Second Aid: Lessons Learned From Past Adventures

[Rick Dubrow]

All too often I’ll run into another hiker and the following conversation ensues:

“How many nights are you staying out?”

“None… I hope. We’re on a day hike.”

“Then why are you carrying so large a pack?

Allow me to unpack my answer… an answer that addresses situations well beyond wilderness travel. An answer that extends into my settled, civilized life as well.  Why, at home, are Cindi and I prepared for a major natural or human-induced disaster?  Why, in our car, is it normal for the trunk to be half full of extra clothing and emergency gear?

‘cause shit happens. The fan is out there somewhere… rotating.  Car wrecks happen; falling down at home happens; broken ankles happen.

Hence this blog post… about our company’s day hike to Mt. Pilchuck this past summer that ended with a helicopter rescue. I vowed to write about what we learned: about safety; about appropriate preparation; about teamwork; at home, at work, in the wilderness.

I’m not suggesting that you should increase your worrying coefficient. Calm down. To the contrary, allow me to quote Cindi, that person who shares my personal and work life, when she talks about ‘creating structure to support your life.’  Preparation and planning reduces one’s need to worry… because if the shitty fan blade striketh, you’re ready for the ensuing stress.

Although you may be knowledgeable about first aid to some degree, have you thought much about second aid? During the initial aftermath of an accident or injury, it’s critical for you to guesstimate when  you can expect experienced aid to show up.  That estimate helps define what needs to happen early on, from the time an injury occurs until the time when an experienced rescue human can step in and take over.  The latter is often referred to as second aid.

First aid is up to you and yours, assuming you’re just about first on the scene. Our recent chopper rescue taught us this: proper preparation and planning depend upon first and second aid… stabilizing the victim and then either transporting the person or awaiting a rescue.

Seconds after Patricia broke her ankle we found her on the ground in severe pain and emotional trauma.  She was with her daughter and her daughter’s friend– strangers to our group of 5 co-workers. No bleeding and no apparent head injury, so her injuries weren’t life threatening.  That was a good thing, given that second aid would probably be many hours away. [The actual time between injury and helicopter arrival turned out to be 4 hours. Compare that to my present situation at work as I write this: I’m next door to a fire station!  The time between injury and rescue, at the moment, might be 30 to 60 seconds!]

Since we had cell phone reception to reach 911 we didn’t need to rely upon my recent purchase of a Delorme ‘inReach’ satellite communicator. [Some sick part of me wanted this rescue to depend upon this new state-of-the-art device I had just bought… for just this sort of situation!]  Emergency dispatch helped us determine that we shouldn’t splint her ankle; the chopper team would use an air splint. So our attention was focused upon:

Keeping her… and ourselves… warm.

Helping Patricia feel as calm, and as cared for, as possible. Call it ‘terror management’; she was one hurting puppy.

Preventing other hikers from tripping over her and us. [We were right on the trail attending to her needs.]

That said, while waiting, we had plenty of time to prepare for the chopper, discussing everything from the noise that would prevent verbal communication, to securing our clothing  that might blow around in the rotor wash. One thing we overlooked:  eye protection.  We should have put on our sunglasses to prevent the intense rotor wash that made seeing almost impossible while it hovered overhead.  Good thing I wasn’t responsible for splinting Patricia’s ankle! Given how poorly I could see without eye protection her lower leg would now look like a pretzel had I done the splinting!

In my pack I carried everything necessary to keep one person warm and dry for an unplanned overnight outside, and keeping Patricia warm required nearly everything I had in my 65-liter Gregory ‘Baltoro’ pack… and then some: extra clothing in others’ packs; some chemical warmers for under her armpits from another passerby. We slipped some insulation beneath her to protect her from the cold ground. We set up walking sticks as visual barriers so that others wouldn’t fall on top of her.

Ultimately, Patricia was invisible to an innocent passerby…wrapped within an insulated cocoon piled high with every piece of clothing and emergency gear imaginable! You couldn’t tell there was a human therein!

[Yes, that’s Patricia, beneath the silver emergency blanket, as warm ‘n cozy as we could make her cocoon while we awaited second aid.]

Two past events prepared me for this appropriate preparation, yielding this large pack that others often ponder about:

I was caught out on an unplanned overnight about 20 years ago, on an overcast, summer evening near the Twin Sisters to our east. My day pack volume at that time was perhaps 40 liters, too small to handle everything someone would need to reasonably make it through the night. So, for example, although I had shorts and light rain pants with me I didn’t have any long pants for warmth. [The very next day I bought a larger day pack, vowing never to make the same mistake again.]

During the 2001 Nisqually earthquake that battered Seattle I anchored a weekly radio program called ‘On The Level’ on KGMI… about remodeling and custom homes.  After the shake I interviewed Seattle’s emergency director on the air, learning how people took as many as 3 days to make it home because of damage to I-5 and its bisection of the city.  Most people had what was in their car; few were prepared with emergency gear.  Soon thereafter I started carrying a 3-day kit for two people in my car, and still do to this day [warm clothes; rain gear; flashlights; water; flashlights; etc.].

That’s my point.  One needs to be prepared to survive until you can access second aid… outside help and expertise… a truism in an urban and wilderness setting alike!  But it’s one thing carrying this stuff around  in your car, another when one’s backpack weight shouldn’t exceed 25% of your own body weight.

Given these past two events, I took safe wilderness travel to heart. The Mountaineer’s Basic Climbing class provided the core of my learning, focused on wilderness first aid, and the inherent understanding that second aid is usually very far away!

Ask yourself this:  if you’re on a hike 5 miles from the nearest road, could you and your group sustain CPR for a victim until rescuers appear? Probably not if your numbers are few; administering CPR is extremely hard, physical work. Instead, sustained CPR just might produce additional injured victims instead of potentially saving the life of the original victim! Hence, the very nature of urban first aid is a far cry from wilderness first aid.

The 10 essentials; extra food and clothing; water; worthy rain gear… takes up a lot of volume!  Got space?

If not, get some! Don’t let your pack size limit your life expectancy!

Consider, too, carrying some technology in your pack. I carry my smart phone.  Why that extra weight?  Because it actually saves weight given what I no longer need to carry.  My phone is loaded with:

A wilderness first aid book

A survival medicine handbook

Freedom of the Hills [the Mountaineer’s textbook from their Basic Climbing class]]

A general-interest reading book for my backpack trips

Information about giardia and lightning

How to signal an aircraft with emergency information

Map and compass instructions

Information about pharmaceuticals I carry in my first aid kit

Owner’s manuals for items such as the satellite communicator, my camera and my UV water sterilizer [SteriPen]

The ‘Earthmate’ app synchs with the Delorme satellite communicator, providing a much larger screen and buttons than relying on the inReach by itself

No books to carry; more safety information on board; more peace of mind.

Enough about technology and what one carries.  A few words about the carrier – your body! Is your body ready, willing and able to submit to what you’ll be asking it to perform?

Consider this metaphor from my friend Phil Damon, referring to one’s body as one’s horse.  Just how well do you care for your horse?  You’re asking it to carry your pack, your essentials… your personality. Is there any obligation mightier than treating your horse with love and respect?  Preparing your horse for an adventure is perhaps the single most important piece of preparation.

A few more top-of-mind lessons to share:

Alert someone who’ll know where you’re going and when you’re expected to return. So important and simple, but how often is this overlooked? Even if you’re heading over a mountain pass in your car!  Someone needs to initiate a rescue if you’re too late! [And since you’ll lose cell coverage heading over the pass, why not take your Delorme inReach satellite communicator on such a trip as well?]

Before you start a trip, ask everyone else in your group to describe their pre-existing medical issues. Shouldn’t others know what to do if symptoms begin for some underlying issue?  Do they have drugs in their packs, or in their cars, that you should know about?

I was so very impressed by the rescue response for Patricia:  the chopper, its personnel… 4 men [pilot; 3 rescue techs]… and the equipment.  These dudes risked their own lives to help us. Isn’t that reason enough to honor, and act upon, one’s responsibility to be properly prepared when taking on an activity, wilderness or not?  I think so. After all, relying upon others instead of your own preparation seems selfish, unfair and unpredictable.   Sure, shit happens, but it’s your doodie to minimize the pile…

Prepare for the worst, expect the best, and embrace what comes.

Onward into the storm…