How much First Aid Training do you have?

[cob]

-I think most people have a good idea of basic first aid for caving.

It might seem cold and heartless,but I think there is little middle ground on treating injuries in a cave. The injured person either makes his way out - hopefully with basic intervention and pain meds - or it becomes a body recovery.

To me ,the best first aid kit is a simple one- a few decent bandages,basic OTC meds,and then a few big guns to just get you out of there! Like, some Percodan,and a stimulant of some kind,if needed.

Realistically,if someone suffers a severe injury, there isn't a trauma surgeon in the world that is going to be able to help you,in the bottom of some pit or tight crawlway.

I have to take exception with a couple of points here.

1st, I suspect the avg caver has no idea of how to deal with shock, which if you are on a team where a member suffers a serious injury, is the first danger point.

2nd, as one who has been involved in 2 full blown rescues, several "self-rescue" situations and have first hand knowledge of several others... it all depends. I know one guy who broke his back, lived and still walks. Another guy had his hand crushed when a large piece of breakdown fell on it. I know another guy who dislocated his shoulder way back in a cave where the situation was deal with it, right then and there... or... let us just say, rescue was not an option, impossible even.

On the flip side, I know 2 cavers who didn't make it, one who died in mid rescue, the other never had a chance. In one of the F-B rescues I was involved with, 5 of 6 people were dead before we even got to the cave.

3rd: I agree that the simple F-Aid pack is best... but if I get hurt underground, and I am not 100% with it, and you give me some Percodans... You have just killed me. I am allergic to aspirin. So if you give somebody something, they better be totally coherent, and you better have a working knowledge of pharmacology.

4th: Yeah, there isn't a trauma surgeon who can help you at the bottom of a pit... But your buddies who are there can... If they know how.

One last personal experience: 4 wks ago my son broke his arm (complete displacement of the Ulna) at the Spring AACS project... fortunately it was above ground, but if it had been underground the result would have been the same: complete recovery. While he was getting "shockie" there were several trained people there capable of dealing with the situation (I was 40 miles back to Misery when it happened) and I actually had to talk myself into turning around and going back to Mountain View. I knew he was getting the best care possible, and I would only be "moral support".

So here's to Emily Frank, Jim Terry, "Big" Ed Corfey and all the rest of the MOLES... I love you guys.

tom

ps: Tim, you might be off topic, but... the patient is stabilized... Now what? go to one of the NCRC seminars, because as Rick Haley told me, it will make you a better caver.

[Stridergdm]

I can vouch for Wilderness Medical Associates (where I got my initial training and instructor's certification), SOLO (which has long been considered one of the best), and MATI (the newest in the Northeast, but run and largely taught by expedition MDs).

- Robert

My alma mater's Outing Club (RPI which is also a grotto) sponsor's SOLO's 2 day Wilderness First Aid course every year. I've taken it 3-4 times and probably will take it again. If I had the time I'd do the WFR course.

It's definitely worth it. Any of the courses at the very least will get you to think about how you cave and what you'll do if something happens.

Anyway, if yor college has an outdoor or caving club, see if you can get them to kick in some money to defray costs. It may be worth it. (In our case, within a month of the first time we had SOLO on campus, members of our club came across a medical emergency in the backcountry. They said having the training definitely helped their confidence level and skill level.

[lenslover2003]

Cob,

I hope I didn't offend you with my last post. After reading your comments,and my own post again,I think I may have been unclear with my point. I should have put something in that reflected my opinions on medical care,if outside rescue was not logical,or even available. My intention was not to simply write off the first guy who breaks his ankle.

Your son's injury would be a perfect example of the case I am trying to make. Say this happened IN a cave. Unless he had sustained another,more life threatening injury,he would fully recover,once he gets proper outside care. It's the part about getting him outside ,that IS important.


His care would basically include stabilizing the arm as best you can,and then trying to make him more comfortable for the trip out. I would think that everyone on this discussion group would agree with this approach,whether they had training or not.

Making him comfortable means an effective pain reliever. I agree,that the person has to be fully aware,and let you know if they have any allergies to a possible med,and want to take it. If there was doubt,don't let them take it. I consider that to be another common sense approach,but I might be seeing things differently, than other people

I think that the people on this discussion group are pretty sharp,and that the best first aid is simple,and mostly intuitive.

Regarding the other injuries and fatalities you mentioned,you have illustrated my point. Only the crush injury to the hand could have been helped appreciably,by first aid. The individual who broke his back,needs outside rescue...period...unless you carry skeds and c-collars. The person who is in shock needs more than just their feet being elevated. They need full blown fluids and possibly blood volume expanders,if it's bad.

My point is that training is always a plus,but we need to be realistic when it comes to caving injuries.

[cob]

LL... just to get the record straight, it is impossible to offend me (I had all my feelings surgically removed years ago)

I was just pointing out what seemed to be a difference of opinion.

tom

[RescueMan]

I suspect the avg caver has no idea of how to deal with shock, which if you are on a team where a member suffers a serious injury, is the first danger point.

Perhaps if there has been significant blood loss (does everyone know how to really stop bleeding with FOCUSED direct pressure?), shock might be the primary problem.

But, if the injuries themselves are not immediately life-threatening, the primary problem in a cave is ALWAYS hypothermia. In fact, in any "wilderness" setting, assume the patient is hypovolemic (dehydrated), hypoglycemic (low blood sugar), and hypothermic (losing core body temperature) - and treat accordingly.

And this is just one of several areas in which basic First Aid or (even worse) EMT training will get you in trouble. One of the golden rules of street EMS is "nothing by mouth", but in a wilderness setting or delayed transport, feeding, hydrating (if the patient is conscious and can swallow), and warming are the primary treatment requirements for ANY injury.

- Robert

[GoHighGoDeep]

I got the state of Ohio to pay for me to take a EMT-Basic course while I was in high school. Most of it has stuck with me pretty well. I've had a few CPR refreshers since then, as well as some first aid refreshers... I usually carry a fairly substantial medkit, if the trip is going to be long and/or with lots of people or newbies. It's always in the car when I go out caving.