SAR Fundamentals/Evacuation

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This page is based on the Lesson plan template.

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Contents

Subject

What is this lesson plan about?

Moving the subject after they have been located.

Authors

List who wrote this lesson plan.


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

Prerequisites

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


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

Time Plan

Total Time: 45 minutes

  • 2013-02: 25 min

See Brett's 2016-10-26 notes

add details about packaging

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

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


00:06

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


00:08

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?


00:10

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
    • lower down, face up, more exposed
    • safety glasses, face shield, clear plastic sheet
  • claustrophobia
    • arms in/out of packaging


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

Types of Stretchers

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


00:18

10 min

Order of Packaging - No backboard

demonstrate packaging

  • 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


00:28

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


00:31

6 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
  • 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"
  • anyone can call a break

exercise: short carry and lower


00:37

7 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


00:37

1 min

Questions


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

References

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

Question bank

List of questions suitable for an review/exam of this section.

See Question bank

Frequently Asked Questions

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Feedback

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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.

Reference Material

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[1]

Notes

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