365 True Things: 230/Medical

Today was our monthly SAR training, and our tri-annual medical training, allowing us to maintain our accreditation as First Responders.

Today we learned about hypothermia. The upshot: you can survive a surprisingly long time after getting really, really cold, but you have to be warmed up carefully, and you could lose a digit or two or ten.

So, really: don't get cold. Or not too cold, anyway. Be smart out there when you're doing those fun winter or high-altitude sports.

Then we practiced CPR and airway assessment, the top tasks when meeting up with an emergency. The good old ABC's: airway, breathing, circulation. Though yeah, C comes first now. If the patient has no pulse, get right on that. 

Here's the protocol for CPR: if you come upon someone who's unresponsive, try to revive them (shake them, talk to them); if that gets no response, check for breathing; still nothing, check for pulse on the carotid artery (in the neck) for five seconds. If there's nothing, get a bystander to call 911, and if someone else is nearby, and there's an AED (automated external defribillator) nearby—like, if you're in a shopping center or other public place—have them go get it. Immediately start chest compressions: thirty straight-armed, hands-locked pumps, followed by two breaths to the mouth (preferably with a pocket mask or bag valve mask [BVM]), then right back to compressions—until the AED arrives and is launched and the blessed machine voice starts to give you reassuring directions.

Our practice babies

As for airway: you start the same, but if you do feel a pulse, you immediately start ventilating, with a BVM or with breaths by pocket mask: enough to gently fill the lungs, every 5 to 6 seconds. Typically, you'll insert an OPA (oropharyngeal airway) or, if there's a gag reflex—as in, the patient might vomit—an NPA (naso . . . ). Assuming you have all this paraphernalia available. If you don't, I guess you just do mouth-to-mouth?

Continue until ALS—advanced life support—arrives.

Strictly speaking, in the backcountry we're unlikely to use any of this. Do we even have OPAs and NPAs in our medical bag? I'm not sure. I know we don't do CPR—once we come upon an unresponsive patient, after a several-hour drive then hike, the patient will not be recovering. Ever. We don't even have an AED on our truck.

But still, I reckon it's good to practice these skills just in case I happen, one day while I'm strolling around Del Monte Mall shopping (which is pretty much impossible: I hate to shop—but sometimes I absolutely have to, so you never know), to witness a person clutching his or her chest or throat and falling to the ground. I will have the drill down.