Guest guest Posted May 10, 2004 Share Posted May 10, 2004 Thank you Liz for setting up this course. And thanks to Tony and Cynthia from WMA for doing an excellent job of preparing us for the unexpected. Linda and I both feel much more confident that we can handle the situation "if things go badly"."The air goes in and out,and the blood goes round and round..."What a concept! Quote Link to comment Share on other sites More sharing options...
glenn Posted May 10, 2004 Share Posted May 10, 2004 I'll second Dan's thanks. I was pleasantly surprised by how much we managed to cover in only two days, and I definitely feel like I should be a little less of a helpless spectator of mishaps in the future. Quote Link to comment Share on other sites More sharing options...
guido Posted May 10, 2004 Share Posted May 10, 2004 I agree Liz. Tony and Cynthia were fantastic. Great program. Now i just have to figure hout where to get that extra week of vacation to do first responder with them...Guy Quote Link to comment Share on other sites More sharing options...
djlewis Posted May 11, 2004 Share Posted May 11, 2004 >Now i just have to figure hout where to get that extra week >of vacation to do first responder with them... > >Guy I echo the enthusiastic reviews. Tony Simpson, in particular, was supurb and incredibly knowledgeable... and punctured a number of myths (like epi pens and how to use epinephrine in general). As for taking another course with them, if you look at the web site... http://www.wildmed.com you'll see that they have a couple hundred instructors. Those are spread over the country, but quite a few are in the Northeast. So I wonder how easy it is to get your choice. Actually, what I'd really like right now is that half-day on spinal assessment, so we don't get stuck having to treat every significant fall-type injury as a potential spine case until they get to an ambulance. I perused WMA's and others' protocols for spinal clearing, and they certainly look like you do need to be trained in them. BTW, that site lists Tony as a PA. But I thought he said he was now an MD, or at least in training. Is that right? --David Quote Link to comment Share on other sites More sharing options...
jeffcasey Posted May 11, 2004 Share Posted May 11, 2004 yup - that was my only complaint, that they set us up for a real conundrum by teaching us to support, but not how to decide when to release.Very good course, and ....ok, I'll say it... better than the SOLO course 2 years ago. I'm ready to sign up for the WFR version myself. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2004 Share Posted May 11, 2004 I'd echo the acolades for the WMA course. I too got more out of it than the earlier SOLO class: Tony did a lot more explaining about the phisiology, systems and mechanisms behind what's going on. Besides satisfying that geek itch, it allows us to reason things through rather than just follow rules. That much said, the SOLO course was very good and as with most topics, when you hear a body of knowledge the second or third time around, a lot more makes sense.I'd also echo David's surmise that what we got from Tony is not necessarily the standard WMA fare. I talked with him afterwards and he acknowledged that he puts in a lot more theory and background than most other WMA instructors. So in general, WMA courses may not be that much different from SOLO. One other difference is that WMA certifications are for 3 years vs. SOLO's 2 years. While this is less hassle, I'm not sure it is an unambiguous advantage as many of us forget much of the material in only two years. Practice!!!! Or at least re-read the material once a year.I, too, initially had the impression that Tony was an MD, but within the first few hours caught the reference to 'PA' i.e. Physician's Assistant. What he said was "I practice medicine" which is true enough for PAs, but obviously led many of us to the wrong conclusion.I also asked about further classes for NSPN, particularly trip leaders. He is very open to more classes, either with CRCK or just with NSPN. There is a four day Wilderness Advanced First Aid course which includes the spinal clearing protocols (i.e. procedures to confirm with reasonable certainty that there is no spinal injury). The good news is that he can teach it over two weekends. The bad news is it must be taught as a unit: no half day on just the spinal clearing protocol. And he cannot just teach the 'other' two days for those of us who went through WFA. We'd have to do the entire 4 days again.Like us, he prefers to do these courses in the shoulder seasons: mud season in the spring and late October and November before snow allows him to run the sled dogs.Finally, a huge thanks to Liz for organizing this! I'm just sorry that she didn't get to take it herself.Scott Quote Link to comment Share on other sites More sharing options...
djlewis Posted May 11, 2004 Share Posted May 11, 2004 Scott wrote:>I, too, initially had the impression that Tony was an MD, >but within the first few hours caught the reference to 'PA' >i.e. Physician's Assistant. What he said was "I practice >medicine" which is true enough for PAs, but obviously led >many of us to the wrong conclusion. My doubt about Tony being an MD began when he answered a question with "I don't know". ;-))) (Apologies to any MDs in the audience; if this doesn't fit you, may I please have an appointment with you asap -- I need a new PCP!) Seriously, he didn't say that very much, and almost always had stunningly logical and convincing responses to questions.>I also asked about further classes for NSPN, particularly >trip leaders. He is very open to more classes, either with >CRCK or just with NSPN. There is a four day Wilderness >Advanced First Aid course which includes the spinal clearing >protocols (i.e. procedures to confirm with reasonable >certainty that there is no spinal injury). The good news is >that he can teach it over two weekends. The bad news is it >must be taught as a unit: no half day on just the spinal >clearing protocol. And he cannot just teach the 'other' two >days for those of us who went through WFA. We'd have to do >the entire 4 days again. OK, a refresher on the first two days...I'll take it, especially if Tony is teaching. Scott, does your conversation with Tony means that we ~can~ arrange for ~him~ to teach it.>Finally, a huge thanks to Liz for organizing this! I'm just >sorry that she didn't get to take it herself. Ditto!--David. Quote Link to comment Share on other sites More sharing options...
Michael_Crouse Posted May 11, 2004 Share Posted May 11, 2004 The protocols for clearing someone's spine involve being in a wilderness context. So if you crash and burn in some surf on Nahant I would call an EMT, even though I know how to clear a spine.Most memorable quote from my WFR...How long do you have to clear his spine?"The rest of his walking life" Quote Link to comment Share on other sites More sharing options...
jeffcasey Posted May 11, 2004 Share Posted May 11, 2004 Agreed, Michael. I'm actually more worried about climbing accidents 2 days out in a southwestern slot canyon...it can take a long time for rescue to come in...a long time to hold onto somebody's neck. Much better to know when walking out is possible. Quote Link to comment Share on other sites More sharing options...
djlewis Posted May 11, 2004 Share Posted May 11, 2004 ... or on a rocky island somewhere, in conditions where the CG can't land, and the only way off is probably in kayaks. I presume that means strapping an uncleared victim to paddles, rafting them out through surf, etc.The practical effect of this wrinkle is that the "right" thing will probably be hard to convince people to do, and won't get done in a lot of cases. 98% of the time, it'll be OK...but 2%... well. (Anybody have real figures?).But in that situation, at least I will palpate the spine gently for tenderness and pain. That much I presume we can manage without training and certification (or can we?), and not assume that it clears the spine.--David. Quote Link to comment Share on other sites More sharing options...
Michael_Crouse Posted May 11, 2004 Share Posted May 11, 2004 If I couldn't clear a spine and a CG boat couldn't land, I'd call for a helicopter, or an EMT that could examine his spine. Like I said the rest of that person's walking life is in my hands. If you think someone's spine is injured and you can't move them in a stable manner then don't move them.I assume that when you say litter you don't mean a back board? A litter isn't going to keep someone spine stable. Quote Link to comment Share on other sites More sharing options...
djlewis Posted May 11, 2004 Share Posted May 11, 2004 >If I couldn't clear a spine and a CG boat couldn't land, I'd >call for a helicopter, or an EMT that could examine his >spine. Like I said the rest of that person's walking life is >in my hands. If you think someone's spine is injured and you >can't move them in a stable manner then don't move them. My point exactly... but not for an actual spinal injury, just for the spinal injury we are now trained to ~assume~ is present until cleared.We were told to treat anyone with sufficient MOI (mode of injury, like a fall from high enough, maytag with head involvement, etc) as if they were spine injured... "clearing" them was not taught in this course. So you have to continue assuming spinal problems until you get medical personnel involved who are trained to do a spinal assessment. There were several stories of ambulatory and apparently OK victims who moved their head in such and such a way and ... bang!Given that, you'd have to call a helicopter for a victim of a sufficient fall who claims they have no spinal problem and are able to move around fine. It ain't gonna happen in practice, especially for a helicopter. Sure, when the copter arrives, the EMTs will say you did the right thing for your level of training. But convincing the victim to hold still while we call a copter, much less the rest of the party, will be nigh impossible.--David. Quote Link to comment Share on other sites More sharing options...
John Leonard Posted May 12, 2004 Share Posted May 12, 2004 Tough question... I'm not sure about the actual percentage of injuries involving spinal damage in the back country or paddling in particular. There probably isn't enough data to get a reliable figure anyway. It takes a pretty significant mechanism to damage the spine, it would be hard, but not impossible, to do that paddling. It's certainly not something I would lose sleep over. Jeff bring up the possibility of a climbing accident and that is definately something to worry about. Once you decide someone has a MOI for spinal injury, you don't want to try to move them without clearing them or boarding them. No exceptions or the liability fairy may pay you a visit. Not only can you paralyze someone but if the injury is above C5 they will stop breathing if moved the wrong way. I would assume (I hate that word) that the coast guard would be able to give you a medical patch via radio to either their flight surgeon or the local ER. It's pretty common for street emt's, medics, and even wilderness rescue teams to use a medical patch to get treatment advice from an ER doctor. If the situation was that bad they could probably talk you through it if you convince them you have a general idea of what is involved. Not as good as getting real help, but it really isn't that hard. How 'bout an NSPN first aid scenarios day? John Quote Link to comment Share on other sites More sharing options...
eneumeier Posted May 12, 2004 Share Posted May 12, 2004 >How 'bout an NSPN first aid scenarios day? Now that sounds like a fun time. Perhaps if he is up to it we could get Leon to come out and describe in a really graphic manner just how if works when you break a femur in surf, and how the medical folks handled it. The we could practice. :-))Liz N. Quote Link to comment Share on other sites More sharing options...
jeffcasey Posted May 12, 2004 Share Posted May 12, 2004 ah ah ah.......that is one of the differences between SOLO and WMA...or 2 years ago and today at any rate....they no longer teach all that stuff about traction on femurs...too much of a party trick, too many things that can go wrong. actually, if you played the two lessons side by side, you would think that they were talking about first aid for two different species... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2004 Share Posted May 12, 2004 FYI: Here's a link to the DOL summary of Physician Assistants http://www.bls.gov/oco/ocos081.htm Maybe that's next for some of us.... Scott Quote Link to comment Share on other sites More sharing options...
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