Today was very cool, because we began by learning something the urban first responders and even EMTs are not trained in, which is Focused Spinal Assessment. The reason that emergency workers in urban settings don't have this skill is that if they have a patient with a potential spinal cord injury they can call an ambulance and get them to a hospital in a "spine safe" manner, where an ER doctor will do an FSA. In the backcountry, transporting someone in a spine safe manner means strapping them to a backboard and carrying them out in a litter or having them evacuated by helicopter. So if we can determine that it's safe for someone to walk out it's usually better, and might even be essential for getting them help for their other injuries in a timely manner. If you're thorough, it's actually not very difficult or complicated.
Another cool thing we learned today that is usually only done by doctors is how to reduce (reset) some dislocated joints. We're not going to mess with elbows, hips, or the knuckles at the base of your fingers or toes, but if you've dislocated a digit, patella (kneecap), shoulder, or jaw, and we're really really far from a hospital, I can help you! When you dislocate a joint, the muscles surrounding it spasm and hold it in its dislocated position. To get it back in place, we use traction (pulling) directly away from the joint in the position in which it was presented and allow the muscles to fatigue. For a shoulder, this is often enough itself. Digits have bumps at the joints, and so we have to gently pull the dislocated portion up around the other side of the knuckle so that it can slide back into place.
We also learned about how to assess and treat head wounds, and how to splint a boatload of fractures. Splinting was perhaps the most fun project so far, as it involved a lot of creative arts and crafts time. A foundation of this that I found particularly interesting is that padding + compression = rigidity. You don't need a stick or anything rigid to properly splint someone, you just need to pad all around the area well (to avoid direct pressure and for comfort) and wrap it snugly and thoroughly with an ace bandage, t-shirt, etc. So we spent a lot of time practicing with our own gear, and talking about different ways to improvise. The most elaborate project in this was to construct a splint for a mid-shaft femur fracture, where traction is used to reduce pressure at the site of the fracture, therefor alleviating a lot of pain. I tried to explain this in words just now, and failed miserably. Wound up with a sentence the began "basically" and then ran for 5 lines. This is worth a thousand words, I think.
Today was our 12 (or 13) hour day, so goodnight!
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