SAR Fundamentals/Evacuation

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