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Sterling, VA – The Center for Wilderness Safety (CWS), a nationally recognized program offering wilderness and remote medical training as well as American Red Cross health and safety training, will be a contributing sponsor for the 2010 Mid-Atlantic Student Wilderness Medicine Conference in Philadelphia, PA. The Conference is an exciting opportunity for medical students and health care professionals to learn about and gain hands-on experience treating patients in extreme environments.
The two-day conference in April will consist of lectures and workshops lead by nationally recognized physicians and experts on a variety of topics. Demonstrations featuring some of the latest technology being used in the field will also be offered. Students are invited to submit abstracts from their own research in wilderness or disaster medicine for poster presentations. This is an excellent opportunity for both students and health professionals to expand their knowledge and network with other like-minded professionals in the field.
Four members of the CWS staff, including Sean Keener, the new program director of CWS, will be attending the 2010 Conference. Sean has attended many similar wilderness medicine and risk management conferences around the US and is looking forward to getting a different prospective on what students are interested in learning and what new programs CWS can develop to bridge the gap between medical students, health-care professionals, and the relatively new field of wilderness & remote medicine.
Stay tuned for updates from our staff as more information becomes available. You can follow CWS on Twitter at (@CWSonline) and the Wilderness Medicine Conference at (@phillywildmed).
More information is available at http://www.phillywildernessconference.org.
It has occured to me that a lot of emphasis is put on “macguyvering” or using whatever you have to self-evacuate a patient to definitive care. Don’t get me wrong, many wilderness first aid classes that I’ve seen have done a really great job of making some very creative (and sometimes even effictive) make-shift spine boards with which to evacuate a patient. However there’s a new train of thought that we teach in wilderness first responder which I think is important to relay to WFA students and alumni which is:
In a wilderness rescue situation where you find yourself in need of evacuating a patient with a severe life-threatening condition, there’s a very strong likelihood of NOT doing a self rescue, but rather an assisted rescue where professional services are utilized. Many folks seem to want to get the patient to definitive care as quickly as possible; which is not entirely faulty – the issue is that with wilderness medicine, the goal is to stabilize the patient and stay with them until either help arrives or you can stabilize them and make them as highly visible as possible while you go get help. Your goal as a wilderness medicine provider (WFA or WFR) is NOT primarily to evacuate the patient; hence why two major teaching points of both courses are extended patient care and evacuation decision making.
WFA and WFR courses should train using professional rescue devices such as actual spine-boards, Reeves stretchers and Stokes basket litters for example.
I just felt that this is a clarification that should be made since so many students have asked the question of “when should we evacuate a patient and how would one go about doing so”. I will also answer that saying ‘it really depends on the situation.’ Remember though your primary goal: stabilizing the patient and if at all possible, sending for help.
Since this topic has now come up several times in greater detail than I had anticipated in going into during CPR & Wilderness First Aid classes, I figured that I would pass this information on to you all regarding the American Red Cross’s stance on Do Not Resuscitate orders and what you as a lay-responder should do if you encounter one.
To Summarize:
1) As the Lay Responder (Red Cross CPR/First Aid certified only), one does not have to acknowledge the DNR Order.
2) If you are Wilderness First Aid certified or higher (WFR, FR, EMT, etc.), you are to look at the document and may “accept it’s conditions” to not perform CPR in the event of a cardiac or respiratory arrest only if the following conditions exist:
a. The document MUST be the ORIGINAL (copies and verbal statements do NOT count in a court of law).
b. The document MUST be SIGNED by the correct people (person’s personal physician; and the patient or power of attorney).
c. The document is only valid for ONE YEAR from the date signed by the physician. After which it is no longer valid.
3) If you are a lay responder (American Red Cross certified only) then take the document and give it to the paramedics upon their arrival.
4) If the patient has a Living Will, it is NOT THE SAME and therefore you are to perform CPR as needed according to your initial assessment.
5) A DNR order can be revoked by the patient (or power of attorney) destroying the document (ripping it in half is sufficient) and cutting of their DNR bracelet (if they have one).
6) A TATOO which says “Do Not Resuscitate” is NOT A LEGAL DNR and must be ignored.
This information is specific for Virginia, Maryland and the District of Columbia. If you live in another state, check their laws regarding DNR orders (it’s fairly easy to find on Google). I hope that answers any questions that you may have had regarding Do Not Resuscitate orders! If you’ve got more questions, please feel free to call us at (703) 444-9468.
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 over the handlebars, and landed on his head. Garrett knew I had first aid training and came home to get me. I rushed to the scene and held c-spine on Marshall until the paramedics arrived. Marshall was altered and barely breathing, in very serious condition. They had to airlift him out to Fairfax. Later the EMT thanked me – he said that when they arrived I had done everything right and had control of the scene. Funny thing is, despite being a little rusty it all came naturally.
Marshall is in the Pediatric ICU today. He has a lacerated liver and some bleeding on the brain. Last we heard he was scheduled for a CAT scan, but that there were no signs of brain damage.
Thanks for a great course. “It’s not your emergency” was key to keeping focused. Everything else seemed to happen naturally.
Mike
PS. All of the boys wear full gear, but sometimes it just doesn’t prevent injury. The motocross track is now slated for demolition per every mom in attendance. Marshall’s career motocross racing has also ended – he is officially retired, also per his mom.
The following article was written by Michael M. and Adam S. of Herndon, VA who did a case study of the effects of how different individuals deal with coming across a patient who is already deceased, as opposed to one to passes away while under their care. These two gentlemen are still in High School – and did a fantastic job with this study!
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, Adam S. and I volunteered at a course called Wilderness First Aid (WFA), taught by the Center for Wilderness Safety. WFA is a 25-hour long course that is open to all people 14 and older. It teaches how to prevent, recognize, and treat common wilderness first aid problems when definitive medical help is more than one hour away. Along with becoming “victims” for them, we also taught a session of the course called “Death and Dying,” in which we taught about Kubler-Ross’ Five Stages of Grief. Read the rest of this entry »
With bones, we have only 1 basic thing that can happen: fractures. Fractures can be either simple (broken or cracked – but still under the skin) – or compound (an obvious break; usually showing through the skin). Either way, we need to make certain that the patient is comfortable, and that we stabilize the fracture and prevent movement of the injured area; thus, preventing further damage or harm to the patient.
How we achieve this goal, is to apply a splint.
We’re very excited about our new partnership between the Center for Wilderness Safety and Lake Fairfax Park in Reston, VA! We will now be offering a number of course available to the public starting in February of 2009. Those courses will include many American Red Cross and Wilderness Medicine courses that will be offered not only to the public, but also to Fairfax County Park Authority employees over the coming months.
