CWS Blog

Stop The Bleed… Means More than Just Using a Tourniquet!

Stop The Bleed, the national campaign initiated by the White House in response to the many recent active shooter incidents in the U.S., has garnered significant attention and support over the past two years. Active shooter situations, coupled with research that has come out of […]

11 Lessons Learned from the FBI Study on Active Shooters

11 Lessons Learned from the FBI Study on Active Shooters

About a year ago, the FBI released its most recent research report on active shooters in the United States.  The 47-page report is quite informative and worth the time to read. The study looks at a very small and well defined subset of mass shootings.  According […]

When should you call Search and Rescue?

When should you call Search and Rescue? What happens when you do? Let’s find out more about when you should call search and rescue (SAR), what information you will need to provide, how long a response usually takes and more.

 

Who should you call if you need search and rescue?

The only way to get in touch with search and rescue is to call 911 and you will get the sheriff’s office dispatch. You tell them the nature of your emergency and if you are in the backcountry they will connect you with someone from search and rescue.

 

What if you don’t have cell service?

If you don’t have voice service it’s important to know that you can text 911 now in many parts of the country. Sometimes if you only have one bar of service and you can’t make a voice call you may be able to make text contact. Texting 911 will probably be slower than a voice call but it’s a good contact.

If there is no cell service at all you have to take stock of the emergency and decide on a plan of action. If the individual that is injured can not move at all you’re going to have to send somebody for help. Depending upon your location you may be able to get cell service by moving up or down the trail or up or down one of the geographical features close to you or hiking out to a trail-head.

 

When is it appropriate to call search and rescue?

Search and rescue operates in a lot of different ways for people. They can help both lost and injured people. From a medical standpoint, anytime someone is having an airway or breathing problem or a circulatory problem such as uncontrolled bleeding it’s always appropriate to call search and rescue (911) immediately for those kinds of problems.

The other things you want to consider are if the patient is immobile, they can’t walk out and you are going to need someone to help you get out, that’s another time to call. Also, time of day does make a big difference as well. If you get injured early in the day and are trying to get yourself out but not making progress fast enough and evening is coming on, it is definitely time to call 911. SAR is typically limited in their response after dark. The use of helicopters after sunset so if you wait until it’s dark to call us it’s going to be a much longer response.

 

How long should I expect it to take for search and rescue to respond?

Once the call comes into dispatch, dispatch will page the SAR board, which is a group of 6-7 experienced SAR members, and we will call in and have a conference call. It’s usually pretty brief – it only takes a couple of minutes to gather the information we need. You may be re-contacted by a member of that SAR board for more information and then if it’s appropriate we will page the team.

The team will either respond to the search and rescue hangar in town to get whatever gear we need and then we will need to respond to wherever you are, which is the backcountry if we’re coming to help you. There are some instances where team members can respond directly to the incident.

It takes search and rescue usually a half hour to 45 minutest to have people at the hangar getting gear and be leaving the hangar in route to where ever they’re going. Then you have to figure it’s going to take several hours to hike anywhere with the heavy packs and gear that we need carry to help an individual get out. So you’re looking at definitely a several hour response time. And helicopter response is definitely not the norm for search and rescue. You’re much more likely to have a ground crew response.

 

How should a person or group prepare for search and rescue to arrive?

If you’re dealing with an injured individual you want to make sure they are comfortable, that they’re off the ground and insulated with a sleeping pad or mat under them. Make sure they stay warm. And then ‘BE SEARCHABLE’. Make yourselves visible. If you are off the trail try to move away from running water which can make it hard to hear if people are yelling from you. Try not to be hunched down near trees.

If you are expecting a helicopter to come, again move away from the trees so you are more visible from the air. At dawn and dusk lights are very helpful, so headlamps are helpful for us. Signal mirrors for air operations are also helpful. Another thing that is really simple is a whistle – it’s amazing how much better the sound of a whistle carries and you can sustain blowing on a whistle much longer than screaming.

You should try out the ones that are built into your pack because the mouthpiece on those are very small and when it’s cold it’s hard to use those effectively so you might want to purchase and carry an emergency whistle.

 

What happens once SAR arrives on the scene?

Once the team arrives we’re going to introduce ourselves and then it really depends on the nature of the emergency. We’re going to assess how everyone there is doing. If people are cold, tired, hungry we’re going to try and fix those problems. If it’s an injury we’ll address that with whatever medical support we were able to send in. And then we’re going to look at what we have to do to get you out of there.

Sometimes in the summer that’’s a wheeled litter where we load somebody up and are able to wheel them down the trail. Other times it will be a helicopter response. We do have the capability to respond with ATV’s in the appropriate locations and we do have some specialized rescue techniques we can use for very technical terrain, like short haul. But again those aren’t the norm. Typically we are going to try and walk somebody out or use the wheeled litter to get them down the trail.

 

Why I Recertified My Wilderness First Aid Early

This is what prompted me to renew my cert almost a year early: Yesterday our kids were out riding motorcycles in the neighbor’s backyard on the small motocross course they have set up. One of the neighbor boys, Marshall, overshot the tabletop and crashed, went […]

Wilderness First Aid: Psychosocial Development and the Five Stages of Grief

by Michael M. Throughout life, people change. Whether it is psychological or physiological, this change will always happen. Although many disagree about whether people change in stages or in one continuous movement, it is unanimous that people develop. For our 10 hours of community service, […]

NEW First Aid & CPR Guidelines Now In Effect

BREAKING NEWS — The American Red Cross and American Heart Association have announced major changes to guidelines for administering first aid. Among the most noteworthy revisions are new and updated recommendations for the treatment of bleeding; recognition of stroke; recovery position; anaphylaxis (severe allergic reaction); use of aspirin with heart attacks; and treatment of hypoglycemia (low blood sugar) in diabetics. 

Every 5 years, the science and practices related to First Aid, CPR and Emergency Cardiovascular Care are reviewed and new recommendations related to providing care are published. As a result, organizations such as the American Red Cross revise their training programs to incorporate new protocols and practices for how to administer care and apply lifesaving skills. This process is often referred to as ECC. Experts analyzed the science behind each question and worked to reach consensus on related treatment recommendations with the goal of reducing morbidity and mortality due to emergency events. Last updated in 2010, these recommendations form the recognized scientific basis for most first aid training around the world.


BLEEDING CONTROL
The revised guidelines stress the importance of stopping severe bleeding as a critical first aid skill. Almost all bleeding can be controlled by steady, well-aimed direct pressure, with or without a gauze or cloth dressing over the wound. The guidelines recommend pressing hard and holding steady pressure for at least five minutes without lifting dressings to see if the bleeding has stopped. While direct pressure is still the first line of defense, the guidelines acknowledge the important role tourniquets and hemostatic agents play in stopping life-threatening bleeding when standard measures fail or are not possible. Tools now available and recommended to first aid providers include tourniquets for severe bleeding on a leg or arm. For open wounds not on an extremity, the guidelines suggest use of a hemostatic dressing, which is coated with a special agent to enhance clotting and help stop bleeding when correctly applied and combined with direct pressure. Hemostatic dressings are readily available online and at pharmacies.


HYPOGLYCEMIA TREATMENT
Early treatment of hypoglycemia (low blood sugar) while the patient is still conscious and still able to follow instructions can prevent progression to more serious hypoglycemia that would require more advanced treatment. To avoid lay responders from giving too much or too little sugar, the new guidelines recommend use of glucose tablets purchased at a retail pharmacy. Glucose tablets have been shown to be more effective at resolving symptoms of hypoglycemia than dietary forms of sugar. If glucose tablets are not available, food sources such as sucrose candies, dried fruit, or orange juice can still be used.


RECOVERY (& HAINES) POSITION
If the person is unresponsive and breathing normally, without any suspected spine, hip or pelvis injury, turn the victim to a lateral side-lying position. Studies show some respiratory improvement in this position compared to a supine, or face up, position. In addition to the change from the supine position, the modified HAINES position is no longer recommended due to lack of scientific evidence.


ANAPHYLAXIS
Under the revised guidelines for treating anaphylaxis (severe allergic reaction), if symptoms persist beyond the initial dose and arrival of advanced care will exceed 5-10 minutes, the first aid provider may give a second epinephrine injection from a prescribed auto-injector.


STROKE RECOGNITION
Approximately 800,000 Americans have a stroke each year, leaving them at risk for long-term disability. Early recognition of stroke through the use of a stroke assessment system decreases the interval between the time that the incident occurs and the time it takes for that person to arrive at a hospital and receive specific treatment. This faster time to treatment may reduce the damage and disability from a stroke. This is the first time that the guidelines have examined the science behind inclusion of a stroke identification system into all first aid courses.


THE USE OF ASPIRIN FOR HEART ATTACKS
The updated guidelines clarify that aspirin should be used when helping someone suspected of having a heart attack, characterized by symptoms such as chest pain accompanied by nausea, sweating and pain in the arm and back. If the first aid provider is unclear on whether this is a heart attack or simply someone experiencing non-cardiac related chest pain or discomfort, then aspirin should not be given. Additionally, the updated guidelines emphasize that there is no need to distinguish between enteric versus non-enteric coated aspirin as long as the aspirin is chewed and swallowed.


CHEST COMPRESSIONS IN CPR
The updated guidelines place upper limits on both the rate and depth of compressions to better improve outcomes.  Chest compressions should continue to be provided for victims of cardiac arrest of any age.  Compressions should now be delivered at a range of 100-120 per minute as evidence suggests that rates above this upper limit may lead to poor outcomes. In addition, an upper limit to the depth for compressions has also been recommended.

For adults and adolescents who have reached puberty, continue to compress the chest at least 2 inches, but try to avoid compressing the chest greater than 2.4 inches to minimize complications. The depth of compressions for infants and children remain that same at about 1½ inches for infants and about 2 inches for children. Both rate and depth of compressions are difficult to judge and the use of feedback devices, if available, may be beneficial.


INTERRUPTIONS OF CHEST COMPRESSIONS

Minimizing interruptions of chest compressions are a critical focus of the CPR guidelines. All responders should limit any interruptions of chest compressions, such as providing ventilations or performing other critical tasks, to less than 10 seconds. Responders should focus on maintaining as high a chest compression fraction (CCF) time as possible during resuscitation. CCF is the proportion of time that chest compressions are being performed during the duration of the arrest as compared to any pauses such as the time to deliver ventilations or apply the AED.  A CCF of at least 60% is desired, with a goal of achieving a CCF of 80% to maximize survival is recommended.

Does Aspirin really help against a Heart Attack?

Chewable aspirin is absorbed faster and is more effective than regular aspirin that is either swallowed whole or chewed and then swallowed, a new study shows. This “seemingly quite simple finding” could lead to improvements in the care of heart attack patients, researchers say. Sean […]

Are We Killing Our Best Chance At Stopping Lyme Disease?

The only good snake is a dead snake. At least, that’s what my high school friend said the time we went backpacking and he chopped a garter snake in half with a machete. He wiped the blade in the grass while the tiny, non-venomous, non-constricting […]

Lightning Safety Basics

Many years ago, I found myself on a camping trip hunkered down on a foam mat trying to find safety from the storm overhead. To this day, I still have memories of my hair standing up on end, the smell of ozone and the rattle of metal objects during that storm. Since that storm, I have found myself in far too many thunderstorms while traveling in remote environments. Some of the storms were closer than others, but each inspiring awe, fear and a good dose of respect.

The most challenging part about being in a lightning storm is the lack of predictability of the strikes. Lightning is random; it can strike in the same place twice, does not always hit the tallest object, and can travel horizontally from storms striking a location with blue skies overhead. This unpredictability combined with the violence of the lightning should produce respect and caution in even the most well traveled adventurer.

Lighting can strike people in two ways – direct strikes and through a ground current. Direct strikes occur when the lightning passes through the body of the person being hit, producing both entrance and exit wounds. Ground currents are strikes from an electrical charge caused by a near by strike that travels through the ground and are responsible for the majority of lightning produced injuries.

The best prevention is to not be outside when a lightning storm hits, however this is not practical for people the recreate outside. Knowing local weather patterns can provide some knowledge of when to travel and, more importantly, when not to travel in lightning prone areas. Learning to read weather to predict the arrival of the cumulonimbus clouds (tall clouds that produce lightning) provides the ability to move towards a safer location prior to the arrival of a storm. In settings where visibility is limited by a mountain or cliff, having and using a barometer to detect changes in the atmospheric pressure allows for warning that a storm is approaching.

You can track the progress of the storm toward or away from you by counting the time between the flash of lightning and the boom of thunder. The storm is one mile away for every five seconds between the light and the noise. If the count between the flash and the boom is getting smaller the storm is moving closer; if the count is getting longer the storm is moving farther away.

If you find yourself in a thunderstorm there are a few things you can do to reduce your risk exposure. If you are close enough to hear the thunder you are close enough to get struck. Start by getting to a “safer” location: summits, ridges, hilltops, and bodies of water are all less desirable than valleys and low-lying areas. Find a low-lying area ideally with a group of trees that are a similar height; avoid being under or near a lone tree. Next, reduce your exposure to ground currents by insulating yourself from the ground by crouching, kneeling or sitting (preference is in that order) on a sleeping pad or backpack in order to limit your contact with the ground.

Lightning injuries are caused by the heat, electrical charge and concussive force of the lightning. Injuries include cardiac or respiratory arrest, loss of hearing and/or vision, burns, and nervous system dysfunction. Many of the injuries can be stabilized with first aid and early high quality CPR for individuals who do not have a pulse and are not breathing or not breathing normally. Regardless of the severity of injury, anyone who is suspected of being struck by lighting should be evacuated to a hospital for further evaluation.

Even with wilderness medicine training and an appropriately stocked first aid kit, the best first aid is always prevention. When spending time outdoors this summer, be sure to keep an eye on the sky to watch for the build up of cumulonimbus clouds. Understand the local weather patterns and have a plan for how to get yourself to a less exposed place if the storm continues to build.

Understanding Hypothermia

Understanding how our bodies create, maintain and lose heat is key to preventing hypothermia. By taking a few proactive measures to make sure that the body is able to optimize heat generation and maintenance, outdoor ventures in cool and cold climates can be safer and […]