2012-09-04 regular training

Announcement
We'll be outside practicing stretcher packaging and transport. Part of the time we'll be in the creek behind the fire hall. There's only a few inches of water. Bring appropriate footwear and clothing.

Booking
19:00-21:30 Pincher Fire Hall

Agenda
outdoor; Equipment use (stretcher, packaging, evacuation)
 * roles
 * team leader
 * first aider
 * advocate
 * stretcher bearers
 * route finder
 * subject stress
 * very scary being the subject
 * losing control
 * calm voices, no shouting, listening, not talking at the same time, avoid side conversations
 * 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
 * lower down, face up, more exposed
 * safety glasses, face shield, clear plastic sheet
 * claustrophobia
 * arms in/out of packaging
 * 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?
 * medical considerations
 * continuing monitoring of vital signs
 * access to injuries and extremity
 * risk of vomiting
 * hypothermia
 * subject comfort
 * pressure sores (can become medical issue)
 * more issue for SAR than other training (longer periods)
 * thermarest
 * packing voids
 * hydration
 * excretion
 * types of stretchers
 * wire basket stretcher (e.g. Stokes)
 * polyethylene basket stretcher (ferno)
 * two piece polyethylene basket stretcher
 * attachable wheel
 * Mariner Mountain Carrier
 * field litter
 * order of packaging
 * backboard (if required)
 * thermarest (deflated)
 * 7m webbing for pelvic harness interwoven with backboard (if required)
 * 2 * 3m webbing for chest harness, crossed (if required)
 * patient
 * backboard straps (crossed at chest, across hips, above but not on knees)
 * pad hollows (neck, small of back, knees)
 * inflate thermarest (if backboard)
 * environmental protection
 * sleeping bag
 * blankets
 * space blanket -- condensation issue
 * tarp
 * burrito lashing
 * inflate thermarest (if no backboard)
 * transfer to litter
 * attach harnesses to litter
 * pelvic (if used)
 * chest (if used)
 * foot loops (if required)
 * lashing
 * cross at chest, cross at hip, above knees, below knees
 * faceshield

Carrying:
 * similar height on opposite sides
 * use of webbing over outside shoulder
 * lift/lower called by person at head
 * "on my call, we will lift"
 * "anyone not ready?"
 * "one, two, lift"
 * anyone can call a break
 * relief comes in from front
 * exchange sides to relieve your tired arm
 * pass forward
 * difficult terrain, stand still with firm footing and pass forward
 * up to 24 people required to sustain carry of stretcher in difficult terrain

Exercise:


 * 1
 * Package subject (volunteer) to be carried in ATV trailer and ride loop around parking lot east of fire hall.
 * Subject has a head injury.
 * Monitor subject for vomiting, stop once due to vomiting and clear airway.
 * Report back on:
 * Best way to package
 * Any equipment needed or should be changed
 * How patient condition was monitored (first aider riding, walking, or periodic stops?)
 * How communications was managed with ATV


 * 2
 * Subject is on other side of creek in brush, has been located by searchers, reports leg injury from a fall, requests stretcher
 * Decide suitable stretcher and reach subject (subject will be one of party)
 * Return to fire hall by circuitous route (if time is short, use direct route)
 * consider trail system an impassable barrier on return until reach stairs by bridge (circle around the sign at base of stairs)
 * return from stairs to fire hall by trail or road
 * creek crossing must be done safely, considering subject cannot protect themselves from drowning if stretcher dropped
 * Report back on:
 * Pros and cons of stretcher chosen
 * Best way to package
 * Any equipment needed or should be changed

As time permits exchange exercise groups, run multiple #2 scenarios using different stretchers.