SAR Fundamentals/Evacuation

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Contents

[edit] Subject

What is this lesson plan about?

Moving the subject after they have been located.

[edit] Authors

List who wrote this lesson plan.


[edit] Scope

What is included in this lesson, what's not and why.

Addresses part of CSA Z1625 4.4.1
  • part of T1. First aid procedures related to relevant search environment.
SAR Fundamentals Manual: Ch.26 "Evacuation"
Basic SAR Skills Manual: Ch.23 "Rescue and Evacuation"
include litter carry / patient packaging
does not include spinal restriction / C-collar / backboard

[edit] Prerequisites

What should students already know/have accomplished before the lesson is presented.


[edit] Objectives

At the conclusion of this lesson the participants:

  1. can identify roles within an evacuation
  2. can reduce patient stress
  3. can package patient in stretcher
  4. can safely carry a patient in a stretcher through terrain difficulties

[edit] Time Plan

Total Time: 40 minutes lecture, 30 minute practice

  • 2013-02: 25 min


Time Material


00:00

3 min

Introduce topic title

Introduce Instructor

Present Objectives

  1. can identify roles within an evacuation
  2. can reduce patient stress
  3. can package patient in stretcher
  4. can safely carry a patient in a stretcher through terrain difficulties

00:03

1 min

Evacuation Concept


00:04

2 min

Carry vs. ...

  • helicopter extraction
  • stay


00:06

3 min

Roles in Evacuation

inner circle (medical) vs. outer circle (rescue)

  • team leader
  • first aider
  • advocate
  • stretcher bearers
  • scouts
    • scout out entire route
    • avoid having to back track
    • entire route doesn't need to be flagged, but does need to be obvious to the guide
  • guide

Additional resources will be sent in

  • up to 24 people required to sustain carry of stretcher in difficult terrain


00:09

2 min

Medical Considerations

  • take priority over most other aspects of evacuation
  • continuing monitoring of vital signs
  • access to injuries and extremity
  • risk of vomiting
  • hypothermia


00:11

2 min

Subject Safety

  • can't protect themselves
  • situations that may be safe for the stretcher bearers may not be safe for the subject
    • e.g. a slip, might mean stretcher bearer catches themselves with hands, subject has unprotected fall
  • what are the risks? how likely are they? how serious are they? how can they be mitigated?
  • lower down, face up, more exposed
  • safety glasses, face shield, clear plastic sheet


00:13

2 min

Subject Comfort

  • pressure sores (can become medical issue)
    • more issue for SAR than other training (longer periods)
    • thermarest
    • packing voids
    • Padding, too much is almost enough
  • hydration
  • excretion


00:15

3 min

Subject Stress

  • very scary being the subject
  • losing control
  • calm voices, no shouting, listening, not talking at the same time, avoid side conversations
    • even if unconscious
  • build rapport with subject, patient advocate
  • use subject's name, introduce yourself, talk to subject
  • engage subject in their own care
  • sight lines, generally move feet first
  • avoid lights in eyes
  • dust, dirt, debris
  • claustrophobia
    • arms in/out of packaging


00:18

3 min

Types of Stretchers

  • wire basket stretcher (e.g. Stokes)
  • polyethylene basket stretcher (ferno)
  • two piece polyethylene basket stretcher
  • wheeled stretcher
  • mountain stretcher (e.g. Mariner)
  • field litter


00:21

23 min

Order of Packaging - No backboard - theory

demonstrate packaging (add 10 minutes)

  • stretcher
  • burrito lashing laid out
  • tarp open
  • sleeping bag (open)
  • thermarest (deflated)
  • empty pockets
  • patient
  • pad hollows (neck, small of back, under knees, between legs)
  • environmental protection
    • close sleeping bag
    • add blankets
    • space blanket -- condensation issue
    • fold tarp
    • tie burrito lashing
    • inflate thermarest
  • stretcher lashing
    • cross at chest, cross at hip, above knees, below knees
  • faceshield / sunglasses


00:24

3 min

Complex Packaging

spinal restrictions

  • advanced or wilderness first aid skill
  • thermarest goes between patient and backboard

rope rescue

  • needed for >15° slope or unstable terrain
  • improvised harness goes on patient
  • stretcher lashing is more complicated

People with these higher level skills will be brought in to work with you on packaging


00:27

1 min

Carrying

  • similar height on opposite sides
  • Carry the litter level or, if not possible, head high unless medical control suggests otherwise
  • use of webbing over outside shoulder
    • don't tie yourself in


00:28

2 min

Rotation


00:30

1 min

Carrying - cont.

  • anyone can call a break


00:31

1 min

Lift/Lower

  • safe lifting practice
    • don't take stretcher bearer role if bad back, shoulder, wrist
    • Lift with your legs (not your back)
  • lift/lower called by person at head
    • "on my call, we will lift"
    • "anyone not ready?" (ask in the negative)
    • "one, two, lift"


00:32

1 min

Carrying Straps


exercise: short carry and lower


00:33

2 min

Moving

exercise: resume the carry, adding complications of terrain to bring out the following points

  • Use of scout
  • relief comes in from front
    • exchange sides to relieve your tired arm
    • pass forward
  • obstacles/difficult terrain, stand still with firm footing and pass forward
  • subject is vomiting
    • place on ground and lift one side to near vertical


00:35

30 min

Exercise

practice wrap

practice raise/lower

practice carry

practice rotation

navigate obstacles


01:05

5 min

Questions


[edit] Aids

What materials are needed or useful in presenting this lesson.

  • slides (download/print: .pdf; edit: .odp)
  • wire mesh stretcher
  • webbing
    • 6 x 5m
    • 1 x 10+m or 2 x 7m
  • improvised terrain or obstacles

[edit] References

  • BICO Module #3 Snowmobiler Basic Tx Principles (10 min video)

[edit] Question bank

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See Question bank

[edit] Frequently Asked Questions

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[edit] Feedback

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[edit] License

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Recommended license below. Fill in the year and the author's name(s):

Copyright © 2013-2018, Chris Jorgensen, Brett Wuth. This work is licensed under a Creative Commons Attribution-NonCommercial 2.5 Canada License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/2.5/ca/ or send a letter to Creative Commons, 559 Nathan Abbott Way, Stanford, California 94305, USA.

[edit] Reference Material

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[edit] Notes

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