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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Original Post - Mar 24, 2015 - 09:44pm PT
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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?
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johnboy
Trad climber
Can't get here from there
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Mar 24, 2015 - 09:56pm PT
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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.
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 24, 2015 - 10:01pm PT
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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.
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HighTraverse
Trad climber
Bay Area
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Mar 24, 2015 - 10:42pm PT
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Re-learn Chest Compression CPR
I'm alive only because someone did it to me.
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Ken M
Mountain climber
Los Angeles, Ca
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Mar 24, 2015 - 10:52pm PT
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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.
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 24, 2015 - 11:20pm PT
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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.
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BuddhaStalin
climber
Truckee, CA
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Mar 24, 2015 - 11:35pm PT
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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.
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the Fet
climber
Tu-Tok-A-Nu-La
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Mar 24, 2015 - 11:38pm PT
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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.
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Vitaliy M.
Mountain climber
San Francisco
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Mar 24, 2015 - 11:44pm PT
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ACLS and BLS certified RN. Maybe I should look for a spot at a hospital so I could be paid like one. Haha.
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Mar 25, 2015 - 12:12am PT
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"... 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.
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BuddhaStalin
climber
Truckee, CA
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Mar 25, 2015 - 01:55am PT
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^^whats your background?
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Evel
Trad climber
Nedsterdam CO
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Mar 25, 2015 - 04:03am PT
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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.
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EdwardT
Trad climber
Retired
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Mar 25, 2015 - 07:36am PT
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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.
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hossjulia
Trad climber
Carson City, NV
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Mar 25, 2015 - 07:50am PT
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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.
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Evel
Trad climber
Nedsterdam CO
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Mar 25, 2015 - 08:00am PT
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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.
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John Duffield
Mountain climber
New York
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Mar 25, 2015 - 08:01am PT
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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.
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WBraun
climber
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Mar 25, 2015 - 08:24am PT
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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 .......
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Evel
Trad climber
Nedsterdam CO
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Mar 25, 2015 - 08:37am PT
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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.
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Mar 25, 2015 - 08:57am PT
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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.
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Reilly
Mountain climber
The Other Monrovia- CA
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Mar 25, 2015 - 09:02am PT
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With a wingspan of 74" I can deal with two pneumothoraxes at once!
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SC seagoat
Trad climber
Santa Cruz, or In What Time Zone Am I?
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Mar 25, 2015 - 09:15am PT
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NOLS Wilderness First Responder
Medical Off Shore Training (when you are 3 weeks from the nearest landfall you have to be prepared for a lot of potential emergencies). So far haven't had to do any major medical stuff (except self stitching) off shore, but the thought of a major bleed or break so far from help is intimidating.
Susan
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Patrick Sawyer
climber
Originally California now Ireland
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Mar 25, 2015 - 09:31am PT
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Former EMT 1 mid-1970s.
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perswig
climber
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Mar 25, 2015 - 09:33am PT
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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.
Dude, you're not spending enough time over on the gun debate sandbox thread!
Those skillz will be in high demand as soon as the gub'mint starts trying to take back our ARs...
WFR plus recert, for me. Would consider that a minimum for at least one member of a climbing/whitewater/ski group to have when venturing afield.
Dale
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kev
climber
A pile of dirt.
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Mar 25, 2015 - 09:34am PT
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I'm a CGTP - Certified Gorilla Tape Provider
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HighTraverse
Trad climber
Bay Area
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Mar 25, 2015 - 09:49am PT
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Additional thoughts on chest compression CPR.
Indeed it's not often successful. I was told something like 8%.
However, that largely depends on the patient's health.
People with serious heart disease, COPD, extreme obesity......yada yada yada......are not going to come back as often.
Without warning my heart completely stopped. Or at least I had no pulse.
There were four keys to my survival:
Good overall health
No general heart disease
I kept breathing (yes, this happens)
Immediate chest compression CPR.
I came back in something like 2 1/2 - 4 minutes.
And yes, it HURTS. 7 weeks later and I've still got two tender spots in my ribs. Thank you DK, VERY much!
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Mar 25, 2015 - 09:55am PT
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HT, pre-existing health condition is a key factor.
How long before BLS/CPR was initiated on you?
Was an AED applied?
How long before an ALS (Paramedic) provider arrived?
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HighTraverse
Trad climber
Bay Area
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Mar 25, 2015 - 10:14am PT
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CPR started: not more than 2 minutes later. Probably less. No one was keeping time at that point.
I came around completely in about 4 minutes. My mind was clear as a bell. I thought I had only fainted. Wanted to get up and keep hiking.
NO artificial stimulation. This was in the "back country". No AED. Nuttin'
Truckee Fire SAR arrived about 40 mins later. Put in a port, pulled a Troponin sample, gave me O2 just in case, put me on ECG. They packaged me for the chopper flight to Renown in Reno. I was wide awake and alternately helping and joking all the time.
2 1/2 hours from falling over to the ER. Exactly 24 hrs from falling over to open heart surgery.
How likely is anyone to need chest compression CPR? Not very likely. When you need it away from an AED nothing else will do.
Will an AED even work for total cardiac arrest? It's largely a de-fibrillator.
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Mar 25, 2015 - 10:22am PT
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I know you described this in an earlier thread, but who provided your BLS? As it was backcountry, they obviously palpated for the presence of a pulse....correct?
A Defibrillator of any kind will not be useful when cardiac arrest progresses to asystole and an AED would not function, as asystole (or normal rhythm) are not 'shockable rhythms'. If defibrillation is to have any benefit, it needs to be applied as soon as possible (assuming there is actual fibrillation at the time).
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HighTraverse
Trad climber
Bay Area
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Mar 25, 2015 - 10:46am PT
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I was resuscitated by an Anesthesiologist who happened to be in my group. He found no pulse at my wrist. He didn't take the time to check my carotid but started chest compression CPR immediately. He had stopped by the time I awoke, after my pulse had returned. The subsequent medical tests confirmed my heart had stopped.
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Guernica
climber
dark places
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Mar 25, 2015 - 11:11am PT
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Lapsed EMT-B. Never did work professionally but had amazing training and ambulance ride-alongs where I witnessed some semi-legit stuff, but nothing too truly crazy or PTSD-inducing.
Was lucky enough to observe 6 autopsies though, 2 of which were homicide victims... one of those a "decomp". That was wild, though obviously nothing that demanded actual medical care (6 months too late to do anything in that case.)
Total respect for our medical professionals out there!
(edit: did get to use some of the training shortly after the course when a woman collapsed in a sushi restaurant in vancouver. Once the medics left with the patient the manager comped me & my gf's meal [incl. sake] for the help we provided :) )
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johnboy
Trad climber
Can't get here from there
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Mar 25, 2015 - 11:19am PT
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I've read a lot here can't handle the trauma.
I was on a volunteer fire department for 20 years before I got my EMT-B cert and the things I saw in the field made me numb to it. Car accidents when they lived were some of the worst I've witnessed. The will to live is strong, even when unconscious.
On the topic of AED's, almost all of them currently in service in schools, stadiums, airports, ambulences and such will monitor a pulse and automaticaly let you know if it's a shockable rhythm or not.
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Mar 25, 2015 - 11:33am PT
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A true Automated External Defibrillator doesn't require anything of the user except to attach it properly- the device will determine whether the rhythm is shockable or not, and will automatically shock as necessary.
Semi-Automatic External Defibrillators require the user to attach it, and if determined necessary by the device, for the user to provide the shock via a pushbutton.
These days, most people refer to either type as an 'AED'. Neither of these types of devices typically have a cardiac monitor that graphically illustrates cardiac rhythms, or the presence of a pulse.
Manual Defibrillators do have a monitor, and the user can interpret it and adjust joule rates accordingly, and shock as they deem necessary. These types of defibrillators are most commonly utilized by ALS providers.
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SC seagoat
Trad climber
Santa Cruz, or In What Time Zone Am I?
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Mar 25, 2015 - 11:51am PT
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We've been contemplating getting an AED on our boat, given our age, and since we can be weeks from shore or days from a passing ship rescue.
This thread has given me a lot of food for thought.
Susan
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mucci
Trad climber
The pitch of Bagalaar above you
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Mar 25, 2015 - 12:04pm PT
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I had WFR and O2 administration certs.
Having had the basic life saving training saved the life of one partner, and expedited the critical care for another.
I would recommend at least the above to anyone doing anything in the mountains.
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Easy Wind
Trad climber
Oakland, California
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Mar 25, 2015 - 12:24pm PT
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CPR and First Aid certified since the Boy Scout days.
Just finished a 7-week EMT course a few weeks ago. Currently doing ambulance ride-alongs and studying for the NREMT. Planning to work as an EMT-B as I apply for nursing school.
A few years back I took a fall, pulled a piece, and was knocked unconscious when my head hit the wall. No helmet. Concussion and laceration. Two friends in the group had medical experience; one was an EMT, the other a WFR. They took care of me and hung in there until the paramedic unit arrived and transported me to the hospital, which luckily wasn't very far from the crag. I was grateful that my friends had training and could handle the situation. Sh#t happens. I think it makes sense to have a basic level of medical training to be able to help out.
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darkmagus
Mountain climber
San Diego, CA
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Mar 25, 2015 - 12:37pm PT
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I'm a Doctor of Chiropractic (D.C.).
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Clint Cummins
Trad climber
SF Bay area, CA
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Mar 25, 2015 - 12:47pm PT
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Zero certs lifetime and holding.
Have had informal training, so I can do basics on wounds, broken bones, spinal, CPR.
I understand the attraction of maybe being able to save a life, and being more self-sufficient.
I feel that getting certs/renewals would not significantly increase the chances of me saving lives/limbs.
Mainly because the frequency of accidents I've witnessed over 40 years has been low.
Good subject for thought and discussion, though.
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 25, 2015 - 12:55pm PT
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Nice to see some great discussions in the thread! Thanks for all the input, and for keeping the thread on topic gang.
HT, that is some scary shyte. Glad he got you back so fast.
I tend to follow local protocols, but my general opinion on compression-only CPR is that in most cases, you will or will not get a pulse back before oxygen loss leads to brain damage. A lot of it is situation-dependent, but I can understand the concept that taking out rescue breaths helps a rescuer avoid contact without a mask. As a general rule, I keep a basic film mask in my pack at all times, but I only have a full mask when I have my BLS bag with me, which stays in the truck. With my BLS bag, I have a lot of O2 options so I probably wouldn't be using a mask then either.
I don't have an AED in my bag, as even the cheap ones are pretty damned expensive. If you do choose to purchase an AED Seagoat, I would do some research before buying.
I usually self-review all my training annually and recert as needed, mainly because protocols such as compression-only CPR can and do change, and I like to keep up with current techniques.
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WyoRockMan
climber
Flank of the Big Horns
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Mar 25, 2015 - 01:05pm PT
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EMT-B (now lapsed) as part of volunteer FD/Ambulance crew in Montana.
Moved to WY where they don't recognize NREMT certs. I started studying up for the WY tests, but was unable to find a volunteer service. I live about 1/4 mile outside of the local volunteer services responder "limit". This is a rural community with only 3-4 EMTs. I tried to sell the model that we used in MT, where we equipped our EMT's outside of the zone with jump kits/O2 to provide a wider range of rapid coverage. The idea was, and works well, is that the nearest responder can get there quickly while the wagon is en-route.
Pretty bummed to have to give it up. I still keep current FA/CPR.
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Mar 25, 2015 - 01:31pm PT
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Compression-only CPR is being taught these days in light of research that suggests that acute onset cardiac arrest will likely have relatively good blood oxygenation, and therefore BLS time is better spent (at least initially) in attempting to perfuse the brain with that blood, rather than wasting time oxygenating it. In the case of cardiac arrest mechanisms that are more hypoxic in nature...many of which are more likely to be encountered in active outdoor people (i.e. drowning, avalanche burial)...compression-only CPR may not be as beneficial.
The other, more practical implementation of compression-only CPR comes in training laypersons, who are skittish about doing ventilations on a patient, &/or do not have Personal Protective Equipment (or comfort with it's use) available to them.
In any case, discriminating between mechanisms & adjusting one's technique is probably more relevant to someone with extensive training &/or experience. Bottom line with CPR: DO SOMETHING. No effort = 100% mortality rate.
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lars johansen
Trad climber
West Marin, CA
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Mar 25, 2015 - 02:06pm PT
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EMT-Paramedic/firefighter, 13 years-lars
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DanaB
climber
CT
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Mar 25, 2015 - 04:31pm PT
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RN, many years ER experience.
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Sierra Ledge Rat
Mountain climber
Old and Broken Down in Appalachia
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Mar 25, 2015 - 05:49pm PT
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EMT Basic
Wilderness EMT
Basic Life Support
Advanced Cardiac Life Support
Pediatric Advanced Life Support
Advanced Trauma Life Support
Board certification in emergency medicine
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Evel
Trad climber
Nedsterdam CO
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Mar 25, 2015 - 06:47pm PT
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SLR-How did you get your Board Cert. in Emergency Med.? I've got mine as well, but only after LOTS of time in class and the field.
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Sierra Ledge Rat
Mountain climber
Old and Broken Down in Appalachia
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Mar 25, 2015 - 11:55pm PT
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How did you get your Board Cert. in Emergency Med 3 year residency in New York
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Batrock
Trad climber
Burbank
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Mar 26, 2015 - 07:35am PT
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Paramedic for the Los Angeles City Fire Dept. for 27 years. It's come in handy on more than a few occasions while climbing. I contend the best backcountry first aid kit it a simple roll of tape. It's all I carry and all I have ever needed.
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 26, 2015 - 11:31am PT
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Thanks Mr. Crag!Great input.
Cragman brought up something that I have been thinking about adding to the thread, so let's expand the topic a bit. If you want to share some scenarios that you have encountered that were unusual and how you dealt with them, please do so. Let's make sure that we keep the discussion civil please, and not use any person's name or exact location so that we aren't invading anyone's medical privacy.
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Clint Cummins
Trad climber
SF Bay area, CA
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Mar 26, 2015 - 01:24pm PT
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How many times have you needed to escape a belay, or ever heard of someone needing to do it?
Remember, it is always possible to construct a theoretical scenario in which no self-rescue is possible.
(Sorry about the thread drift - maybe start a separate thread and I'll delete this post).
[Edit to add:] Sorry if I missed your main and first point. Having someone die in front of you and not having the training to possibly help - that is pretty brutal. As I age and am around older people more, maybe I will get a clue and refresh my CPR training (I'd probably be OK with just looking on youtube).
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 26, 2015 - 02:15pm PT
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That's OK Clint - being as this is a climbing site and we are discussing scenarios, escaping a belay would be included I think.
I've never had to escape a belay before, but I've had to do a very fast lower of a partner that pulled a rock off, which hit the belayer to my left. Had to get the partner down and safe as quick as possible so that I could attend to the injured party.
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the Fet
climber
Tu-Tok-A-Nu-La
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Mar 26, 2015 - 03:19pm PT
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For chest compression only I'd do it on a stranger that didn't look healthy. I'd do full cpr on a buddy buried in an avalanche or anyone I knew wasn't diseased.
During the last cert I did for cpr the instructor ran through the results of some recent studies. Basically getting a pulse at the wrist is something like only 15% effective in an emergeny situation and even when tested by professionals in a hospital it was only like 30% effective. It makes me feel good because I've always had trouble checking a pulse at the wrist and I guess that's totally normal.
On another note for me this is all just like insurance or an airbag on a car or escaping the belay. I hope I'll never use it but it's nice to know what to do if it comes down to it. The only time I've ever really used my training is when a guy had a mini stroke next to me at Home Depot.
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 26, 2015 - 03:30pm PT
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I used to have the same problem Fet, I have gotten better at it but I will go for the carotid pulse if I can't get it right away. You have to have your fingers very LIGHTLY on the wrist, and if your finger tips are trashed or calloused that makes it even worse :)
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 26, 2015 - 04:10pm PT
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Never have I had to however if I needed to do so I could. Sorry but you can know all the first responder there is to know if you can't get out of the belay and to the injured person what good is that training.
No reason to be out, WTF - I agree with you. Self Rescue by David Fasulo was one of the first books I bought when I started, and to be honest I need a refresher.
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Sierra Ledge Rat
Mountain climber
Old and Broken Down in Appalachia
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Mar 26, 2015 - 04:35pm PT
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The Wilderness first aid and EMT courses are fantastic, I recommend them to everyone.
I contend the best backcountry first aid kit it a simple roll of tape.
Batrock, I agree wholeheartedly.
People ask me about a simple backcountry first aid kit. I tell them:
1. Duct tape
2. Tube tent
If it's a minor problem, then duct tape can fix it.
Otherwise, you'll need shelter while you wait for help at arrive.
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 26, 2015 - 05:16pm PT
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HAHA Crag, nice one :) I do that too! Had a bike vs. car that went to the hospital with a maxi on his chin.
My favorite item in my BLS bag - a roll of commercial grade plastic wrap. 101 uses.
And you're welcome for the thread, I don't post threads a lot but when I do, I like to think of things that are important and/or engaging.
We actually met briefly at Facelift a couple years back, but I am looking forward to talking to you more at Todd's gathering as well - I have some free time coming up and you have some hikes planned that I would like to be part of.
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kaholatingtong
Trad climber
therealmccoy from Nevada City
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Mar 26, 2015 - 05:28pm PT
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None, beyond non current CPR. I have done a bit of reading, basically enough to know that anything beyond the very basic I would be totally clueless for dealing with. I have however taken a self rescue class at least, I can confidently escape the belay and stabilize a person before going for help, which I figure (hope ? ) is enough, with the very basic basics, to cover 99% of the situations I will encounter. I haven't encountered that 1% yet, and hopefully I have the spare cash enough to have taken a few more courses before that situation arises...
I have always been into the idea of taking not just a WFR but some basic EMT courses, but it has been a matter of having both the spare cash and time, simultaneously, that has been slowing me down in that regard.
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JLP
Social climber
The internet
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Mar 26, 2015 - 07:19pm PT
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EMT maybe 20 years ago, haven't used any of it a single time even though I have been present at many emergencies. What is needed is clear thinking and a willingness to act. What needs to be done is generally very simple and obvious.
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johnboy
Trad climber
Can't get here from there
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Mar 26, 2015 - 09:51pm PT
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There must be more EMT's then one thinks. So many times on a car accident call I've had a lot of people stop and say, "can I help, I'm an EMT".
Never needed one yet but I'm amazed at the amount of people that want to help, even when they're on vaction just passing thru our area.
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phylp
Trad climber
Upland, CA
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Mar 26, 2015 - 10:13pm PT
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I don't have much training at all.
But after a friend had a serious accident I finally decided I needed to take at least the two day WFR course , which I did.
And the great thing about it was that I put together a much better med kit which I now always have in my pack.
Even on multi pitch routes, I've decided I want to have it with me. I throw it in a superlight pack and lead with it, never notice it.
I've used it twice.
Once, doing a day hike in Death Valley, a little kid stumbled and got a tiny scratch. But, as kids will do, he was screaming and crying. I approached and followed the protocol, his parents played along, and I very seriously got a bandaid out of my kit and applied it, after a little cleaning wipe. He was rapt with attention and no crying after that.
The second time was just about 6 weeks ago. I was walking (walking!) and a small rock dislodged and tumbled into my shin. I looked down and thought "well that's going to be a scratch" ... and looked in horror at a hole that had been poked all the way into my white bone. And then the blood came gushing.
But I didn't panic! Took out my kit, cleaned it with sterile saline, dressed it up, wrapped it and walked out. 3 hrs later the emergency room finally got around to putting a staple in it. Man, I'm glad I had that kit with me.
point is - carry some kind of first aid kit!
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GrahamJ
climber
In the rain
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Mar 27, 2015 - 01:23am PT
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Did a wilderness first responder course about 10 years ago. I have since become a veterinarian - most climbers are animals anyway...
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justthemaid
climber
Jim Henson's Basement
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Mar 27, 2015 - 07:01am PT
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It's good to have some general knowledge and take a CPR course IMO. My WFR has lapsed and I don't think I'd take the full course again since it's pretty intense and time consuming if you don't need it for employment.
Right now I'd like to just take the 2-3 day Wilderness first aid course just to brush up on the basics and renew the CPR cert, just so I'm not standing there like a bump on a log when sh#t goes down.
So far I've been lucky.. the only medical emergencies I've had to fix were (two separate incidents of) diabetics allowing their blood sugar to drop so low they became totally incapacitated. I think I have that one dialed.;)
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Batrock
Trad climber
Burbank
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Mar 27, 2015 - 05:29pm PT
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knowing CPR is great and everyone should know it and if you don't at least start jumping up and down on their chest. The sad reality is that CPR in traumatic cardiac arrest such as a fall or blunt force trauma is pretty much an act of making yourself feel better and those around the incident. Getting viable pulse and rhythm back after a traumatic full arrest is somewhere in the 1-2% range and that may even be hopeful. After 27 years as a paramedic in South Central and East Los Angeles I have only witnessed one successful save. By all means do it but do not expect a positive outcome. I have performed it 3 times off duty on motorcycle riders on Angeles Crest Hwy. and the only reason I did it was for the friends of the riders who want to feel like something was done but in each case as soon as SAR medics arrived they pronounced them dead. Witnessed medical cardiac arrests with immediate CPR has a much higher rate of survival.
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Evel
Trad climber
Nedsterdam CO
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Mar 27, 2015 - 06:09pm PT
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Batrock and SLR have it right-Best first aid item is a roll of coaches tape and a pocket knife. That, and common sense. And I usually have a space blanket at the bottom of my pack. (came in handy when I delivered a kiddo a few miles in on a x-country ski trail. Mom was due that day and thought some skiing would help things along. She was right!)
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 29, 2015 - 11:20pm PT
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Great responses all, thanks for the continued input. That's quite a tale Evel!
I've had a couple of "Kid boo-boo" events happen when training up pn Mt. Charleston with SAR - in both cases, I treated with a healthy dose of jokes and their choice of Frozen or Cars band-aids that I keep for just that reason. (Secondary application of Disney band-aids go to whiny adults, which I encounter quite often in ultra races - they don't get a choice :p )
I tend to agree with Batrock - many of the EMTs I know will work a full code just for the benefit of friends and family members. It seems to help in many cases, and easing suffering is never a bad thing.
Maid, if you happen to get a few days in Vegas, I'd be happy to help you get your FA/WFA recert done.
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 31, 2015 - 04:21pm PT
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So I just found out that a lot of the WFR courses require you to have a CPR-Pro cert, so I am going to knock that out next week. One advantage of working for an ASHI Training Center is I can just self teach and test out. Coming up in about June I will need to renew my Instructor cert, but I have taught enough classes the last couple years that I won't have to retest there.
Having a hell of a time finding an ASHI WFR program - I don't mind traveling to get the cert, but I'd prefer to stay with the ASHI courses so that I can upgrade my Instructor to Level 1.
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lars johansen
Trad climber
West Marin, CA
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Mar 31, 2015 - 05:43pm PT
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Batrock said it-lars
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Mar 31, 2015 - 09:22pm PT
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The two major wilderness medicine programs (esp. WMA & WMI) include CPR training within their WFR curriculum. WMI (aka NOLS) has a layperson-level CPR (1 rescuer adult CPR, FBAO), while WMA includes Professional BLS CPR (1 & 2 rescuer adult/child/infant CPR, FBAO adult/child/infant), as well as training in the use of AED's, oxygen, and airway adjuncts.
Even most of the smaller, lesser-known programs typically integrate some level of CPR into their WFR curriculums.
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WBraun
climber
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Mar 31, 2015 - 09:32pm PT
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There's people with lots of certificates and no live real time in the field experience.
Then there's people with one or two certificates and years of live real time in the field experience.
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Vegasclimber
Trad climber
Las Vegas, NV.
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Topic Author's Reply - Mar 31, 2015 - 09:38pm PT
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Yeah Apogee, I just figured that my CPR/FA/AED would be enough. Not a big deal though, I can get the Pro done in a couple days.
And yeah, Werner, I know that's a truth. I spent a couple years on SAR here, but we weren't super busy as the team was still building. May go back to it now that they have agreements with Metro SAR and the parks. I want to get my NASAR cert at some point. But between the two, I will go with the guy with years of experience and few certs (if I had a choice at that point.) You managed to package me up and get me off the base of the Cap OK, so I have first hand experience that you know what you're doing :p (As if there was any doubt.)
I'd love to get on YOSAR, but quite frankly I can't cut the mustard on the physical requirements, and I don't think the wife would want to live in Merced.
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