Medical Response

[froggie 0]

good news. i cant believe i forgot to post it....
i talked to John and he told me that the ambulance squad has full use of the facilities any tuesday nite we want (our drill night). So after talkign to the rescue captain its been decided that we are going to do some high rescue drills... rooftop rescues. work on the roof of the hanger! i love EMS. It lets me do these things that I would never be able to do any other time. And ive also talked to john, and other jumpers, and we all feel that a drill is needed on stabilization of a parachutist. I want my squad to be familiar w/ rigs, so that unneccisary 'cutting' doesnt happen. I just want to familiarize them w/ how to safely, quickly and efficently remove a rig w/ out cutting it away. But sometimes cutting it is needed.
Thse are all really good ideas Karen. I esp. like the concentration on medical emergencies. Thats what will occur more i believe. And its good to have the staff familiar w/ those emergencies so that at least they can recognize what the emergency is, even if they can only perform minimal care. No more ideas from me, anybody else?
kelly

[billvon 2,400]

>I just want to familiarize them w/ how to safely, quickly
> and efficently remove a rig w/ out cutting it away. But
> sometimes cutting it is needed.
to remove the rig with minimal disturbance and damage:
-remove leg straps and chest strap
-cut lateral straps between rig and main lift web
-lift main lift webs out of the way
mick cottle taught me this trick. lateral straps are pretty easy to repair, and removal in this manner doesn't require any motion on the part of the jumper.
-bill von

[froggie 0]

billvon,
thanks for the tip. We had just planned to go out to the DZ and let everyone play around w/ different techniques then just compare how each one felt from our 'patients' point of view. We actually do that alot. When drilling, everyone has to be a patient at least once. this way we better understand what our patients go thru. And lemme tell ya... Have you ever heard of Spider Straps? they attach to the spinal immobiziation board and are 'webbed' over your body, basically keeping you between them and the long board. It was a lot of fun cause they turned me upside down (hello floor!) to demonstrate their stability.
but back to what you wrote... We will definitally have to improvise so that we can practice this w/ out actually cutting up somebodys rig. Thanks for the tip. Much appreciated.
kelly

[froggie 0]

hey guys. well it happened 5 times this past week. On sunday we had a jumper land in the trees. but he hit a small one and was already out of his harness fishing his parachute out of the tree by the time we got out there. So all i did was give him a look over and asked him a few questions to make sure he was oriented. He didnt want to go to the hospital. Then yesterday I had one person want their BP taken, another cut his foot on what we suspect was a beer cap when he was running thru the fire this weekend (laughed at him cause i witnessed the 'injury' then i cleaned it out), then i had another guy hit his face on the door frame when exiting~ cleaned him up and sent him to the ER to get a few stitches.. Today i taped up a broken pinki (that happened about 4 weeks ago, but it was bothering him today)
So to say the least, some of my supplies are being wiped out but ill replace them tomorrow. At least nobody is getting seriously injured. Glad to see that i can help.
kelly

[skymedic 0]

Good job froggie, I am new to the board but found this string interesting, as I an experienced paramedic(9yrs) and work on a chopper down here in florida so I tend to care for injured skydivers quite often. hope to see ya around some time(not in my chopper that is) marc

[froggie 0]

karen,
ive figured it out.... Im going to get a locker at the dz. Jumpers can rent one for a six month period. SInce i dont have a rig or anything i dont really need one. But keeping my jumpkit in the manifest office is okay but i would rather have my own locker to keep it in. THis way, only a limited number of people (me, dzo, other medically trained jumpers perhaps) will have the key to the locker. Im figuring John, our DZO will give it to me no charge.
kelly

[unclbennie 0]

Kelly,
Good idea on the locker. Keep some kind of stock list so you know what you have and what you have to replace. Also make sure the DZO is paying for the supplies. The only thing I would have tons of are bandaides, seems like someone always needs one. That and gloves!!
Good luck
Karen

[SpeedRacer 1]

Depending on where you live, snakebite can be a problem. We have a problem with copperheads sometimes.
Speed Racer
Brew Skies

[PalmettoTiger 1]

I'm surprised no one has mentioned alcohol poisoning kits.
Blues, squares,
PTiger

[Billy 0]

Excellant Thread,,
Just a couple thoughts,, Kel youre awseome! Ya ever wanna move ta Spokane and don't have an armload of recommendations I'll pull some strings!! Our DZ is 30 miles from the closest trauma center,, we have several flight crew RN's, RRT/EMT-P's, an MD, and an OR RN who jump and at least one is there almost every weekend, in addition to the BLS supplies we've also "obtained" equiptment for doin intubations, cric's, chest darts, central lines and fluids,, our EMS helo # is on all the phones and on safety day we stressed anyone can make the call for help,, the DZ lat/long and contact freq and phone # is on file, some basic airway mangement was discussed,, but Kel I am impressed with your "drill's" and etc to get folks thinking along the right lines!! When I worked Ski Patrol we offered discount tickets to local ER MD's, RN's, EMS personnel etc if they checked in and would respond if we needed help,, I would think a DZ is easier ta get them to the site than at a ski area,, anyone know of any DZ that does this??
2 cents
Blues!!
Billy

[froggie 0]

Billy,
hey! hows washington treating ya? thanks for the "kel youre awesome" :) just doing my job. Im not quite sure if what you mean when you said:

Quote

I would think a DZ is easier ta get them to the site than at a ski area,, anyone know of any DZ that
does this??

but i think that you may be asking if its easier to get EMS trained personelle to respond while at a dropzone versus at a ski lodge. Are you asking if its easier to locate the 'volunteer help' at the dz versus the slopes? IF thats what youre asking then id have to say yeah. Even at Xkeys, which is a big dz its easy to be found. manifest just pages you. but at the slopes theres literally miles of area. cant really distinguish who anybody is "hes the guy in the goggles. with the snow suit on! you know, the one on the skis going down the hill!" get my point? But at the dz the only time its difficult to distinguish people is when their in the holding area or higher.
Im glad to see that so many medical personelle jump at your dz. The fact that the closest trauma center is 30 miles away is a real cruddy thing. I hope that theres no need for the trauma runs this season!
Thats a good thing stressing that anybody can make the call. I know that in the past (before EMS) i was anxious and doubtful that i needed to call an ambulance, even when i did need one. A very important point to stress is to call 911 and have vital information when you make the call. Screaming "i saw him belly to earth, parachute below him! then he went behind the building!" doesnt tell the dispatcher anything. What the person calling 911 needs to know is the CAO (conscious, alert, oriented for the non ems reading this thread) of the patient, the basic 'look' of the scene (is his leg 20 feet away?).... vital patient information. I gave a speech on what information a 911 caller must have before calling 911. Ill find my notes and post that later.
by the way~ to everyone contribuating to this thread~you guys rock. THanks for all the information.
kel

[Albatross 0]

Kel I think that Billy is saying that the DZ sould either pay the employees with training more or offer discounts to the jumper with training who are willing to make their services available. I totally agree.
Billy where you and your girlfriend down at Perris earlier this spring? I think that I met you.
Fly Free, Fly fast, Fly together
Albatross

[Billy 0]

Howdy,
Sorry Albatross not me,, haven't been ta Perris,, yet!! Like Kel thought of a couple more things,, AOL keeps punting me off if I type too long and try ta look "proffesional",, Suction equiptment,, ya ever tried ta manage an airway of someone with facial fractures who is unresponsive? ABC's and all,, at safety day we told the folks if this was a prob to log roll so fluids drain out and get help fast,, another thing we have ta deal with is the DZ local EMS ambulance folks are volunteer,, so from time of injury to a BLS rig showing up can be almost 15-30 mins,, the local ER there is no bigger than an average bedroom and they fly out all critical pts,,the helo can be on scene in 15 mins IF available,, Ya my point on the other thing was even if the ALS folks are in the plane they are still easy to get hold of and can get to the pt before any local response,, Hay Kel ya motivated me ta get in touch with them and talk about some of these issues!! Way ta go Girl!! We don't have tree's really at our DZ but I hadn't thought of roofs etc.. did a climbing accident this weekend and it was very eye opening to see the differance between rec climbing and the logistics of a rescue,, different hardware for the heavy loads etc... (I'll send ya a couple picts asap)
Soft Landings!!
Billy

[froggie 0]

Billy,
so you experienced a rope rescue huh? yeah it sure is different. ive only been indoor rock climbing once and i was belayed, not the one belaying. it was easy as hell. now with all the gear on, 3 different carabiners to use, different ropes. different systems. it gets overloading. i did that rope rescue drill a few months back and it was a lot of fun but took a lot of energy. kinda hard to secure the 'parachutist' that i had to rescue. but like you said the systems are differnet. gotta expect that.
about the facial fractures and suctioning.. imagine this.. we get dispached for an MVA with entrapment. While enroute we get radioed that now we have an MVA w/ entrapment and a ped MVA...
turns out the drunk guy hit my friends car (didnt find out it was her until in the rig), sent her into a pole divider. he was outside of his vehical yelling "my friggin leg is broken" when his friend (also drunk) came flying down the same road. SPLAT! the broken leg guy (who caused the whole thing) gets hit by his friend and leaves a nice imprint complete with his scalp and some hair in the drivers side windshield area. not a pretty sight. but he had to be suctioned. i didnt suction but i was watching. I can only imagine how difficult that was to do. Some crazy sh*t ehh? Instead of having suction equipment (remember the training to use it?!?) how about a little blue bulb suringe? a regular (non medical) person could easily use that until something better gets there. Just gotta think "must cover my ass first, then everything else after that..." i could manage using a bulb syringe if i had to. anything is better than nothing and suction machines aint cheap! ya know?
more ideas., this is great
kelly

[billvon 2,400]

one thing that i think is important to point out - there is nothing that exposes a drop zone to more liability than anything other than competent first-responder treatment of injuries. for example, a first jump student that lands hard, and hurts his back. if you do anything other than recommend he go to an ER (and/or give him whatever help he requests or obviously needs) you may end up in court answering a lawyer who is asking why, if you are not a doctor, did you perform a diagnostic procedure you were unqualified to perform which left his client with permanent spinal damage.
i know it's stupid, but i've been at DZ's where lawsuits have been filed over less. this used to apply only to students, not skydivers, but after the recent spate of skydivers suing skydivers, i'm not so sure any more.
-bill von

[froggie 0]

billvon,
you bring up a very good point, but there are laws to protect against such things. In New Jersey (and elsewhere?) we have the Good Semaritian Law which protects people from such incidents. As long as the help that you provide is within your given capabilities, and you perform in a competent manner you can not be sued. It was created to help protect those 'good semaritians' that were too afraid to stop and help in cases of emergency. In cases that gross neglagence on the helpers part occurs then no law can protect you. This is why we discuss ways to keep the equipment that needs special training away from the untrained. Another thing that is GREATLY stressed in the EMS field is the use of the word "possible". when callling the hospital i always say 'possible this or possible that' never give a diagnosis, im not an Xray machine and i cant decipher blood tests. ya know what i mean? Ive spent a great deal of time learning what im allowed to do by law, so as long as i dont superside that knowledge then i have no worries. As far as back injuries go.. if theres a possibility you have a spinal injury then you had better not even move your eyes a fraction of a centimeter or else im gonna get on your shit something fierce. Ive done it before. ill do it again. I constantly tell my patients (who suffer trauma injuries) "dont move a single muscle. you arent here to do any work. you just lay there. were going to do everything. your job is to be as still as possible. If you move you could aggrivate a potential back injury should you have one" phrases like that can save your butt.
A big part of trauma injuries is spinal immobilization techniques. I dont care if i cant do anything else but immobilize your spine. thats all ill do if its all i am capable of. Ive held stabilization for 20 + minutes before. its not hard to do unless you have a combative patient. then you gotta roll w/ em (most combatives tend to roll from side to side)
but thanks for the words of advice. Everybody contribuating to this thread is somehow envolved in the medical field (just about everyone) and for those reading this thread that arent: dont touch the person. tell them to be very still. only move a person if their in serious danger of further injury. explain to them that they have to be still because they might end up hurting themselves further.
Thank goodness for the good semaritian laws!
kelly

[Billy 0]

LOL!!
Loved the drunk guys takin each other out!! Hope your friend was ok!?
Ya Bill the Good Sam law protects us like Kel said as long you don't go beyond your skill level,, and actually ya can be taken ta court but as long as I been doin this there hasn't been one case won,, the things they have ta prove are again gross negligence as a result of an act, or an omission of an act,, I can get in trouble more easily if someone there is hurt,, people know what I do,, and I fail to act to the best of the circumstances, and that results in harm to the pt... Hay Kel ya ever hear of a V-Vac?? Hand held disposable pump unit,, cheep and may be able to get a couple donated by an ambulance or purchased by the DZ. Check with the guy that gets your supplies for the ambulance...
Blues
Billy

[unclbennie 0]

Billy & Kelly,
The Good Sam act protects you to a point, if you are a licensed person, or a professional in the medical field an atty, WILL go after you. Say a skydiver lands hard, has face injuries, your DZ bought a suction machine, but everyone has been playing with it and now it doesn't work. (yea I know, we would all keep something like that locked up). Or they used all the suction tubes to drink beer the last time it rained. Anyway, now you have equipment that didn't work or was not properly maintained. The DZ by just having that equipment available and not maintaining it can be sued. You can be sued because you where the identified medical professional and you didn't ensure that the equipment was maintained.
I know of what I speak, I review malpractice files for attys (defense). I've seen some pretty strange lawsuits and some strange ones settled out of court because it was less expensive.
Anyway, as medical professional and a skydiver, I don't go to the DZ to be the identified medical person. Also do remember, all that fun equipment would be stored in the hanger, probably locked up. Most people who get hurt don't land right next to the hanger, I always seem to have to walk a bit to get to em!! (how inconserate of them!!!)
I will help out to best of my ability if someone is injured, but I"m going to do it with whats available, and wait till the ambulance arrives. Then you are covered for sure under the Good Sam act. Keep helping but remember there are limits to what we can do and stay within your boundries and only do what you are absolutly sure of!!
Blue skies and long weekends!!
Karen

[Billy 0]

Hmmm..
OK I gotta ask Karen,, whats the unclbenie handle mean?? Theres a story there right!??,, Ya make some good points,, I've done some mediacal-legal consulting also,, so the defense Atty doesn't waste his time on a case I din't think would stand up in court,, the Good Sam laws don't cover "paid" professionals,, for that ya fall under your medical director, protocols etc,, the good sam laws cover me on my own time acting within my training and with the equiptment availabe is that not correct?? If a DZ new that folks were pilfering supplies ta drink beer, make bongs etc,, than ya that would be gross negligence on their part and grounds for a lawsuit,, Kel's suggestion of keeping that stuff away from folks, in a locker or in Manifest area,, and I would suggest also having that "kit" clipped or tagged so ya would know if someone got into it,, know what I mean? I don't go to the DZ either as a designated medical person,, it's my day off and I'm there ta jump.. but if one of my fellow jumpers were injured I would want the stuff I needed to do BTLS, not necessarily ALS or ACLS,, I'm sure ya've seen MD's RN's etc at the scene of a trauma and they can't perform for squat because they are otta there element, no lab work, X-ray, forget sterile fileds etc,, and it's just them,, not what they are used to,, I would rather have an excellant EMT than an uncomfortable RN or MD workin in the field with me any day,, at work when confronted with an MD o/s who wants to direct pt care and do things that I don't feel comfortable with I have to advise him that I don't agree and if he/she want's to assune medical control he has to fly in with us and take full responsibilty for that pt,, they usually back down at that point,, OK now I'm babbling!! Gotta get some sleep!!! : )
Billy

[unclbennie 0]

Billy,
Yes there is a story to the Unclbennie name!!
And yes the Good Sam law "should" cover you. But.. an atty see's that someone with medical training responded and they WILL try and sue you. Now, you are covered by the Good Sam law, but there are legal fees, time lost from work going to court etc.
I agree with you about who I want with me responding to an emergency. I was helping a jumper who had a very hard landing, I was worried about a compression fx., a doctor who jumps showed up and wanted to move her to the hanger where "he would be more comfortable examining her". I kindly asked him to go check to see if 911 had been called. I will say that over the years I have become jaded, when I help in an emergency, I never give my name, or at least my full name, and when 911 shows up, I fade into the background. I will always stop and help, but I won't always give my name.
American Red Cross offers a good class called "When Help is Delayed", it covers how to help someone when EMS is more than 20 minutes out. Tell your DZO's I'd be happy to come teach it, all they have to do is come pick me up!!
Blue skies
Karen

[Billy 0]

OK Karen,,
I see ya left the story behind your name out,, and I spose ya want jump tickets for the class also!! Well I'll check but don't hold your breath,,, Ya lawyers,, "skeet" just read the article Sangiro posted on the lady sueing the DZ,, sounds like the winds made her have a spinning mal and then made her forget her emergency procedures,, reminded me of a lady who sued a boot manufacturer cuz she got frosbite on her feet,, the fact she took them boots way up on Mt McKinley in sub zero temps had nuthin ta do with it.. guess it depends on how much personnal responsibilty your willing to assume,, I'm not reffering to stable injured jumpers I guess,, I'm reffering to the few who would be veggies in the 20-30 minutes you refer to,, and then again here that doesn't mean neccesarily ALS personnel,, so if some cheesy lawyer wants ta try and get $$ from me let him try,, I wouldn't even hire another attorney to represent me,, some states are getting it set up that $$ lost in frivolous lawsuits can be reclaimed against the suing party and I think that is really needed in the US,, but you definately have some points the DZO's should look into,, like how much responsibilty do they legally have to an injured jumper,, I know our little DZ is already bothered by the waivers not standing up in court and how ta protect themselves,, this was a major discussion I believe in the conferance for DZO's couple months ago in CA and is a shared concern for many,, so I guess it is up to each of us ta do what they are comfortable with,, and like Kel is doin ta be as prepared as possible,, but the best thing is ta be safety conscious from the start and do the things like pin checks etc,, prevention ya know,, OK now I'll shut up for a while and see if there are any legalease speakin lawyers with some input into these issues,,,
Billy

[billvon 2,400]

>In New Jersey (and elsewhere?) we have the Good Semaritian
>Law which protects people from such incidents. As long as
> the help that you provide is within your given
> capabilities, and you perform in a competent manner
> you can not be sued. It was created to help protect
> those 'good semaritians' that were too afraid to stop
> and help in cases of emergency.
I believe that is true for any non-employee of the DZ. If you _are_ an employee of the DZ - even if you pack student rigs once in a great while, or organize for jump tickets - the good samaritan laws don't apply, as far as I can tell.
>I constantly tell my patients (who suffer trauma
> injuries) "dont move a single muscle. you arent here
>to do any work. you just lay there. were going to do
>everything. your job is to be as still as possible. If
>you move you could aggrivate a potential back injury
> should you have one" phrases like that can save your
> butt.
Yep. Unfortunately, several of our jumpers (and some instructors) are SEALs, who do things like tell injured jumpers to go through a series of manuevers (including pulling their knees up to their chests) to see if they have a spinal injury. May work for other SEALs, but not a great idea for jumpers (IMO.)
>Everybody contribuating to this thread is somehow
>envolved in the medical field (just about everyone)
>and for those reading this thread that arent: dont
>touch the person. tell them to be very still. only
>move a person if their in serious danger of further
>injury. explain to them that they have to be still
>because they might end up hurting themselves further.
Yep. 90% of the first aid courses we've given at Air Adventures concentrate on what _not_ to do. It can be difficult for type-A personality skydivers to just stand around someone who's hurt and not do much of anything. I'll never forget a jumper who landed next to another seriously-injured jumper, and immediately pulled his helmet off. (It turned out to be the right thing to do - we would have had to do it in a minute or so to clear his airway - but it was a scary first reaction.)
-bill von

[froggie 0]

Billvon,
thanks for the info on the good semaritian law. Ill definitally be checking that one out. Im not sure though, cause the ambulance squad knows that i do basic first aid out there when needed and they havent mentioned that i wouldnt be covered by it.. but im definitally checkiing it out.
to everybody:
tonight the local FD and the neigboring towns FD (were right on the boarder) came out to the DZ. we went over the caravan and frankenotters build. Discussing where to cut and where not to cut.... Number of people on each plane on average (what to expect). we discussed bail out alitudes for jumpers if the pilot gives the go ahead to jump out... stuff like that.
Then we reviewed a tandem rig and a student rig. I worked with Tandem JM to discuss the rigs. We taught the EMS people how to disconnect the RSL and how to cut away a canopy. I showed them how to remove a rig without cutting it. and thankyou Billvon, we were able to show them where to cut a rig if they have to (you posted how to before).. We also discussed the reserve canopy and how it is activated. Gave them some overlooked but good tips to handling a situation.
Basically, we familiarized them w/ the planes that we use most often and the rigs that we jump. It was a really benificial drill and the chief from the neigboring town even got to go for a sunset fly along! he loved it. our pilot gave him a good show :)
Kelly

[froggie 0]

it's been a while since this thread was active and i was wondering how the safety records are maintaining themselves at your home dz's.. has the need arisen for you to step in and provide EMS? if so, did the dz support you? are you glad that you helped out? any feedback is appreciated.
btw~we've had a few injuries, all landing based injuries, and everything has worked out fine. A few broken bones, but not anything that I couldnt handle until the ambulance got there. a medical emergency that at first appeared to be a truama EM. involving an elderly lady occured a few weeks back. I believe i put that story up (?). In any case, some quick thinking and the good ole' jaw thrust manuver cleared her airway and improved her health...
The support that i recieve from the entire DZ staff is amazing.. always ready with a radio, my medical bag, a cel phone, using canopies to block the sun, gathering up gear and securing it in a locked office.. anything that i need, they're right there helping me and the patient out.
hope your getting the same kind of support if your training is being needed.
kelly

[unclbennie 0]

Kelly,
So far no real injuries while I have been at the DZ, but last week I trained 7 JM's and fun jumpers in first aid and CPR, we had fun and they where glad they took the class. I'm hoping to run another class in the fall.
During the class some interesting questions came up such as what to do if someone is wearing a full faceshield helmet and you suspect a neck injury and they vomit? Get the face shield open. If its a fixed shield held in place with velcro, try to unfasten the velcro while someone stablizes the head. I would say don't remove the helmet if you suspect a head/neck injury, just get the face shield open and clear the airway that way. Once EMS is there and has imobilized the neck spine, let them take the helmet off. Any other thoughts?
Karen