RE: [Paddlewise] accident scenario

> a:  what's your first plan of action

Assuming that we're beginning this scenario with the injured paddler on
shore and it's not an arterial bleeder.

Perform quick initial visual evaluation of patient.
Get the patient down and treat for shock
Direct pressure on wound

Have someone call for help if within radio or cell range.  If this is not
possible - dispatch a _pair _ of paddlers to either get a car if your
transport is nearby or to flag down a passing car or truck.
Put someone in charge of dealing with the rest of the group - you don't need
six people hovering around watching.

Clean and bandage wound.
Check entire body for other less obvious injuries.
Assess the patient's capacity for being moved.

Have someone attend to and talk quietly to patient - keep'em calm - some
people get panicky if they're hurt.

> 
> b:  how do you decide if the person is capable of continuing 
> on, on their
> own, or if someone needs to play ambulance driver

  My take on most serious injuries is that once you start treating the wound
care for the patient should be continued until responsibility is handed off
to the next care-giver.  Don't let the patient make decisions right now.
Don't argue with the patient - just quickly and efficiently make things
happen to deal with the situation.
> 
> c:  how do you notify the "next of kin" --- ie tell them to 
> meet you at
> the hospital/ER, without adding undue stress to the callee
  
  Do not let this notification get in the way of anything else - taking care
of the patient is primary even though they might not agree with your
prioritization.  In some cases it might even be best to make that call from
the hospital.  "Hi Sue/Ted.  Ellen/John was hurt, but we're at the hospital
and he's OK - the doctors are with him right now.  Can you find someone to
bring you down here? (that's important!)  Keep your voice calm and even.
Communicate efficiently, don't go into too many details - just notify them
and get them there.

> 
> d:  what other factors should be involved/considered

  Well, we've treated the obvious wound and checked for other problems.
We've arranged transport and handled it until the handoff to the pros.
We've notified next of kin.  Maybe the next thing is a group debrief - it
depends on how tight or loose the group is - if you're all good friends you
might find it useful and beneficial to talk it through in an _informal_ way
- sometimes surprising details surface in the post-game analysis.  Do not
push this issue - it's only helpful to someone who wants to deal with it.
> 
> e:  is this discussion usefull?
  
  Yes, it is.  Sometimes stuff like this seems too far-fetched and frivolous
to even waste time on - right up until something really happens.  At that
moment you do not want to be wondering what you should be doing - you want
to be doing it!

Dave Seng
Juneau, Alaska
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