Accidents - You Can Make a Difference

PSYCHOLOGY/SAFETYDOWNLOAD MP3

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John Hovey is an experienced first aid trainer and expedition leader with the with the National Outdoor Leadership School (www.nols.edu). This podcast looks at what to do in the event of an accident. It covers liability, taking charge, moving a casualty, emergency procedures, kit to carry etc. This podcast could help you feel prepared if you have the misfortune to witness, or be involved in, an accident.

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Your Comments

Judith Mole says:

Matt Wilkes, a Registrar in Anaesthesia and Critical Care, has contacted me with the following comments which I have permission to share with folk.

"A few additional points and comments for those who might be interested:

1) When John describes how to call for help, remember that Mountain Rescue in the UK is through the Police, not the Ambulance service. So you need to ask for the police first if you are somewhere remote when you dial 999. If you are unsure of your location, but have mobile phone signal, Mountain Rescue have a system called SARLoc that will enable them to find your position. You can also setup your mobile phone to send text messages to 999: http://www.emergencysms.org.uk/registering_your_mobile_phone.php

2) The podcast was right to discuss the risks of blood borne viruses and the importance of appropriate protection. However, the risks of transmission of these viruses through intact skin are extremely low and should not put you off treating a casualty.

3) Spinal immobilisation: in the podcast, they allude to the fact that while you should be suspicious of spinal injury in a crash, it should not prevent you moving the casualty if you need. Just be gentle. I would wholeheartedly agree with this. Several people have asked me in the club what to do if they casualty is agitated. Should you try to restrain them if you are worried about their spine? The answer to is a clear "no". By all means try to verbally reassure them but do not attempt to hold them still.

If they truly have a neck injury, they will be very likely to "guard" (protecting themselves with their hands). Also, by holding them still, you provide a fulcrum that might lead to more movement in the vertebral column.

See the Wilderness Medicine Society Guidelines on spinal immobilisation (here) for a more detailed discussion:
http://www.wemjournal.org/article/S1080-6032(14)00272-5/abstract

4) One area that I think is often neglected is the value of splinting. When John talked about internal bleeding and femoral fractures, I think it would have been useful to mention binding the pelvis and about straightening and splinting limbs. Of all internal injuries sustained in paragliding accidents, a broken pelvis is the most likely to cause life-threatening bleeding (followed by a fractured femur). To bind the pelvis, take a jacket and tie it firmly around the bottom of the hips, roughly at the level of the flies on a pair of trousers (the level of the greater trochanter of the femur is the anatomical description). People have a tendency to put pelvic binders on too high. Binding the pelvis "closes" the fracture and does a vast amount to stop bleeding. It can be truly lifesaving.
https://rydestation.files.wordpress.com/2014/08/pelvic_binder.jpg

Equally, straightening and splinting broken limbs will reduce bleeding and do a lot to relieve pain, especially in a prolonged evacuation. Use a stick, jumpers, or a lightweight SAM splint (I always carry one in my harness). http://www.sammedical.com/products/sam-splint/

5) On the subject of bleeding, if there is one thing you take from the podcast, it is the value of keeping a casualty warm. Cold blood does not clot properly leading to increased internal and external bleeding. Casualties lose heat through radiation, convection, conduction and evaporation. Judith mentions a space blanket, which may help a little to reduce heat loss from radiation, but will not help if the casualty is already cold. If I am honest, they are not my favourite. Instead, think about using the glider, other people and active treatment like heatpacks to keep the injured pilot warm.

6) John is absolutely correct – anaesthetists are not bothered if a casualty has had something to eat prior to surgery – because of delayed gastric emptying following trauma, we treat all emergency cases as if they have just had something to eat. Obviously don't force anyone to eat or drink, and be very careful with semi-conscious casualties - but definitely encourage an awake casualty to take small sips of warm fluid, particularly if evacuation will be a while. Also painkillers.

7) While talking to a casualty will probably not prevent them becoming unconscious, it is still a very important thing to do. Providing verbal reassurance and distraction is compassionate and pain-relieving, but also allows you to be alert to any changes in the casualty's condition. Any change should prompt a systematic reassessment, using the ABC system John described.

8)If possible, write down timings – the timing of the incident, treatments given, any deteriorations etc. This will be of great help to medical and accident investigation staff later on.

9) The podcast talked about emergency cards. I designed one last year, which Jocky Sanderson is hoping to convince the BHPA to adopt and distribute. It has medical advice on one side, and space to write your most common flying locations on the back.

10) Finally, I would absolutely agree about the importance of leadership and first aid training. But, even if you have none of those things compassion and common sense will go a long way. Have a go and don't be afraid to help your friends.


A huge thanks to Matt for adding these comments and I have a copy of the emergency card if anyone wants a copy for themselves or their club. Just email me at "judith (at) theparaglider.com"

Cheers,
Judith

Posted 733 days ago

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