Boundary Waters Quetico Forum :: Group Forum: Wilderness Challenges :: Leadership Challenge #3 (Broken Ankle)
|
Author | Message Text | ||
Old Hoosier |
Based on the bushwhacking statements, I assume this party is all adult men. God help me if this would happen with women and children, even if it were in a more accessible area. Definitely NOT move the victim unless instructed to do so by OPP. Here is when a SAT phone and GPS are priceless. Get all going simultaneous to administering first aid. Stabilize leg and ankle with paddle and duck tape. Treat for bleeding and shock. Give pain relief last so you can get the rescue rolling. Would definitely ask lots of questions from OPP regarding treatment and rescue. Even a first aid book is lacking as severity makes a big difference in treatment. One related question - if WE were the victim - could we count on someone else to take charge? Could we direct them (wife/kids) on what to do? Even if we could maintain composure while in extreme pain, do they know how to run the GPS and SAT phone, etc? |
||
kevheads |
|
||
GSP |
DON'T GO |
||
moosedrool |
first, check out the area of pain - upon seeing a bone sticking out immediately tell a person to get on the phone - as in a person not "someone get on the phone" more - you - get on the phone. I would have the fourth member dig out the first aid stuff and anything else i would need. from there, provide standard stuff, address immobilizing the area, stop any bleeding, check rest of the person for any other injuries, etc. during this time, i would also instruct the group member on the phone to get the gps out to tell the emergency number our current location, and ask that they negotiate an extraction point based on where we are and what is closest that the float plain can land on and what is easiest to get to. From there, grab some food, some water, the lightest pack that i know has a sleeping bag - preferably 2 - and also if available, that person's identification and insurance information and head to the agreed upon extraction point. I'll assume you ment tibia or fibula as femur doesn't sound as likely so in that case, nothing should need to be built to move the victim - they will just need help probably from two people to walk on one foot. |
||
gbuskk |
|
||
quetico1 |
That image of the compound anke fracture is not really the ankle. That is the distal end of the tibia - more properly the leg. The reason that I said compound fractures of the ankle are unlikely, is that formally, the ankle is a collection of small bones that are unlikely to protrude except in circumstances of extreme crushing such as a metal stamping machine injury. As for which lake, a helicopter does not need a lake for evac. Bring it right to the victim. |
||
Koda |
Applying pressure to the thigh wound is probably unrealistic. I'd apply a tourniquet to the thigh above the break, releasing it at the proper intervals (I think it's 5 or 10 minutes on, 2 minutes off; hopefully there would be instructions in the med kit). I'd call for evacuating two people, one of them being one of the drivers. The victim will need care and attention after getting to safety and shouldn't simply be delivered. I'd also try to get some extra gear flown out so the return trip would be easier for the two remaining trippers. |
||
rlhedlund |
I am not found of A or B. My concern is moving the victim with a compound femural fracture. I'm not moving him unless directed to. first aid is first. all hands on deck. glove everyone that will touch victim. peel back clothing, stop bleeding. tourniquet in place, but not used unless needed. treat for shock, keep warm, elevate leg if possible due to fracture, clean wound area extremely carefully, cover wounds loosely with gauze, give tylenol. splint leg and apply traction to ease pain, (traction can be applied with a couple sticks and rope)evaluate spirits of the victim, keep him talkative and constantly under evaluation for unseen blood loss. check pulse and respirations every ten minutes and record. check temp periodically and record. prepare litter only to move to immediate area for safety and comfort. after immediate care is given, contact authorities with report of victim's condition and party's location. I truly think authorities will come to the victim in this case, but we'll do whatever we are told to do. Be prepared to spend the night as weather can change while flight is in progress. Set up camp, get fire going for signal purpose, and keep one person at side of victim at all times. Do not give heavy foods to victim, light fluids and snacks only. contact authorities on the hour, if battery life allows, or every couple hours and report victim's vitals. It may be a couple hours before help arrives. When it does victim goes. The rest of us take care of his gear and head for home. |
||
rlhedlund |
I'm thinking a real litter will arrive with the helicopter, so i'm not worried about having one after we move victim to safe area. When setting up camp, we put a tarp over victim, so we don't have to get him in and out of a tent or hammock. Fire gets built close to him for warmth and comfort. other factor to keep under consideration is mental condition of companions. are they holding up well under the conditions? may have to keep them comforted and motivated as well. Call kanoes on the sat phone for some fart jokes to keep up everyone's spirits. :) |
||
gutmon |
-Dwight Schrute also- my guess for the surprise ending of challenge #12- eat them. |
||
bojibob |
Note the comment about the compound fracture of the ankle AND the Femur is Broken. With additional references to Additional symptoms: Extreme Pain in LEG (duh!), pale complexion and feeling dizzy. This person now has zero capability to move on their own, and they may be going into shock. In regards to the comment about a compound ankle fracture not possible. See this attached Link: (Caution very graphic) Compound fracture dislocation of left ankle Additionally there are two options for evacuation. Hoare Lake, which no one has seen and no knowledge of the depth or the number of potential shallows that exist or Camel Lake which will take a longer time to reach, but you have knowledge of this lake. Your comment about attention to detail is SPOT ON. Just apply it Read the entire question. Think. Answer |
||
hexnymph |
1. Calm the poor victim. Reassure that “everything is going to be OK”, and get some Tylenol-3 in him. 2. Get on the SAT phone (This is the time) – Explain our situation, the accident, obvious wounds, pain meds given, location on map explaining as best as possible with lake names north, south east and west, GPS location. (This will most likely be recorded so they can review later with maps in hand) Provide victims name and family contact information. Ask for their recommended action and instructions. Set up a call back time per their suggestion. (They are going to call the shots on where we move the victim if we are to move at all. All their suggestions for immidiate first aid will be followed as well. That is what they are trained to do.) 3. At the same time the call is being made, first aid will be provided based on an agreement between the group or hopefully as suggested by OPP... that should be documented and signed if possible. My suggestions would be have water available. Wrap/bandage open wounds after a disinfecting wash. Secure ankle and femur with whatever splint making material we have available. Gently elevate legs and make the victim as comfortable as possible. Apply pressure to external bleeding if needed. 4. Use rope/ponchos/Logs to build the litter in case moving the victim is required. 5. Recontact OPP and await instruction. 6. If we were unable to contact the OPP we would do our best to evacuate the victim on our own until we could recruit help. If possible all actions decided on would be documented and signed as group decisions… for example additional medication, tourniquet, etc. 7. Pray |
||
snakecharmer |
|
||
drnatus |
I'd let the OPP decide if they could land on the current pond or for where would we have to head. Like rlhedlund's steps above. |
||
canoe212 |
|
||
tremolo |
surprise ending for 12-- the identity of #2 is revealed and #6 gets off the island? |
||
RT |
Since there are 3 uninjured people, duties would be split up between them. The person with the most first aid experience should get the person laid down and covered (because that is about all you have for shock treatments) and get water and medical supplies going in treating the wound and splinting the leg using (4 if possible) cut branches. The person with the least experience in emergencies should should be busy getting branches for the splint (while person one is gettin the wound dressed) and then go into litter making mode. Seeing where you are, a float plane might only be able to land on Hoare Lake and you might have to litter the injured to it. The last person should be on the SAT phone calling for help. An open wound of this type needs imeadiate medical attention. Deep muscle wounds and compound fractures are prone to quick infection and needs hospital care asap. Lastly, assumin the plane is pickin up the injured guy, have him plus your least experinced BW'er take the flight (unless someone else wants to go... like the guys best friend. He might have latched on to one person as his "rescuer" and that person should go with). The other two guys just have to suck it up and get all of the gear out of the BW. |
||
Corndog |
Stop the bleeding treat for shock Call for help start a fire keep the injured warm and stay calm. |
||
solotrek |
Great challenge!! I agree with those who treat and call for help at the same time. The GPS will be very useful. As for no knowledge of Hoare Lake, I don't think it's necessary. This is a life and death situation. My reliance would rest entirely on the OPP. They know the area. They know their equipment. They know the appropriate medical personnel. In this case, I would make the victim as comfortable as possible, treat as best I could with the guide and medical provisions available, and take direction from the OPP. Very interesting! Keep 'em coming! |
||
myceliaman |
|
||
woodsandwater |
|
||
oldgentleman |
|
||
preacher |
|
||
camp-n-scrap |
|
||
jdevries |
|
||
andym |
Plus, what the heck are you doing bushwhacking at midnight and how did he break both the femur and the ankle? :) |
||
deadeye |
|
||
SouthernExposure |
A few points that I would do differently: I would make the call on the SAT phone immediately upon discovering the compound fracture to minimize the evacuation time. Evacuation would be for 1 person. I would provide the lat/long data at the site of the injury and have them meet us in Hoare lake since reaching it involves only 1 more portage and it is oriented parallel more or less with the wind direction and would make for an easier landing for the plane. I would also request that the OPP round up an experienced canoeing volunteer to take the injured fellows place and arrive with the evac crew. Once the injured man was secured safely on-board, all emergency information was transferred, and the plane has left, we would then immediately make our way back to our original entry point and vehicle. Pray. SE |
||
nojobro |
The first thing I would do is get that leg elevated and try to control the bleeding, giving the patient tylenol 3 ASAP, too. Then I'd be trying to get on the phone to OPP; this is way out of my first aid league and I'd need help, definitely. If the bone is sticking out, that's pretty darn serious. I would then try to do whatever the OPP said I should do. "The call"? Sounds interesting! |
||
L.T.sully |
|
||
bojibob |
|
||
kevheads |
|
||
bojibob |
It's tough to keep all these made up details in sync, trust me. I'm attempting to create a lot of variables that people will have to consider which may or may not lead to a particular course of action. |
||
quetico1 |
First, the injury is supposedly a broken ankle. Yet you say that the femur is sticking through the skin. There is no femur in your ankle. The femur is your thigh bone. Fractures in the "ankle" can be the bottom end of either the tibia or fibula which are really part of the lower leg, or one of the many small bones in the ankle, none of which would be likely to produce a compound fracture. This "detail" is very important. Second, you said there is no right answer to the challenge. Not true. Any condition with a compound fracture requires immediate evacuation. A SAT phone call to arrange for helicopter extraction from the present location is paramount. Without a helicopter, the injured party needs to get to the nearest place where a floaat plane can land, and fast! Of course first aid to the max in necessary immediately. No other solution is acceptable. |
||
hexnymph |
|
||
bojibob |
|
||
TwoByGreenCanoe |
The evac team should let you know when you call them if you should move him on a litter or wait till they come and put in IVs and apply a traction splint. Any wrong movement with his leg could kill him. |
||
bojibob |
OPP Aircraft However, they could hover and lower a basket to retrieve the victim. But without a suitable landing area. This would have to done over water. With the victim in canoe being loaded into the basket. But as a note: The article states the OPP helicopter are located in Orillia which is about 350+ nautical miles away. |
||
cheesehead |
|
||
firftr911 |
Question #2 - What do they do to horses that break legs? |
||
Beemer01 |
This is of course the real reason to carry a Sat phone. I don't carry one, and it would appear I'm just hoping for the best. This is a real situation and could happen to any of us. Absent the 'pop smoke' option, I guess we'd have to stay on the nearest lake, stabilize the patient and try and signal the random float plane. (I do carry a signal mirror, a reflective space blanket and am expert at building big smoky fires). I do hope it never happens to my crew. |
||
Winemaker |
As I have related on the board before, this happened to four good friends of mine in the Q about 15 years ago. A guy slipped on a wet rock, hit the ground with a compound fracture. Good news was they were on a big lake, bad news was there was no sat phone. One guy was a fireman with EMT skills; they got him stabilized and then one guy stayed to watch him. Two guys paddled back to the ranger station about 18 miles away at a pretty fast pace, running the portages. A big problem was comunicating to the ranger the gravity of the situation, but that problem was eventually solved and the guy was air-evacted and after surgery was OK. The story did make the BWJ. I was glad I was not along, I could not have done anything better then these three guys did for their friend. Mike Bach - Doug Thomas - Randy Richey all of Kokomo, IN I will reserve the "victim's" name, although I think his reaction to the injury and what followed was equally courageous. hummm? |
||
brerud |
I would probably be more worried about the victim dying than losing a leg so I would probably tie the tourniquet right away and then ask the OPP what to do. I am guessing that the OPP would want the victim left where they are so the medical personnel can be brought to the victim. A short paddle and portage would be better to bring the medics in than to haul the victim out on our own I think. Pray - the broken femur is scary. |
||
Minnesotian |
And I was also thinking helicopter too, but if there wasn't one, I would send someone ahead to scout out Hoare Lake to see if a float plane would be possible to land there. That is moot if the pilot already knows he can land. The less I have to move the victim, the better. If I didn't know first aid, my instinct would be to try and slow the bleeding while calling on the Sat phone. Hopefully, someone on the other end would give me direction. If not, well...then...what have I learned from watching television and movies? Because that would be my knowledge base. Thank god I learned basic First Aid. |
||
Rapid Runner |
shoot it? but then you have a horse with a broken leg and a gun shot wound! Call the OPP, get him stable and get him to a suitable evac point the aircraft should have over a 700 mile range there and back plus hang around fuel. |
||
Georgiaboy |
I am not sure that without a helicopter rescue this person is going to make it. |
||
rlhedlund |
|
||
Georgiaboy |
I tried to find a link but I was unable to. I have it somewhere in a magazine I will look for it. |
||
mc2mens |
|
||
bojibob |
Challenge #3: (Broken Ankle) Situation: You are traveling in a party of 4 (Combined crew weight of 800 lbs) in two rental Old Town Penobscot 17 foot Royalex Canoes (max load weight of 1100-1150 Lbs). You are carrying 4 large packs, 4 smaller personal packs and misc. fishing gear with a total gear weight of approximately 350 lbs split evenly between the two canoes. Your current location: You have completed a long bushwhack from Camel Lake to a series of small ponds that you will leapfrog into Hoare Lake (A LAKE THAT NO ONE IN YOUR PARTY HAS BEEN TO BEFORE) The 1st Bushwhack took 3 hours (double portaging) to get your crew, gear and canoes to Pond #1, You completed the next hop (15 minutes) into Pond #2 and then another hop (5 minutes) over a boulder field into Pond #3 (See photo-Your location is the Red Flag) (Click to enlarge and once open, you can click again to zoom in) Additional Information: The current time is 12:00 PM. The Date is August 21, 2010. Sunset is at 8:11 PM, Twilight lasts until 8:45 PM. Weather is good, clear skies with slight breeze with gusts 5-10 MPH from the NW. Pond Information: Ponds #2 and #3 are shallow, less than 5 feet deep, littered with rocks and a few deadfalls. Pond #1 you don't remember any rocks or deadfalls and it wasn't as shallow as Ponds #2 and #3 but you are uncertain of the depth. Items of interest in your gear pack: You have a comprehensive Medical Kit. This kit contains the following items that may be of interest. 2 SAM Splints, Large Ace Bandage wrap, several 4” Gauze Bandages, Tylenol-3, Thermometer, Medical Tape, Hand Sanitizer, Suture Kit, assorted bottles/tinctures of antibiotic creams. Assorted misc bandages and over the counter pain, cold, cough medicines. Other items of interest: • You have 2 “old style” Army Ponchos and 200 feet of various cords or rope. • You also have a hatchet and saw. • SAT Phone with emergency contact information for the Ontario Provincial Police (OPP). • You have a GPS. The Challenge: While loading at the end of the portage to Pond #3, a member of your party with a fully loaded pack (50+ lbs) slips on a wet rock and his foot is wedged between two rocks and as he falls, he sustains a compound fracture of his right ankle and his femur has broken the skin and there is moderate bleeding. Additional symptoms: Extreme Pain in leg (duh!), pale complexion and feeling dizzy. This person now has zero capability to move on their own, and they may be going into shock. Now What?(Pick Only One) ***Looking up first aid treatment for preventing/treating shock and compound fractures on the Web is prohibited. Camel and Hoare Lakes do not have WIFI*** a. Perform First Aid (describe steps you would take based on symptoms and supplies available), After First Aid, I build a litter to move victim. We continue on to Hoare Lake, triple portaging the Canoe, Gear and Victim. We contact the OPP and ask for medical evacuation via float plane. What is the key information you would give to OPP to coordinate the landing and pickup? Is the pickup for everyone? The Victim Only? The Victim+1? If it is the Victim or Victim +1, how are you going to get the Canoes, Gear and the rest of the party home? b. Perform First Aid (describe steps you would take based on symptoms and supplies available), After First Aid, I build a litter to move victim. We contact the OPP and ask for medical evacuation via float plane or other means from Camel Lake, upon approval we triple portage the Canoe, Gear and Victim back to Camel Lake. What is the key information you would give to OPP to coordinate the landing and pickup? If it is the Victim or Victim +1, how are you going to get the Canoes, Gear and the rest of the party home? c. Perform First Aid (describe steps you would take based on symptoms and supplies available). Observe victim for several hours to determine the next steps before over reacting and calling in the Calvary. d. Your answer: (free flow thoughts) ** Notes: Imagine the additional difficulties or steps required if you did not have some of the items listed and a very good knowledge of First Aid. Did your friend potentially die because of your crews lack of knowledge or preparation? Honest private self assessment Next Challenge: “The Call”. If you missed Leadership Challenge #1 Bear Island If You missed Leadership Challenge #2 Destroyed Canoe |
||
bojibob |
|
||
mc2mens |
|
||
Mad_Angler |
For this one, my answer is easy: use the SAT fone and call for help. This could be life threatening injury if treated incorrectly. It could also easily be a lifetime disabling injury. Why not use the SAT fone since I have it??? |
||
Mad_Angler |
Have someone use the GPS and sat fone right away. Have someone else stabilize the victim as well as possible. Also, ask the OPP for any additional first aid advice. |
||
Jayhawk |
...it's that guy who whines by day and snores at night, is first in the chow line taking half of what's in the pot, complains then refuses to help clean up because the rest of you left him nothing for seconds. in this case I'd take one of the ponchos, 100' of rope & tie the guy up with a bundle of rocks -- pool #1 & #2 are no good so I'd roll him into pool #3, call the OPP & tell 'em the guy in your party just went streaking off into the woods for no apparent reason somewhere NW of Hoare Lake ( this way they won't get an immediate fix on his scent ). Go through his stuff & exchange for anything of higher quality. Continue on as if nothing happened allowing a little extra time in the evening for fishing. Sell his car to a scrap dealer & stop at a really nice steak house on the way home. Find a new friend & immeadiately start planning the next trip. |
||
Basspro69 |
|
||
SunCatcher |
Stabilize Victim don't move adminsister first aid. (Stop Bleeding) Then Call for help. {Treat for Shock) Feet above head. (Utilize sleeping pad and bags to keep comfortable) (Splint) Start fire to let Cavalry know where we are. and let them know on phone call that you are building fire so they know where you are. Pray |
||
Amok |
I'd choose C. Here's why: I would first, immediately, make the injured member as comfortable as possible (Tylenol 3 would do the trick, and a quick tournequet or pressure point to slow the bleeding) while checking the FA manual AND the other members' knowledge to figure out what would be the best thing to do. IF the manual/member knowledge does not cover the splinting/etc. that is required for this injury, we would use the SAT phone for immediate help and stay put. If we deemed we had the knowledge necessary to keep our injured member alive for a trip out, we would, once we took care of him create a 'stretcher' of some sort from one of our tarps and some wood and slowly head to the nearest entry/exit point. Portaging him along with everything else :) |