Medical Smarts at the DZ

[Jethers203 0]

This is a message from my Pops about an incident that happened at my home DZ in El Paso last weekend.
Hey Guys,
Yesterday (Sat.) I went to boxing then out to the DZ. Time: 12:15 p.m. There was hardly anyone there because a bunch went to Marana. It was colder than heck! Ruban, Chris, Liz and I went on a jump. When we got down and started repacking. Time 1:45 p.m. Ruban said he did not feel well, that he felt cold and clammey and that his stomach felt upset. The wind was also really blowing so we cancelled. I finished packing and left. The only persons remaining were Bob, Liz, Carlos (a chiropractor) and Ruban. Time: 2:30 p.m. Bob(the DZO) starts to wheel in the planes when he hears Liz yell. He runs over and Ruban has collapsed and is not breathing. Bob starts CPR on his chest, Carlos starts mouth to mouth. Ruban's pulse is growing weaker and weaker and is almost lost. All his body functions cease and his bowels empty into his pants. Doesn't look good but they keep at it and they get him breathing and after a few minutes he seems to stabilize. A few more minutes and he sits up. At that time he says, "I can't see". He is completely blind. (Stroke?). A few more minutes and the decision is made to not wait for the ambulance that has been called. Ruban's sight starts to return. He is talking. Carlos loads him into his car and takes him to the hospital. 40 minutes after being called and AFTER the wounded is gone the ambulance shows up. (Call for an ambulance, call for a cop and call for a pizza and see which one shows up first). Ruban is in the hospital having tests today. You know all I know.
Glad we didn't go on that last load.
Dad

I wonder, on average, how many people at
a DZ know CPR and would be able to perform it confidently and successfully. What if this would have happened at 10,000 ft in the airplane? What would you all do? I think that there should be a plan for things like this. Maybe an idea for the next safety day.

John D-24352

[encinoadam 0]

[jtgadget 0]

You have brought up a very good point. I recently organized a course at our DZ. We had not only a EMT that is also a jumper (like ten billion jumps), but we also invited the local volunteer paramedics, and some other first responders. I encourage all DZ's to do the same. Offer a CPR first aid course. The more people that sign up, the cheeper it usually gets. The locals were delighted to come. By working with them, they made some great suggestions like: If you call 911 from a cel phone, it is routed to the dispacher from were your cel service is from. It could take up very valuable time just pinpointing locations and such. Hold a short course just for the local EMT's, they don't know how to take off your gear without ruining it!! If it's a chest strap that they cut, it can be easily fixed. If it is the main lift web, it's a total to your harness. Show them where to cut if need be, they don't know where the cutaway cables, housings, reserve cables, etc. are routed. Those scissors that they use don't easily tackle these jobs. By showing them, they were more confident, and more willing to help save some gear next time. Our course director is very knowledgable about skydiving related emergencies, and had many many suggestions. Among them were....Divide the airport and surrounding area into quadrants, make a arial photo, divide them up and give a copy to the locals. When calling in an emergency, it is much easier to pinpoint the location. Some spots on or around the airport have totally different points of access for the ambulance. Make sure that you have spotters waiting to direct the responders to where they have to go. With training, the fellow jumpers can already have the injuries and vitals assest to relay to the responders, saving valuable time. If you have training, you may be able to help the EMT's, if they have it under control....get the hell out of their way!! Designate one person (maybe the manifester) to make the call to 911. Make sure he or she has all of the information about locations, address', waivers with medical info, etc. The people that run out to the "scene" should take a two way radio with the other end with the phone person. Keep one in the first aid kit (in the form of a backpack or something easily carryable on the run) with fresh batteries already set to the same frequency as the "base station". Don't have anything in the first aid kit that nobody knows how to use (you can do more damage than good sometimes if using equipment improperly). Have a bump and scrape first aid kit that Joe Jumper can access, but have a more in depth first aid kit for emergencies that only trained staff can get to. The most important thing is to have TRAINING!! Perform drills on cloudy days. Invite the locals in for some drills. Jumper down, AIRCRAFT DOWN, multiple jumpers down. Nobody wants to think that this is a possibility at your DZ, but let's face it guys....it's reality. I want more people to take training at my DZ. Who knows, it may be my butt that they save. There is a ton more to say, but I don't want to put you all to sleep. If you have any questions, feel free to e-mail me, I can help you organize an Emergency course with contacts and ideas. I may even post a forum about it. Take care guys, jump smart, be safe, if not....at least be prepared!!!!
J.T.

[rigging65 0]

Some things that we've done to help out with accidents and facilitating the First Responders:

1) Write a script for Manifest to call 911 with. Sit down and think about every little thing you'd want to put in the script, then call your local Fire Dept. of First Responders and ask them what it should have in there. They don't need all the info you may think they do, but they may need something you haven't thought of. At our DZ, nobody calls 911 except for Manifest, otherwise you end up with total chaos. The only possible exception to this is if there was no way to get a hold of Manifest, but we try and make sure everyone has Manifest's number (since there are so many cell phones out there now) and encourage them to call Manifest FIRST, and let our procedure work the way it's been designed to.

2) Have an administrative plan. Ours includes Manifest gathering up a copy of the injured jumper's waver (which includes medical info, and contact info) and sending it to the scene to go with the ambulance to the hospital.

3) Have a plan for guiding First Responders to the scene. The best way to establish this plan is to ASK the First Responders what would help them the most. Usually it includes staging a person at field entrances to flag them down. As always, explain to everyone how vital this position is...if help can't find the injured jumper, they can't help him.

4) If you call your fields something special (Student LZ, 5-sided field, HP LZ, whatever) get a map to the First Responders with these names on them BEFORE you have an emergency.

5) Ask around and find out which jumpers have certified EMS training and are willing to help out. Make a list. We have an Emergency Binder that includes all this sort of stuff (including the script, maps, and a written procedure - in a LARGE font to make it easy to read under stress). Make the Layout simple. Most people don't react well under heavy stress, make it easy and it'll work.

6) Probably the biggest thing you can do to help make your DZ a more efficient place during an emergency is to have practiced what you plan to do. Actually go out and walk through it.

Your Staff should know the large-picture-plan, what the whole process is, BUT there is only ONE person in charge and only ONE point of Contact (at our DZ, it's an Instructor/Staff Member on-scene and Manifest), that's it! No more than that!

Keep it simple, rehearse it, plan for it...it will happen, so be prepared!

"...and once you had tasted flight, you will walk the earth with your eyes turned skyward.
For there you have been, and there you long to return..."

[freakydiver 0]

Very good point - I know when travelling into the backcountry, we always have at least one person along with us with EMT training.

-- (N.DG) "If all else fails – at least try and look under control." --

[councilman24 36]

I presented a talk at the 2003 PIA symposium entitled "First Aid for the Dropzone." Subtitled "What NOT to do when someone get hurts." This was a general presentation and needs some refinements, but I'll be glad to email the Powerpoint presentation to anybody who wants it. PM me if you would like it.

Terry

I'm old for my age.
Terry Urban
D-8631
FAA DPRE

[nic 0]

congrats on your quick thinking and hope recovery goes well, I myself am a emt-b and hope I never have to use my skills on the d.z.

[sunshine 2]

Quote

Offer a CPR first aid course. The more people that sign up, the cheeper it usually gets.

I"m glad things worked out ok. Having people around trained in CPR is always a good thing.

I am a certified First Aid/CPR instructor. I am always willing to give my time free of charge to teach people First Aid and CPR. The only thing they would have to pay for is the rental of the mannikins (which is very cheap).

___________________________________________
meow

I get a Mike hug! I get a Mike hug!

[Jethers203 0]

All good points everyone. Just to clarify my first post. Skydive El Paso is located in Santa Teresa, New Maxico at Santa Teresa airport. It is a small place and is about 5-10 minutes away from anything. The ambulance took like 40 minutes to get that distance. We never count on ambulances when we are out there. We also can't count on residents in the area. There is just desert everywhere.

One thing that has helped our DZ in some cases of broken ankles and such has been a stretcher. We have an old army stretcher that is easily portable and fits perfectly in the bed of a truck. It wasn't used in the stroke incident, but we have definitely gotten our money out of it. You can pick one up at army surplus stores.
Keep it safe
John D-24352

[popeyefireman 0]

not to sound like a preaching medic, but you should have waited for the ambulance, I know thouse guys up there arn't aleays the best you can get, so use your best judgment. If he had sarted going down in the car and something bad had happend (as in die) you acualt can be held at some fualt because the ambulance was already called. That whole law AZ has about helping people, doesnt hold up in civil court and the family (if full of assess) could fill suit. As for CPR......you are a idiot if you don''t have it. I will even go as far as teaching it for free to friendly jumpers and getting them cirt. I will offer my services to anyone who needs them at the dz or anywhere, kinda go's with being a public servent. And if your at alti., well, there is only a little more room in the back of a ambulance, so I would feel at home. I think if you wanna jump, at the very least you can take a first aid class or two......who knows you could save someones life.
I am not saying what you did was wrong, after 45 min I would have driven him myself. I can't give to much input on your situation because I was not there. I am glad to hear your friend is doing well. It doesn't sound like a strock...but then again it sounds like so much with the few symptoms and signs you gave. Keep us up to date, I am kinda wondering.

"I Yam what I Yam"

I am not afriad to die, only to die without living.

[popeyefireman 0]

just to add another point, as a skydiver and a firefighter I know where to cut and what equipment can come off without getting ruined. Other poeple wont and they also wont care. And unfortunatly for us skydiving is not something someone talks about in there courses they have to take. My suggestion is, get them where they are tought. Don't go to the employees, that mountain is to high to climb. Go to the instructors, because everyone has to get renewed sometime.

"I Yam what I Yam"

I am not afriad to die, only to die without living.

[Jethers203 0]

I guess I wasn't to clear earlier, but I wasn't at the DZ when this happened. My Dad who has a thousand something jumps was the one who relayed the story to me. Skydive El Paso is my home dropzone, but I live in east Texas at the moment.

I still haven't heard any good imput on what you all would do if there was a health problem in the plane at 10,000 ft. Let's see what you all got!!!

John D-24352

[billvon 2,434]

>Bob starts CPR on his chest, Carlos starts mouth to mouth. Ruban's
> pulse is growing weaker and weaker and is almost lost.

I'm glad he's OK, but it is generally a bad idea to perform chest compressions on someone who has a pulse. If they have a pulse, even a weak one, they are circulating blood. Chest compressions can interfere with that (and do things like break ribs, damage heart muscle etc.)

[popeyefireman 0]

problem at 10,000+, Well I would have the pilot start back for the air field with radio in hand to have airport emergancy personel there(if aval.) and maybe even have anyone that is of no help or in the way bail out. Then I might be able to do what I could for the person with out equipment ( which isn't much more then getting a airway and maybe compresions). Lets face it guys, in the air you are like a mormon in a whore house, you could get fucked quick. The only thing I could think of is airway breathing circulation and treat for shock. Anything else would take a act of god. I guess a fast dive plane could be of some good use. And let your dad know that he did a good job, the guy is alive. Advise him to take a CPR class if he hasn't.

"I Yam what I Yam"

I am not afriad to die, only to die without living.

[AggieDave 6]

Quote

I guess a fast dive plane could be of some good use.

Excerting more G-forces on the body, during a time that it really probably shouldn't have a lot of G's being pushed or pulled.

--"When I die, may I be surrounded by scattered chrome and burning gasoline."

[skymedic 0]

Quote

>Bob starts CPR on his chest, Carlos starts mouth to mouth. Ruban's
> pulse is growing weaker and weaker and is almost lost.

I'm glad he's OK, but it is generally a bad idea to perform chest compressions on someone who has a pulse. If they have a pulse, even a weak one, they are circulating blood. Chest compressions can interfere with that (and do things like break ribs, damage heart muscle etc.)

exactly what I was thinking....you can do much more damage to a person if they havn't actualy gone into vfib/pulseless vtach...

you needed to treat him for shock...as they were not profusing well...but never EVER start compresions on someone who does not need it. now peds is a different ball of wax all together

I also take concern with the comment "call a cop, call an ambulance, call a pizza delivery guy and see who show's up first."

one thing people have to be aware of is what type of EMS/Fire/EMS/Police protection they have. there are dropzones where you might not even get an ambulance due them not being in a protection area. there are also others with full time union firefighter/paramedics...some with only EMT-Basics to come to your aid.
when you are at the dropzone dont assume that it will be like your at home...that the paramedics will be there in 5 minutes. also dont assume that you will have Advanced life support also. those guys could have been doing CPR and a basic unit could have showed up without even an AED or further advanced cardiac life support....

just food for thought that even if you call an ambulance there is no guarantee it will be there. also ask around your DZ to see what kind of coverage you have. at the two DZ's nearest me....one has a hospital based EMS system that has two ambulances that cover the whole county....if there busy...your hosed... the other has full time firefighter/paramedics that are within 10 minutes away....


be safe,

marc

[popeyefireman 0]

good point with the G's, butin the long run, time is your main concern in EMS. You don't know what is wrong and have very little to work with, and at 10000 you have even less to work with. The dive would have to be situational depending on stability and patint condition. But most deff. have the pilot declare an emergancy. It is a hard situation to figure out with out being there. I do have a question, I am new to the whole g thing, how much more presure is put on the body by diving ni say a 182 or a king?

"I Yam what I Yam"

I am not afriad to die, only to die without living.

[Billy 0]

At altitude just remember the basics, ABC's,, positioning for shock and airway too.. some jump ships have 02 on them in some form and may be usefull,, another thing I would add to the list of good stuff already mentioned would be ta have the number to your local EMS helo available,, Our DZ is 30 miles from the nearest trauma center,, local ambulance folks are volunteers and do a good job,, but theyre all basic EMT's,, and the local hospital is more like a nursing home with an ER "bed" that may /may not have an MD in house... speed is critical in the serious patient so I wouldn't hesitate to call the helo directly, Our helo pilots are familiar with the DZ, having your local helo folks familiar with your ops might be something to consider... I don't think the G's in a rapid descent would really do much harm to a patient, unless they had ya'll floating around the plane!! Most G's occur during take off and landing,, then ya should consider the positioning of the patient away from or towards the anticipated forces...

Natural Born FlyerZ.com

[Medic1210 0]

[kevin922 0]

This is a little off topic, but we are having a "Skydiver Down" event at orange where we are inviting the local first responders, fire fighers, police, etc.. out to the DZ to learn more about the sport so when something does happen they know what to cut what not to cut what to do with airplanes, etc.. i think one of the medical helis is also coming out.

We are planning on having some skydivers "play injured" for the attendees to practice on

Kevin

[Jethers203 0]

Oy,
You gotta write something. I got my hopes up for nothing.

[tombuch 0]

I've written a feature for The Ranch web site about our emergency response plan, and how regular skydivers can help. It doesn't relate directly to this event, but it can offer some interesting elements for thi discussion. Find it at ranchskydive.com>S&TA>In An Emergency, or click http://ranchskydive.com/safety/tb_article10.htm

Tom Buchanan
S&TA, The Ranch
Author, "JUMP! Skydiving Made Fun and Easy"

Tom Buchanan
Instructor Emeritus
Comm Pilot MSEL,G
Author: JUMP! Skydiving Made Fun and Easy

[jose 0]

[replyI'm glad he's OK, but it is generally a bad idea to perform chest compressions on someone who has a pulse. If they have a pulse, even a weak one, they are circulating blood. Chest compressions can interfere with that (and do things like break ribs, damage heart muscle etc.)

[wmw999 2,148]

He lives with a doctor, and has for quite awhile. I learned the same thing when I took CPR class, also.

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[skymedic 0]

Quote

What medical background do you have Billvon?

anyone who has taken CPR is supposed to have been taught NOT to do this. I believe Bill is an EMT or first responder trained.

I am a Paramedic/Flight Medic/Critical care transport paramedic....it is NOT smart to do CPR on a person that still has a pulse and is breathing...all you will do is accelerate there travel to the grave(in MOST cases).....

Marc
otherwise known as Mr.Fallinwoman....