Remote Area First Aid

(Image: A simple slip and fall in the bush can happen at any time.)

If you’ve prepared for the unexpected, then you’ll have had the foresight to take a first aid course before you headed out into the Great Outdoors. So you should be able to provide a competent first response to many incidents and injuries. But are you prepared to carry out CPR (mouth-to-mouth resuscitation) for an hour until the ‘cavalry arrives’?  What about two hours?

You see, effectively raising the alarm is just the start of getting assistance.  

It’s reassuring to know that Search and Rescue (SAR) helicopters and planes are on 24/7 call-out.  But there’s more to achieving an emergency response than simply getting an aviation asset off the ground, and even that can take up to 60 minutes, depending on conditions and available assets. 

(Image: Learn to manage a suspected spinal injury with shock.)

PREPARATION IS NO ACCIDENT

Realising that you may have to deal with a serious injury or illness while you’re on the road is the first step towards taking full responsibility for the safety of yourself and your travel party.  The next step is to ensure that you have adequate training to respond competently when a great day in the outdoors suddenly turns bad. This means getting first aid qualified – and then committing to maintaining the currency of your skills by requalifying at recommended intervals.  The reason is that first aid skills degrade quickly if they aren’t used.  

How long before your first aid skills ‘expire’ will depend on the particular type of assistance you’ve been trained to provide.  Complete a basic St John Ambulance first aid course over two days, and your currency lasts for three years.  If you undertake a four hour nationally accredited training in just CPR, you’ll need to be re-certified after twelve months.  Other programs of training, including Asthma and Anaphylaxis, or Occupational First Aid training have different re-certification periods.  

(Image: Do you carry a Triangular Bandage when hiking?)

GETTING REMOTE

While a basic first aid course will position you to provide a ‘first response’ to a patient for a short time until professional assistance arrives, remote first aid courses will enable you to care for an injured or ill casualty over a prolonged period.  

To complete this type of training, you’ll need to have your basic first aid skills, including CPR, under your belt.  

(Image: Face sheilds help you not get spewed or spat on let alone contract viruses.)

To learn more, we dropped into the St John Ambulance in the ACT and spoke with Darryl Rice OAM OStJ. Darryl is a 36 year veteran of the Australian Army. He’s worked extensively in Australia and overseas, both commercially and as a volunteer in the para-medical field.  He’s now one of the Senior Trainers at St John Ambulance ACT. We asked him about the benefits of undertaking a Remote Area First Aid Course.  

“As good as our emergency services are, Australia is a BIG place and very sparsely populated – this will lead to delays in getting medical aid to the patient in need. The current Provide First Aid course centres on a metro environment scenario and hence the need for a more advanced first aid requirement in remote areas. The current Remote Area First Aid course has been developed over a 25 year period. St John Ambulance has consulted with many experts in developing this course and the resources we provide” Darryl told us.

(Image: A Survival Blanket can help treat shock, hypothermia and keep you dry.)

Darryl went on to expand on the importance of calling 000, or setting-off your PLB, earlier rather than later.  He also foreshadowed the need to improvise with the equipment and resources around you while you wait for professional assistance. 

“Because of possible delays in medical aid, the first aider in a remote locality needs to start considering what extended care can be provided. They need to think of early communication of accurate status of the patient or patients. The best use of all resources at hand, not just their first aid kit, but starting to think of what else they could use to assist in the patients’ care.” 

We then asked Darryl for his top tips for remote area first aiders.  “Nothing beats experience in this area, but having a good reference document like the St John Ambulance ‘Remote Area First Aid Field Guide’ guide will, we hope, help people manage those difficult situations. After that, a well-stocked first aid kit, suitable for the environment is a good start. The first aider has to consider things like, how long will I have to manage this patient for (normally for greater than 30 minutes); where will my assistance come from – it might not be an ambulance but organisation like the RFDS; what will they do with extreme injuries and conditions, such as a catastrophic haemorrhage?” Darryl reminded us that even relatively minor issues can flare up into something more serious, so it pays to remain alert to your health and that of your travel party. 

(Image: There are many different kits out there to choose from and some are better than others when remote.)

WHAT'S IN THE KIT?

So you can identify what’s missing from your first aid kit we asked Darryl to provide a contents checklist for a basic kit.  He also offered his thoughts about what other items would ‘value-add’ to a remote area first aid kit. It's also important to double-check your kit regularly, replacing any items that have expired or were used on previous trips. 

Darryl told us that a basic kit should include at a minimum:

• First aid booklet
• Triangular bandages – non-elastic bandages used for everything from slings, bandages, pads and to hold splints in place.
• Survival blanket - can be used when a patient is suffering from shock or hypothermia
• Crepe ('conforming' or elastic) bandages of varying widths – these elastic bandages are used to create pressure, hold dressings in place, reduce swelling and provide some support.
• Heavy-duty crepe Bandages 10cm wide -  for snakebite and splints
• Non-adhesive (non-stick) dressings of varying sizes – best used for covering burnt or abraded (scraped or grazed) skin.
• Disposable gloves (medium and large) - preferably made of non-latex material because you have to look after yourself too
• Adhesive tape (2.5 cm wide) – preferably a breathable tape such as Micropore)
• Resuscitation mask or face shield – again you have to look after your safety
• Medium combine dressing pads (10 x 10 cm) - used to help control bleeding and reduce the risk of infection.
• Large combine dressing pads (20 x 20 cm) - used to help control bleeding and reduce the risk of infection.
• Adhesive dressing strips (eg. Band-aids) - used for minor cuts and skin injuries. Never use adhesive dressings on burnt or abraded skin.
• Medium gauze dressing (7.5 x 7.5 cm)
• A good number of sterile tubes of saline solution (minimum 10 ml) - to flush out dust, sand or similar particles from the eye and cuts. 
• One pair of scissors
• One pair of tweezers – and maybe a spare because they always go walking
• Plastic bags of varying sizes – to put all the rubbish in or to preserve a severed finger
• Notepad and pencil – to write down your observations and the patients symptoms to hand over to the cavalry when it arrives.

Some other things you might like to add to make your kit to more robust for when Murphy’s Law kicks in …

• Hot and Cold instant ‘ice packs’ - to help reduce swelling, bites, sprains and to treat Hyper- and Hypothermic patients
• A purpose- designed Tourniquet like the C.A.T. – for severe uncontrolled (catastrophic bleed) haemorrhage
• Israeli Bandages – uniquely combining a compression bandage with a haemorrhage pad and torsion bar.
• Flexi-Splint – having one at hand stops wasted time improvising and they come in handy when particular nasty breaks are pointing in strange directions.
• Defibrillator – because about 50% of the 45 – 65yo age group in Australia have heart disease, are overweight or obese, have High Blood Cholesterol and/or high blood pressure.
• Oral Hydrating Salts – because dehydration happens due to vomiting, diarrhoea and the sun
• Remember the need for water.