Backcountry Medicine 101 (youtube)



Enjoy!

Awesome! Thanks

Good video. One thing she said wrong was that sweat sodium goes up with heat acclimatization. That should be sweat sodium goes down with heat acclimatization.

Interesting find Wayne -- thanks for sharing.

I don't I buy into her suggestion to spear the sides of the tongue with safety pins and tie it off to a PT's chin to protect the airway. A $2.00 Berman OPA would be a much safer and more effective solution.

The tongue is full of relatively large blood vessels, sensitive nerves, and taste buds, not to mention that the mouth is full of bacteria (especially in a prolonged back country environment with less than optimal oral care).

I'm sure her argument would be that the safety pins and string serve as an improvised OPA without having to carry additional medical devices, but one could make the same argument by saying drop the safety pins and string and simply skewer the tongue with a sharpened stick found along the edge of the trail.

Yeah, that isn't going to happen either...

Jim

Wilderness medicine books have taught the Safety pin method of securing an airway long time, it is an old technique.

Well, a safety pin is a lot thinner than a sharpened stick and a lot less likely to do damage ;-)

(I've actually heard this from a number of sources, and it was mentioned in our WFR training as well; I carry safety pins and blanket pins in my pocket FAK as they have a number of uses, including creating improvised slings.)

As for the video, excellent - thanks for posting it.

Note that it provides the same answer as noted in our Sawyer Extractor discussion as well - don't use it; she says your best snakebite kit is "a set of keys" so that you can get to a hospital asap after you hike out of the wilderness.

Lots of other solid, if not novel, information in the video, and well-presented.

Re the safety pin thingy, imagine a few things. You are an airman last class, hitching a ride across the jungle of Panama in the co-pilots seat of an Army OH-13 which is equipped with litters on each skid (think a MASH re-run here). Now imagine that there is an unconscious soldier strapped to the litter on your side of the aircraft. Imagine that the soldier "swallows his tongue," and is in real trouble. Imagine that the pilot, an officer of course, tells you to open the first aid kit, find a safetypin, and run it thru the soldiers tongue. Now comes the fun part. Imagine removing your seat belt, leaning waaayyyy out of that little bird (there are no doors by the way) about 1000 ft up, fishing in the soldier mouth, finding his tongue, and running the safety pin thru it, from top to bottom (easiest to go in this position). Been there, done that. In addition to all of the other stuff, the tongue is mainly muscle, really hard to run a less than needle sharp pin thru. But he lived, or so I was told...

I'm just some schmuck on the net, here to listen and learn. But it seems to me that neither bleeding nor infection can kill someone who's dead from lack of air. Isn't it all about priorities?

Taking that logic one step farther one could argue that in the absence of having safety pins and string available, we should just gouge the tongue out with a knife to protect the airway. The alternative that was suggested was that a $2.00 disposable Berman airway would hardly add any bulk to a wilderness FAK, and would be significantly more effective and less invasive.

Jim

These Berman Airways, are they something any layperson can get their hands on, or is it some specialised kit that requires some training or at least instruction ?

Sorry I'm not paramedic but I have done some first aid courses, not come across mention of these things, ( first level too basic I suppose) but I think everybody understands safety pins.

Or we could just use some common sense.

Typically a locally-owned medical supply/drug store will carry them, although you can also order them indivdually online. For most applications, the 90mm version (#4) is the size that you'll want. To confirm the airway is the proper length, it should reach from the patient's earlobe to the corner of their mouth.

As far as insertion, there are a bunch of online videos showing the technique. The airway is inserted into the patient's mouth upside down until contact is made with the back of the throat, then the airway is rotated 180° to secure the tongue. No rotation is necessary to remove the device, as it follows the curvature of the tongue.

Despite what the linked video shows, OPA's are generally only used on unconscious patients, because of the high probability of stimulating a gag reflex.

Jim

I believe the point is, given the average first aid kit MOST hikers would have... using a safety pin to secure an airway long term is the only choice in the back country. Is it the absolute best? No, but then again either is an OPA... in fact it is virtually impossible to provide the BEST care for almost anything in the back country...

Wilderness/Austere medicine is about providing the care you can in crappy conditions while (hopefully) arranging for evacuation to a medical facility. In the back country you will just have to use what you have. By equipping your own IFAK with the tools you will think you need, you are improving the odds but you still won't have everything.

Now what if you don't have your IFAK and have to rely on some random average IFAK or no IFAK at all? Granted, probably not a big issue with the members of this forum in most situations but, it could happen. I can think of multiple situations where I would be without my own IFAK. Most of those situations are not in ideal circumstances or conditions and I would probably be very very happy to have my PSK.

Why do I feel like we have had this conversation on ETS before, I just can't find the old thread.