Keeping calm under pressure: first aid for the outdoors

Our team of 9 club members gathered early on an overcast Saturday morning at the Woolshed in Belmont Regional Park. We were all excited to see what the weekend held and looking forward to gaining some new skills to make our tramping experiences safer.

There was a wide range of people on the course. The group included those who had never done a first aid course, or for whom the last course was 10-20 years or so ago through to some undertaking their refresher course. Others had basic workplace first aid but sought an opportunity to tailor their skills for the outdoor environment. Those with previous training appreciated getting up to date information on first aid best practice. Everyone took away new learnings from the weekend.

One of the hard lessons came as we were waiting for the door to the Woolshed to be opened. Suddenly our instructor for the weekend, Rus, appeared quite distressed and alerted us to an ATV accident up the gravel road behind the building. He called on our group to come help him. Everyone scrambled up the road to see two casualties (dummies) and a tipped vehicle (a small wagon) sprawled on the grass. Some people dove in to try and help while others, confused and uncertain, held back. It was hectic, with a lot of yelling and talking going on. Most of us forgot about the spilt petrol all over the ground before walking through the scene.

Although this was a made up scenario, in amongst all the chaos lay some of the most crucial lessons our group would learn on the course: 1) looking at the danger and keep your group safe before helping others and 2) acting systematically as a team with clearly assigned roles.

Over the next two days our heads were filled with knowledge. The skills we learnt were wide and varied. Rus taught us how to do CPR, apply splints, slings and bandages, stem major bleeding, and deal with medical conditions, such as strokes, anaphylaxis or asthma. We also found out how best to approach an injured person and gain their trust. We learnt about patient transportation and it was surprising how easy it was to move a patient using only a blanket and four people.

Rus constantly plunged us into “real life” practice and he did a great good job of coming up with creative and unexpected scenarios for us to respond to. Everything was tailored to the outdoors so all situations one might encounter on a weekend away tramping. The great value in this was not knowing what we would come across until we were in it. The many scenarios emphasised that while every situation is unique, more knowledge and skills can make a huge difference in outcomes for all.

Some of the scenarios we encountered included: a drunken hypothermic tramping party rapidly becoming trapped by rising river levels at Turere lodge; a paraglider whose ropes had gotten caught and had fallen out of the sky; and a person who had injured their leg and quickly fell into a diabetic coma. Some of these scenarios you could never dream of happening. However, stranger things have occurred in the backcountry and you never know what you might come across.

Everyone took turns at being both a patient and a first responder.

For our patients, club members’ secret Hollywood acting skills came out of the closet. It was hard not to feel like you were in a real-life incident when patients let out agonising howls of pain, suddenly went completely limp and unresponsive, or had a concussion and kept looping back to the same questions. Being in the shoes of the patient taught us the value of having a calm and clear headed first aider who listened. Being treated by someone whose whole world was you and your needs instantly boosted morale and made you feel safer.

As a first aider, we learnt the necessity of having a clear process to assess patients. With so much activity going on, it was a struggle to stay focused on your patient and remember all of the information you needed to gather. We quickly found out the importance of getting as many details as possible when patients passed out before we could complete a full assessment. We also learnt the limits of what we should be doing as basic first aiders and the need to effectively communicate injury details to emergency services. With repeated scenarios these processes became more ingrained.

Some in the group took up the tough job of being an incident controller in a multi-patient situation. As we found out with our opening scenario, it is extremely important to have one person in control. While the incident unfolded this person could then assign sub leaders for each patient, so that everyone was clear on what they were doing. Sometimes it was necessary to shift first aiders around to higher-need patients. Incident-controllers had to make the tough calls on when to shift patients to a safer location away from rising floodwaters or out of freezing conditions. Where there was an assigned leader, we also learnt the value of being a good follower to avoid arguments and confusion.

Our final scenarios stood in stark contrast to our initial uncoordinated ATV accident jumble. By the end of the weekend, we were like a well-oiled machine. Our weekend concluded with a second vehicle accident. The driver, Everard, was allergic to bee stings and had been stung while out driving in below-freezing, snowy conditions, away from any towns. He had crashed into a tree and broken his ribs. His passenger, Maj-Britt, received a concussion and broken leg, their son (a dummy) was unresponsive and not breathing. A fourth patient, an unfortunate pedestrian, received extreme injuries as well.  After administering an epipen to the driver we managed to transport all patients into a nearby building. Our communication was clear and every first aider had clearly assigned roles. Each patient was taken care of and kept warm from the cold. The incident controller also made sure the first aid crew were kept warm and safe. There is always room for improvement but by the end of this scenario we were doing far more right than we did wrong.

We were all so impressed with the course delivered by Peak Safety and Outdoor Training New Zealand. The content was on point and carefully considered the needs of the group and differing ability levels. Throughout the course we had the benefit of Peak Safety’s real world experience in delivering first aid at outdoor events. As we all appreciated, there was always time for additional and clarifying questions.

A big thank-you goes to Chief Guide, Anne, and OTNZ for organising the training, and Rus from Peak Safety for his fantastic instruction. Most of all, we are grateful to FMC for the grant they provided to run the course, which has been invaluable.

Although we were dealing with life threatening situations, the weekend was also a lot of fun. The more people that can do such training, the safer and more enjoyable trips, the club and tramping community will be. Even a basic understanding of first aid can make a huge difference to people’s quality of life. The new skills we have learnt will make us more confident when confronted with emergency scenarios and more capable of supporting emergency services.

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