I'm A "WFR"!!

Terribly sorry for the delay in posting, everyone. Robin and I spent the weekend in Portland. And my doggie ate my homework.

Pronounced "woofer", Evan and I are now certified CPR givin', First Aid administirin', broke bone fixin', blood pressure takin', shot givin', shock treatin', vomit dealin', wound cleanin', elbow/ankle/what-have-you splintin', knot tyin', richeous bad asses.

This post would literally be pages long if I were to outline exactly what we learned about the body, trauma, and how to assess and care for an injured person until the EMT's arrive. Don't get me wrong, it will be plenty long anyway, but it could be longer so consider yourself blessed.

One of my most favorite facts that I learned is that when hiking in the "back country", you are being stalked by a cougar 25% of the time. On that note, I kept referring to cougars as "pretty kitties" until I saw graphic images of what happens when you are mauled by one. Now they're "hissing death pussies", and although still cute, you don't want to cross one. Here's a couple of tips to avoid cougars:

1) First, by "stalking", I don't mean "will kill you given the chance". They stalk things that they find mysterious, like a curious kitten.

2) They WILL attack you if you corner them, go near their young or walk towards their food. How do you avoid this? Well, if you see an animal, OF ANY SIZE, lacerated and dragged somewhere, WALK AWAY. You are not just near their kill, they are watching you. As you know, kitties are very quiet and their cougar cousins are no exception. You won't hear or see them until it is far too late. So, start backing up, DON'T TURN YOUR BACK and get the hell out of there. If one decides to attack you, before they do (if you can see them first), put your arms up and out to the side of your body, scream really loud and look menacing. Believe it or not, chances are they'll back off; unless you're near their food or young. Or you smell like delicious Ben & Jerry's Half Baked ice cream. Cougs can't resist the ice cream.

By the way, if a bear attacks you, fight back. Yes, I said fight back. Particularly, go for gouging the eyes or hitting it's temples. Why not run? Because they can run a straight line through the forest at 30-35 miles per hour. Why not climb a tree? They'll rock it so hard it will break and if it's too big for them to break, they'll crawl up it and get you. What if these aren't options? Well, get as loud as you can, scream and yell, put your arms up to get "big" and hope for the best.

Enough with the "fun facts". Just what the hell did I learn about survival and treatment of patients, anyway?

Instead of go through all the examples, I'll just give you the two major situations I had to deal with (during our practical "night scenario") and just remember, this is only a fraction of my total knowledge on the subject.

On Wednesday the 21st, we were to complete a scenario at night. We had to set up base camp, get triage tents organized, elect an Incident Commander (like the President, only not stupid) an Equipment Manager (self explanatory), and two "Hasty Team" leaders. Evan and I were elected HTL's and we both had two others who worked with our group. The HTL's were responsible for moving quickly over our terrain and trying to find survivors. Once found, we would provide treatment until the Litter Team (stationed at base camp) would arrive. Note: Not all survivors of an incicent need to be littered out. Only if they are severely injured is this necessary. Why? Well, YOU try carrying out a 200+ pound man screaming obscenities and tell me how you like it.

Evan and I had spent a considerable amount of time during the two weeks hiking around the camp. There were so many trails to be discovered and it was breathtaking (Oregon nature, after all). So, he and I had a good idea of where everyting was in relation to base camp. We drew up a quick map and divided it in two. We were told that there was a plane crash and several survivors needed to be found. Off we went.

We all had walkie-talkies, which was superb because ALL the teams were on the same channel, listening and organizing. Keep in mind that mine and Evan's other two people were carefully decided back at camp, so we had an excellent balance of strengths and weaknesses between the six of us.

My side of the map had no one on it. We searched and friggin' searched, thinking we were either missing people or complete rejects as Evan's team was radioing in "found two survivors... found one survivor... found two survivors...". Turns out, ALL of the survivors were on his side of the map. There was one survivor in the middle of the map, who was the first that we found.

Quick note before I continue: the "injured" people we found were all at least WFR's. More likely, they were EMT's. Basically, they knew exactly how we should be caring for them, exactly what steps to take and exactly how to dock us if we messed up. No pressure, right?

Other quick note: our instructors have a makeup kit the likes of which I have never seen before. Deviated trachea? No problem. Deep, gashing, oozing wound? Got it. Anyway...

My guy, "Chuck", had a broken femur. Not only was it broken, but his jeans were cut away and the bones were jutting out of his leg with blood pouring everywhere. I immediately felt sympathy pains in my right leg. Off I went. As Hasty Team Leader, it was my responsibility to assign specific duties to my other two team members, care for the patient and keep accurate records of his heart rate, resting rate and blood pressure. I'll spare you the smaller (though no less important) details and tell you about tractioning a person's leg. This is what I had to do to Chuck, and would do in a real-live situation with the same circumstances:

1) Use special ankle "knot" and put around ankle, which will be pulled once traction device is secured.
2) Using a telescoping pole, or another device which can extend, place the handle end high into the patient's groin. Pad as necessary to help with pain up there.
3) Tie webbing (nylon cord) around leg and high up to the hip. Once that piece is secure, you may begin pulling traction.
4) Hook up ankle "knot" to the end of the traction device and extend telescoping pole (or other such device) in order that the bones re-set inside the person's leg. This will provide immesurable pain for them and excruciating angst for you. Deal with it; you're a WFR!
5) Once the bones have lowered into a more normal position, it will alleviate a LOT of pain for the injured person, as well as provide them better circulation. This does NOT mean that you have "set" the bone!! Only doctors can do that, so don't think their leg is somehow fine now. Oh sure, it's much better off, but it's not fine.
6) Continue care for patient, watch for circulation problems, GET THE HELL OUT OF THERE.

Easy enough, right? Keep in mind that I'm quickly going over all of this. There are other steps that are essential as well, but you've already been reading this for several weeks, so I shant keep you further.

Next and last for this post; chest decompression. So you thought pulling traction was fun? Try this on for size:

My second patient was not one my team found. Like I said, Evan's super-team (who were obviously taking steroids) beat mine to all the other patients. I assumed care of "Sara" who had respiratory problems. Evan's team did a great job caring for her before I arrived, except for injecting 500cc's of anabolic steroids into her face. Evan seems to think injecting faces with steroids is a good way to heal people. I totally agree, I just didn't have any with me. Plus I'm not as cool as Evan. Damn him.

Anyway, I was told she had shallow breaths, bruised ribs and a broken elbow. Her arm was in a sling, and she was protecting her injured lung. The other girl that was with her could walk (with help from us, because she hurt her ankle), and so could Sara, so down we went. The other girl and two other WFR's were ahead of Sara, Dave (my teammate) and myself. Sara was moving consistently slower and eventually, plopped onto our ridge rest, for her breaths were too shallow. Situation deteriorating!!!

I called in a "helicopter" and had base camp get an oxygen tank ready and a litter team to me YESTERDAY. While David and I waited for the litter team, we were monitering vitals on Sara, which were becoming more and more severe. My instructor, Jenni, was standing behind watching us and was "giving" us vitals, even though we were really taking them (as you can imagine, Sara didn't actually have a blood pressure of 90/40 - yikes). Then, the fun started.

Jugular vein distention. JVD for short, it's when your lungs/heart are backed up with blood, and the patient's neck becomes veiny and purple. It's oh so very very yucky and though it wasn't actually happening, Sara was acting oh so very very well. The litter team arrives. No time for chit chat, I brief them quickly and get Sara into the litter. Jenni (instructor) was following behind us as we begin our quick and painful descent to base camp. About 1/2 way down, she says, "you notice tracheal deviation on Sara." Soooooooo bad news. What's that anyway? Well, it's when your trachea literally shiftes to one side of your neck. What do you do? You have to relieve the pressure build-up in order that they can breathe again, which = hardcore shit:

1) Prepare an IV needle or pen by removing excess packaging. For an IV needle, this means very little, as all you need is the needle and hollow connector. For a pen, this means getting it down to the tube itself. As you can probably imagine, we were fresh out of IV needles, so the pen would have to do.
2) Cut a 1" section off the finger of a latex glove. NOT the tip, both ends must be open. Attach this piece of latex to the end of your pen tube, securing one section to the pen with medical tape. Leave the other end (the one sticking past the end of the pen) open.
3) Find the middle of the patient's clavicle (sticky-outtie bones at the inferior part of your anterior larngynopharnyx). From there, go down two ribs until you hit the third. Right at the top of the third rib, what you must do is puncture a hole until you hit the outer lung. With an IV needle, this is relatively easy, as the needle itself just needs to be shoved down. HOWEVER, for a pen device, that means using a knife or other puncture device to carve a hole, then insert the pen, to relieve the pressure. The end of the pen with the latex around it is the one that will remain outside the body. As the patient breaths in, the latex will close on the pen, not allowing air directly into the lung/chest cavity. This is a temporary solution to a hardcore problem, but it works and I "saved" Sara's life. Yippee!

No one died even though our instructors told us they would. They lived because we provided excellent care at the right time and got those people the hell out of there.

Thanks for taking the time to read this post. I could go on forever about the benefits of this class, how it changed my life and how everyone should know this stuff. But I won't. Instead, I'll tell you a funny joke one of my fellow classmates told me:

Q) How many A.D.D. kids does it take to change a lightbulb?

A) WANNA GO RIDE BIKES?!