What medical training do you, or would you like, to have?

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Vegasclimber

Trad climber
Las Vegas, NV.
Topic Author's Original Post - Mar 24, 2015 - 09:44pm PT
Just kind of curious to see how many of our tribe have medical training, or would like to get more training. This isn't so much for guides, who in many areas are required to have WFR or higher, but more for the rest of us mere mortals.
I'd also like to hear from folks like Crag and Mr. Duck - have you found that people with minimal, as opposed to no, training are more of a help or a hindrance in emergency situations? I can see it going both ways.

I'm an ASHI instructor in and certified for Infant/Child/Adult CPR/AED, Wilderness First Aid, Bloodborne Pathogens and Emergency Oxygen. The CPR class came about when I was on SAR, and after re-realizing that I really like to be able to help people in a medical capacity, I moved on to get more training.

I'm planning on taking it to the next level soon, and getting my Wilderness First Responder before moving on to EMT-B at least, and EMT-A if I have the time before I move to Germany. Not so much as a job prospect, but more because I really like learning the material and having the ability to help someone if needed.

I feel that if you're going to be out in the wilderness or doing high risk sports then it's a good idea to at least have some basic knowledge, but then again I think carrying enough water is important too and a lot of people don't seem to bother with that :p

Thoughts?
johnboy

Trad climber
Can't get here from there
Mar 24, 2015 - 09:56pm PT
Ive had my EMT-B for quite some time. Now with more time on my hands I'd like to get my EMT-A, then on to Paramedic to finish off with.
Vegasclimber

Trad climber
Las Vegas, NV.
Topic Author's Reply - Mar 24, 2015 - 10:01pm PT
Awesome to hear, John. I don't plan on going past -A for now, especially as if I do end up with a service over in Germany, it would be all BLS transports for SNFs and such. Over there, they have a doc in each bus that handles all the ALS stuff.
HighTraverse

Trad climber
Bay Area
Mar 24, 2015 - 10:42pm PT
Re-learn Chest Compression CPR
I'm alive only because someone did it to me.
Ken M

Mountain climber
Los Angeles, Ca
Mar 24, 2015 - 10:52pm PT
As a physician, I've always found it much easier to work with trained people, as opposed to untrained. As an example, I can direct an EMT to apply a splint to a limb, and can give minimal attention to that problem. With someone untrained, I'll probably have to do it myself. Also, untrained people are often very shocked by trauma and illness, and I often find that I have more than one person to treat!

Climbing specifically, and outdoor pursuits in general, are high risk activities in terms of minor and major injuries, where the EMS system cannot respond for many hours---days.

This is especially true offshore, in the third world.

I encourage people to get Wilderness First Aid as a minimum. More may be warranted, depending upon the specifics.
Vegasclimber

Trad climber
Las Vegas, NV.
Topic Author's Reply - Mar 24, 2015 - 11:20pm PT
Some good posts here, thanks. Ken, thanks for chiming in as a physician. Traverse, thanks for the personal experience share - it's good to hear from someone that got the benefit side as well, and I'm glad you're still with us.

Part of the problem with being a full medic is that in most cases, even if you are a paramedic you are limited to scope of practice - you can be a full medic, but if you push drugs in a wilderness setting outside of your actual job, you can be liable. First responders are afforded some protection under the Good Samaritan Law, but the higher you go the less protection you have. That's part of the reason I am going back and getting higher certs - my knowledge and skills currently exceed my certified scope. I just can't stand the thought of being ABLE to help someone and having to STOP.

Dingus, I have trouble dealing with some trauma as well, but after the fact. Most of the time it's kinda like a light switch for me, I just click into another mode and it doesn't get to me. Afterwards though is another story sometimes.

BuddhaStalin

climber
Truckee, CA
Mar 24, 2015 - 11:35pm PT
Level 2 trauma RN for 6 years, ACLS, BLS, PALS. No more trauma please, now just work a regular med floor. I swear though, once you have some training, sh#t just starts finding you or happening in front of you.

Snowshed wall 2 years ago, some guy decked onto a rocky base from about 15 feet up, whacked his head good. No helmet. There were a total of 4 RN's climbing there that day and 3 fire-medics. Patient was annoyed at all the help. Youre alive enough to hate me. Youre welcome.

I am pretty numb to traumas, meaning I can handle some gnarly stuff. Ive picked up mandibles, scooped up brains, etc etc etc. Over it for sure. I just hope none of it happens to me or near me much of ever again.
the Fet

climber
Tu-Tok-A-Nu-La
Mar 24, 2015 - 11:38pm PT
I got my EMT 1 in the late 90s.

I've since refreshed my CPR, First Aid, Blood Born Pathogens, etc. certifications a few times as a first responder.

For myself I realize it's so easy to forget stuff that I don't use, that it's more important to refresh every year or two than take an in depth course which I won't remember in 2 years. I don't think I really need a course to refresh, just review the basics, but my courses are paid by my work so I stay up to date on my certifications.

I'm glad they changed CPR to compressions only being fine. I don't want to go mouth to mouth on someone I don't know and I rarely have one of the masks on me. Nice to know that just chest compressions should do the trick.

Vitaliy M.

Mountain climber
San Francisco
Mar 24, 2015 - 11:44pm PT
ACLS and BLS certified RN. Maybe I should look for a spot at a hospital so I could be paid like one. Haha.
apogee

climber
Technically expert, safe belayer, can lead if easy
Mar 25, 2015 - 12:12am PT
"... they changed CPR to compressions only being fine."

That procedural recommendation is just that...a recommendation...based on the best, current medical science...which is far from complete in the area of cardiac arrest, treatment & outcomes.

And importantly: it is most relevant in the acute onset cardiac arrest patient (i.e. MI), whose blood oxygenation is theoretically better...as compared to an asphyxic/hypoxic mechanism (i.e. submersion/burial), where oxygenation is probably much less. These patients would probably derive benefit from additional ventilations.

Giving strong consideration to MOI is probably a good idea...and adjust accordingly...and expect that accumulated medical science (esp. pre-hospital care) suggests otherwise. Which it undoubtedly will, eventually.
BuddhaStalin

climber
Truckee, CA
Mar 25, 2015 - 01:55am PT
^^whats your background?
Evel

Trad climber
Nedsterdam CO
Mar 25, 2015 - 04:03am PT
First aid since Boy Scouts,EMT-P since 1991. Never fails to boggle my mind how many people don't have any first aid training at all. As KenM mentioned above, I've also treated/transported folks for psychological shock from just being witness to an event.
EdwardT

Trad climber
Retired
Mar 25, 2015 - 07:36am PT
Never fails to boggle my mind how many people don't have any first aid training at all.

Boy howdy. And they just stand there, spectating.

hossjulia

Trad climber
Carson City, NV
Mar 25, 2015 - 07:50am PT
I had an EMT-B and OEC for ski patrol, but the medical aspect of that job really freaked me out. I was never faced with anything too gnarly, thank god.
I think about getting my WFR, so I can guide, but if anything super bad were to happen, I think I'd go off the deep end. PTSD is a real bitch.

I do have the training and would never hesitate to use it if needed.
Evel

Trad climber
Nedsterdam CO
Mar 25, 2015 - 08:00am PT
Boy howdy. And they just stand there, spectating.

Yup. And wringing their hands wishing they knew SOMETHING to do.

WFA/WFR is easy stuff. Should be ninth grade health class material. I'll go so far as to say EMT-B could fit in there.
John Duffield

Mountain climber
New York
Mar 25, 2015 - 08:01am PT
Good discussion. We're in a sport, that may increase your need to have these skills.

I took my EFR refresher in January. I take it every two years. Not only does it prepare me to help some one, but it juices my application to the better dive expeditions. In a real emergency, having several trained Emergency Responders, vastly increases the odds for a happy ending.

I was a Combat Medic in the Army. About the only thing I remember how to do, is the "Sucking Chest Wound" where someone is shot straight through the lungs. Prolly not gonna see that.
WBraun

climber
Mar 25, 2015 - 08:24am PT
Never fails to boggle my mind how many people don't have any first aid training at all.

40 years active on SAR and I don't have any medical qualifications.

Not even one.

Not everyone on SAR needs to be a medic .......
Evel

Trad climber
Nedsterdam CO
Mar 25, 2015 - 08:37am PT
I agree Werner. But I'd guess it's fair to say that you know to put pressure on bleeding etc. Lot's of folks without even that basic sense.
apogee

climber
Technically expert, safe belayer, can lead if easy
Mar 25, 2015 - 08:57am PT
Buddha, I got my EMT-B in '87, and took a WEMT Upgrade in '90 with Wilderness Medical Associates. Became a WMA instructor about a year later, and have taught several hundred wilderness medicine courses since that time.
Reilly

Mountain climber
The Other Monrovia- CA
Mar 25, 2015 - 09:02am PT
With a wingspan of 74" I can deal with two pneumothoraxes at once!
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