NOLS WMI Wilderness First Aid Part 4 (Misc Stuff)

To finish up this series I putting all the rest of the notes I haven’t rewritten yet here. These are out of context but maybe writing them down again will help me out.

In between learning the PAS and going outside to practice it we did a ton of other stuff. Covering:

• Spine injury
  • immobilization
  • rolling techniques
• Head injury
• Shock
• Wound management
  • infection
• Burns
• Muscluloskeletal injury
  • splinting
  • dealing with dislocations
  • taping ankles
• Heat illness
  • dehydration
• Cold injuries
  • treatment myths
  • real treatments
• Lightning
• Altitude illness
• Anaphylaxis
  • carrying Benadryl
  • where do they keep an epi pen?
• The medical patient
  • abdominal pain
  • chest pain
  • shortness of breath
  • altered mental status

This stuff is all online already or in books. It was a lot to take in that fast. A few things I wrote down above and beyond the handouts they provided:

Infection

The acronym here is SHARP:

• S - Swelling
• H - Heat
• A - Aches (lymph swelling)
• R - Redness
• P - Puss

Infection is bad. If you see fever, swollen lymph nodes, sigh/symptoms of shock, read streaking it’s time to go. No good progress in 24 hours is also an EVAC.

Athletic Injuries

First time I ever taped an ankle. Kind of crazy how much something like that can help. Assessment here is LAF:

• L - Look (swelling, discoloration, deformity, compare to other side)
• A - Ask (severity of pain 1-10, what’s a 10? What happened? How much force? Pops? Snaps?)
• F - Feel (tenderness, range of motion)

Treatment is RICE - Rest, Ice, Compression and Elevation.

When taping two rolls of 1”x10yard athletic tape will do about three ankles. Since you want to take it off each night to monitor, check CSM, and run cold water over it, that could turn into a lot of tape.

Medical Patients

When dealing with things like abdominal pain or general aches and pains it’s OPQRST:

• O - Onset (abrupt or gradual? when?)
• P - Provoke (what makes it better? what makes it worse?)
• Q - Quality (chronic or acute? localized or general? try not to lead them.)
• R - Radiate (one spot? moves?)
• S - Severity (1-10. What’s a 10?)
• T - Time (how long has this been happening?)

Low Level of Responsiveness

When dealing with low levels of responsiveness it’s TO STOP:

• To - Toxins (white gas is a possibility)
• S - Seizure/Sugar
• T - Temperature
• O - Oxygen
• P - Pressure (altitude sickness)

What to Have With You

We didn’t talk much about first aid gear. Most of this can be done with what’s around you, like splinting with tent poles, branches, and their foam sleeping pad. Couple things stuck out as items I needed to add:

• Something to put between the patient and the ground to prevent hypothermia
• Tape; I never really thought about an ankle injury on a day hike
• Tincture of benzoin helps bandages sick which would be really handy
• 12cc irrigation syringe
• A watch
• A notebook and pencil
• Gloves
• Benadryl

These are all things that are hard to improvise, make a real difference, and are (generally) small. Otherwise, you’ll improvise. And, again, use there stuff when possible so when they EVAC away from the group you don’t loose your coat or pack stays.

Conclusion

The two days were absolutely worth it. My WFA certificate is good for two years and when that’s coming due I’ll probably sign up for another class. I’d really like to take the WMI Wilderness First Responder course (WFR or woofer) but it’s 10 days on site. That’ll be hard to swing but it’d be great.