meds for MI and stroke go I would give someone a 350mg asparin on the trail if thought they were having an MI or stroke on the rubicon. dont make em take it but offer it. lots of old dudes wheel and they are often wheeling because they arn't in shape to hike...thus the heart attack.

I have a partner who took an iv bag on a 7 day hike over Mt whitney here in cali (14900ft). he had IV access supplies. He found a down hiker who was way sick and dehydrated. he started the IV, let it hang off a tree, and went for help. my partner found a ranger who called in a heli that came the next day. likely saved the dudes life. If you got the skills and the supplies use em. let the legal system work itself out.

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Old 09-20-2010, 03:37 PM   #16 (permalink)
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Anybody have any idea on who to contact for a wilderness first responder/first aid type of class in in Alabama? Preferably Huntsville or Auburn.
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Old 09-20-2010, 04:28 PM   #17 (permalink)
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If you got the skills and the supplies use em. let the legal system work itself out.
as litigous as california is, I would certainly disagree. While the patient may want you to, if they expire, the family will certainly not honor any agreements you had. Being a licensed medical personnel, you are certainly hanging your nuts in a sling. You would be acting outside of ANY medical control and totally in the wrong.

How are you even licensed to have benzos and narcotics> The FDA has a VERY tight contol over all of that stuff. Maybe you have a different sort of medical control, but as a 10 year paramedic, I would be VERY selective of who I would perform ALS skills on. My family comes first, and I certainly would not put my job and paycheck on the line.
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Old 09-20-2010, 06:19 PM   #18 (permalink)
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While the patient may want you to, if they expire, the family will certainly not honor any agreements you had.

How are you even licensed to have benzos and narcotics> The FDA has a VERY tight contol over all of that stuff. Maybe you have a different sort of medical control, but as a 10 year paramedic, I would be VERY selective of who I would perform ALS skills on. My family comes first, and I certainly would not put my job and paycheck on the line.
I too believe one should avoid litiginous scenerios if possible. But if someones life is in peril, and you have what could save there life, especially if it is advanced licensed training, go for it. Of course some judgement is required (Im not going to do club prostate exams or a "wilderness" breast exam clinic) but if your club buddie's dad is having an mi or stroke you dont need to worry much. If some kid or someones dad you dont know needs an advanced skillset then id go for that too-its somebody's kin and they will likely be thankfull if you tried even if it doesn't work out. if you did the right things, and have the right training, the jurry would be on your side anyway

when you think about it anyone could sue you whether or not they have given consent. From a legal standpoint im more worried about some random stranger off the street landing himself in the ICU than i am about some stranger i meet wheeling.

you are right about class II drugs-someone better have a license to use them.
They are in my office (MD). If someone in the club gets hurt bad, a narcotic would be handy if used properly. Like if you broke your arm bad and and were boucing down the trail to get home, (as passenger) you would accept the pain med if you trusted the guy giving it. I wouldnt give a class II or a pelvic exam to a stranger
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Old 09-20-2010, 06:42 PM   #19 (permalink)
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most cant even get narcotics or benzos, that is a luxury only you as an md have. Further, a medic can only work under local medical control. Work oustide of it, and you get in big time trouble. Its a risk Im not willing to take, and I doubt you would find many in my line of work that would. Im curious if the sentiment is different as a Doc, since you have a more general approach and scope???
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Old 09-20-2010, 07:59 PM   #20 (permalink)
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as litigous as california is, I would certainly disagree. While the patient may want you to, if they expire, the family will certainly not honor any agreements you had. Being a licensed medical personnel, you are certainly hanging your nuts in a sling. You would be acting outside of ANY medical control and totally in the wrong.

How are you even licensed to have benzos and narcotics> The FDA has a VERY tight contol over all of that stuff. Maybe you have a different sort of medical control, but as a 10 year paramedic, I would be VERY selective of who I would perform ALS skills on. My family comes first, and I certainly would not put my job and paycheck on the line.
I completely agree with you. I have passed on a couple medic side jobs for remote travel because of no medical sponsoring Physician. I am a firefighter EMT 3. Lawyers will hang you out to dry. I keep it to basic EMT skills. That is enough to stabilize a patient. I will not administer drugs unless its on myself or I have a sponsoring Physician.
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Old 09-20-2010, 08:11 PM   #21 (permalink)
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Very interesting stuff as I never thought of the legal ramifications of it. I guess keeping it to a basic EMT skill-set might be the furthest I'd want to go as it could stabilize someone yet keep me somewhat safe legally if an incident where to happen.
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Old 09-20-2010, 08:38 PM   #22 (permalink)
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yeah, unless you are a dumb ass, you are safe legally as a BLS (basic life saving) person. Its when you become licensed and people expect you to 'know' better that things can get expensive for you.

An EMT training is good, but as I think Camo said, not really necessary for what I think you want. Its prolly the same trauamtic injury training, CPR, etc but the EMT class goes more into OBGYN, Medical Conditions, Psych, etc. Its not bad stuff to know, you just need to decided if its a factor for you, as its not likely to be on the trail, as opposed to a broken/sprained limb, traumatic injury c-spine type shit. If you have a pregnant wife (or plan to), ailing family memebers, or are just otherwise motivated or looking for a career change, than EMT is the place to go, otherwise get a wilderness FA, FA and/or CPR stuff.
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Old 09-20-2010, 11:55 PM   #23 (permalink)
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CPR is good to know on the trail or at the family reunion.

Even the ACLS (advanced coronary life support) course starts with basic CPR mastery.

But if my kid is down 20 miles from noplace in the mountains with no cell service, them i would rather have a good 2m radio or a satalite phone than 5 doctors standing around with no tools or diagnostic equipment.
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Old 09-21-2010, 09:10 AM   #24 (permalink)
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many communities have C.E.R.T. training classes, I think a 30 hr course, it is community emergency responce team, taught by the F.D., basic first aid, triage, and site assesment, I was sent by my employer but it's offered to private citizens for a small fee, good stuff

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Old 09-21-2010, 09:27 AM   #25 (permalink)
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Meaning, as a medic, you 'shouldnt' start IV's
IV's are nice to have around. I would start one if someone needed it bad enough.Hell of a lot better than hydrating them the "OTHER" way.

Anyone know what the legal ramifications would be for someone with a CLS cert from the military starting an IV or Oxy?

Speaking of which.....I have some WWII era syrettes....how long do they last
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