Remote area first aid

The risk of something going wrong may be remote, but when you’re far away from help, it isn’t one worth taking.

As that old saying goes, ignorance is bliss. And in some ways, it’s true — but only until that ignorance comes back to bite you.

It wasn’t until I undertook senior, and then remote area, first aid training that the real risks of remote area travel — and the dangers of not being adequately prepared for those risks — really came into focus. I felt knots form in my stomach as instructors explained the treatments for various wounds and ailments, and I recalled all the situations I’d been in where something could have gone wrong — and I wouldn’t have known the right thing to do.

Surely it’s just dumb luck that I haven’t been faced with any disasters yet? Well, not exactly. Common sense and prevention go a long way, and that’s what a lot of first aid is: pure common sense. However, there are many scenarios that cannot be properly or safely managed without prior learning, and they only need to occur once for you to regret your lack of preparation for the rest of your life.

A certificate in senior first aid is a prerequisite to studying remote area first aid which, as the name suggests, focuses on longer-term initial care, in situations where advanced help (a paramedic, nurse or doctor) may be hours — or days — away.

I took both courses in preparation for a three-week off-road trip I was planning in the spectacular (and spectacularly remote) Kimberley region of WA. Senior first aid consisted of an online course plus a day of practical training, while the remote area course was two full hands-on days (assessed throughout, with a theory exam at the end) in which I joined a group of rural firies completing the course as part of their overall training.

While several organisations offer the training, I studied with the reputable Australian Red Cross. Another notable provider is St John Ambulance Australia. Getabout Training Services — with whom I did my four-wheel driving course earlier this year — also offer senior first aid training, with a focus on four-wheel driving and outdoor travel. However, all registered and accredited training providers should be up to scratch and will offer comparable training and information.

Both days of remote area first aid training consisted of a mix of theory and real-life scenarios. For example, the instructor would draw red whiteboard marker-inflicted wounds on some class members, to be appropriately bandaged by others. Or, trainees would be instructed as to their symptoms and sent off into the bush (the scrub surrounding the Glendenning Rural Fire Service car park) to then be discovered, diagnosed and treated by their classmate — observed and assessed by instructors throughout the process.

My patient turned out to be suffering from heatstroke — a potentially life-threatening condition, differentiated from the earlier stages of heat stress and exhaustion by the ominous sign that the overheated patient is no longer sweating.

We also treated imaginary snake bites, broken bones and puncture wounds (note: where possible, don’t remove the offending object, bandage around it), and there were plenty of opportunities to ask questions and share anecdotes with instructors and classmates, especially during lunch and tea breaks.

I returned home at the end of each day a little mentally drained, but at the same time eager to share all of my newfound knowledge with anyone willing to listen. (Did you know the only spider bite that should be treated with ice, and not compression, is the red-back?)

UNFORGETTABLE
As anticipated, First Aid Training Is Acronyms Galore (or, FATIAG, if you prefer), and, once you hit your first acronym-within-an-acronym-within-an-acronym, a little fatigue may start to set in. However, they really do help (okay, some more than others) and, as it turns out, they make a lot of sense.

Nobody really knows how they will react in an emergency until they are faced with one, and I’ve heard stories of people forgetting the Triple 0 phone number in their panic. So, if seemingly trite acronyms in fact help you to organise your thoughts and stay calm under pressure, then I say embrace them.

However, that doesn’t mean you need a photographic memory to be a successful first aider. Much of the rationale behind the training is simply increasing confidence and getting the fundamentals right. So, if you come across an unconscious person, that old favourite DRABCD (Danger, Response, Airway, Breathing, Compression, Defibrillation) might just provide a safe haven for your mind to seek refuge from the potentially debilitating dark void of panic.

On the other hand, if you forget the name of, say, a certain sling technique, but have managed to remember that the fractured limb should be immobilised and elevated, then the course has been worthwhile. And, besides, the top of a button-up shirt can suffice as a sling for certain injuries, in the absence of the appropriate bandage. That is, there are always options, and this was one of the most valuable facets of remote area first aid training — there was scope to stray a little from convention in order to cater for the endless range of scenarios that could potentially arise ‘out there’.

And not everything required a cleverly invented noun (RICER, anyone?) to form part of our education. Fashioning stretchers out of wool blankets by rolling up the sides, for example, is something that will stay with me for its sheer cleverness.

CHANGING TIMES
About seven years ago I undertook Bronze Medallion training through Surf Life Saving Australia, so I embarked on first aid training with the impression that I already knew a thing or two. I was, however, quick to realise the importance of retraining, and only in part to refresh one’s acronym vocabulary. For a start, the C in DR ABCD no longer stands for circulation, or the point in which you should check for a pulse. Instead, if there is no breathing, then the first aider should immediately commence chest compressions. That’s because research discovered that the risk of a first aider misinterpreting the presence or absence of a pulse was too high. And, besides, if the patient isn’t breathing, their heart will probably only hang in there for a few more minutes, anyway.

Similarly, the five ‘rescue’ breaths that were once taught to precede CPR (cardiopulmonary resuscitation) or the now-outmoded EAR (expired-air resuscitation), are no longer necessary. Instead, start with compressions (30 at a rate of 100 per minute), alternated consecutively with two full breaths, until the patient recovers, advanced care arrives, or you simply become too exhausted to continue. However, such updates to accepted procedure don’t mean that your training in 1982 is no longer relevant, or that you should avoid helping someone in need.

The appropriate authorities are constantly reviewing the latest in science and research to refine first aid training, but the fundamentals remain more or less the same. And, unless you’ve been watching too many episodes of ER and attempt something way beyond your level of qualification (our instructor was amazed at the number of trainees familiar with the dramatic tracheotomy-using-an-inkless-biro technique… Don’t try it!), then most often doing something is better than nothing at all — provided you have gained consent from the injured person, if they are conscious. Also, the Good Samaritan Act — applicable in all states and territories except Tasmania — ensures you are not, within obvious reason, liable when you genuinely attempt to help someone. The logic is that a fractured rib over a beating heart is surely better than the inverse — and I wouldn’t like to meet the individual who would sue the person that successfully saved their life. However, your duty of care and subsequent liability becomes more stringent when your employer has trained you in first aid specifically for the workplace. Also, in the Northern Territory, anyone involved in a road accident is legally required to assist any injured persons — although this could simply mean dialling Triple 0 (remember, that’s zero, zero, zero).

Basically, if the law ever stops anyone from enacting common human decency, then there is surely something wrong with the justice system.

THE UPSHOT
So, you may be wondering, was I required to draw on the first aid training during my Kimberley adventure? No, I wasn’t. And if I’m lucky, I’ll never have to. Like most safety measures — whether they be first aid training, or recovery gear for your 4X4 — after forking out the cash and (in the case of the recovery gear) using up the majority of your cargo space, you then do everything you can to avoid ever needing them (…perhaps less so in the case of recovery gear). But I couldn’t be gladder to have the knowledge that I now do at my disposal.

I plan on having many more middle-of-nowhere adventures in the future, and that means advanced care will often be hours away. I may not have experienced it before, but I know that if I’m ever faced with a sick or injured friend or acquaintance and am their only immediate source of care, the last thing I’ll want to be is ignorant.