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From: Seng, Dave <Dave_Seng_at_health.state.ak.us>
subject: RE: [Paddlewise] what was missed during Mark's mis-adventure
Date: Thu, 10 Aug 2000 11:28:00 -0800
Mark wrote :

ok, the biggie ... from what you read, and saw [and thank you for all the
well wishes, hopefully i answered everyone personaly] what was the thing
we missed? during this whole ordeal, one basic thing was missed!! i think
this will generate a bit of discussion, after i reveal it, as it is not
appearant from my previous post, but this is clearly MISSING ... my wife
and i didn't realize it for a week, with unfortunate consequences ... i'll
let a little guessing go on, then reveal it tomorrow night, as the
questions YOU ask [like 40 questions] will also reveal other things along
the way.

 OK, so I was wrong with my first guess and learned something new - I've
always just let puncture wounds bleed for a while to hopefully flush out the
bad stuff.  My first aid can sometimes get quite "field-expedient" - I once
used a combination of spider webs and sawdust to stop the bleeding in a 1.5
inch gash (from a rusty nail) in the palm of my hand so that I could finish
the job without going to the hospital (back in my younger more foolish
days!).

  A couple of other thoughts that crossed my mind when I read the original
post:

  - it seemed as though no-one addressed the possible shock issue during the
initial treatment (always treat for shock in trauma cases - and in my mind
having a paddle shaft shoved into your leg counts as trauma!)

  - did anyone ever make contact with the group you had been paddling with
to let them know that you made it to the hospital and were fine?

Dave Seng
Juneau, Alaska

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From: Mark <canoeist_at_dotzen.org>
subject: RE: [Paddlewise] what was missed during Mark's mis-adventure
Date: Thu, 10 Aug 2000 13:46:20 -0600 (MDT)
On Thu, 10 Aug 2000, Seng, Dave wrote:

>  OK, so I was wrong with my first guess and learned something new - I've
> always just let puncture wounds bleed for a while to hopefully flush out the
> bad stuff.  My first aid can sometimes get quite "field-expedient" - I once
> used a combination of spider webs and sawdust to stop the bleeding in a 1.5
> inch gash (from a rusty nail) in the palm of my hand so that I could finish
> the job without going to the hospital (back in my younger more foolish
> days!).

i let the wound bleed freely while i was still swimming the river, when i
got out of the water, i checked to make sure i hadn't severed the femoral
arterty [turnaquette time!! if you live] and then held pressure on it
while 1st aid supplies were gathered... one materials were gathered, i let
it bleed while drying off the rest of the leg. i literally had to hold the
"plug" in my leg, so it would stop "popping out"
 
>   A couple of other thoughts that crossed my mind when I read the original
> post:
> 
>   - it seemed as though no-one addressed the possible shock issue during the
> initial treatment (always treat for shock in trauma cases - and in my mind
> having a paddle shaft shoved into your leg counts as trauma!)

please expand on this....
 
>   - did anyone ever make contact with the group you had been paddling with
> to let them know that you made it to the hospital and were fine?

well, eventually, mostly due to canyons, and the fact cell phones, etc
were useless. this was a day trip from a base camp, so there were not any
phones/signal _readily_ available...  someone may have called the next
day, i was pretty "out of it" sunday!! the trip coordinator followed up
first thing monday morning.

mark

-- 
#-canoeist[at]dotzen[dot]org-------------------------------------------
mark zen                      o,    o__              o_/|   o_.
po box 474                   </     [\/              [__|   [__\
ft. lupton, co 80621-0474 (`-/-------/----')      (`----|-------\-')
#~~~~~~~~~~~~~~~~~~~~~~~~~~~_at_~~~~~~~_at_~~~~~~~~~~~~~~~~~~~_at_~~~~~~~~_at_~~~~~
http://www.dotzen.org/paddler     [index to club websites i administer]
---- A smooth sea never made a skillful mariner.  --  English Proverb

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From: Seng, Dave <Dave_Seng_at_health.state.ak.us>
subject: RE: [Paddlewise] what was missed during Mark's mis-adventure
Date: Thu, 10 Aug 2000 13:12:52 -0800
Dave wrote:

> >   - it seemed as though no-one addressed the possible shock 
> issue during the
> > initial treatment (always treat for shock in trauma cases - 
> and in my mind
> > having a paddle shaft shoved into your leg counts as trauma!)

Mark replied:

> please expand on this....

  Not sure why you've asked me to expand on this, because in the end you
proved that you weren't suffering from traumatic shock.  In any serious
traumatic injury I always treat for shock (I once had to explain to two
passersby how to treat _me_ for shock after I recovered consciousness after
a bad motorcycle accident). 
  Shock can be insidious and once it sets in it's difficult to treat in the
field.  Get the victim down, cover them with something to keep them warm,
elevate the feet for anything other than a head injury, for a head injury
raise the head.  (Face is red, raise the head - Face is pale, raise the
tail)  Simple steps that can be done quickly and easily while other primary
attention is being given to the wound/fracture, etc.  It doesn't hurt to do
it and it can safe a life.
  Signs of shock can include (but aren't limited to):

Pale, clammy skin
Rapid, shallow breathing
Nausea
Thirst
Evidence of a loss of body fluids
Weak or rapid pulse
Loss of consciousness

Dave Seng
Juneau, Alaska

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From: Mark <canoeist_at_dotzen.org>
subject: RE: [Paddlewise] what was missed during Mark's mis-adventure
Date: Thu, 10 Aug 2000 17:09:17 -0600 (MDT)
On Thu, 10 Aug 2000, Seng, Dave wrote:

> Dave wrote:
> 
> > >   - it seemed as though no-one addressed the possible shock 
> > issue during the
> > > initial treatment (always treat for shock in trauma cases - 
> > and in my mind
> > > having a paddle shaft shoved into your leg counts as trauma!)
> 
> Mark replied:
> 
> > please expand on this....
> 
>   Not sure why you've asked me to expand on this, because in the end you

because your answer is now in writing for the lesser knowledged to read
and think about ;-) [i'm a parent of teenagers, have to keep them
thinking]

> proved that you weren't suffering from traumatic shock.  In any serious
> traumatic injury I always treat for shock (I once had to explain to two
> passersby how to treat _me_ for shock after I recovered consciousness after
> a bad motorcycle accident). 

correct, and the answer to what i'm looking for is in another thread, but
not this one ;-) so other folks can ponder for a few, i'll save my answer
for later this evening ... the questions and answers given now are
priceless, as they are real events, through which the participants learned
something. and lived to tell about it, but, under edxtremely similar
circumstances, could lead to a permanent disablity, or in extreme, death.
i was NOT anywhere near that extreme...

BUT ... one week after the first hospital visit, i ended up back in the
ER, with something related to the accident, but not neccessarily due to
the first injury, HINT ;-)

mark

.sig included previously

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From: Seng, Dave <Dave_Seng_at_health.state.ak.us>
subject: RE: [Paddlewise] what was missed during Mark's mis-adventure
Date: Thu, 10 Aug 2000 15:29:50 -0800
Mark (who is toying with us) wrote:

> the questions and answers given now are
> priceless, as they are real events, through which the 
> participants learned
> something. and lived to tell about it, but, under edxtremely similar
> circumstances, could lead to a permanent disablity, or in 
> extreme, death.
> i was NOT anywhere near that extreme...
> 
> BUT ... one week after the first hospital visit, i ended up 
> back in the
> ER, with something related to the accident, but not 
> neccessarily due to
> the first injury, HINT ;-)

Mark,

 When they were treating your leg wound on the riverbank, did anyone check
to see if you were wearing any kind of Medical Alert bracelet or necklace?
(Note - this should be done as part of the full body assessment).  Since you
were a conscious patient, did they query you regarding any allergies or
other existing medical conditions?

Dave Seng
Juneau, Alaska
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From: Mark <canoeist_at_dotzen.org>
subject: RE: [Paddlewise] what was missed during Mark's mis-adventure
Date: Thu, 10 Aug 2000 18:41:14 -0600 (MDT)
On Thu, 10 Aug 2000, Seng, Dave wrote:

> Mark (who is toying with us) wrote:
> 
> > ER, with something related to the accident, but not 
> > neccessarily due to
> > the first injury, HINT ;-)
> 
> Mark,
> 
>  When they were treating your leg wound on the riverbank, did anyone check
> to see if you were wearing any kind of Medical Alert bracelet or necklace?
> (Note - this should be done as part of the full body assessment).  Since you

no full body assessment was ever done, not even at the ER, which i have
mixed feelings about... nobody EVER did this to me ... not even the ER drs
... all _my_ focus was on my bloody leg, and what to do about it ... no
other blood. ER drs ass-u-me-d i knew the extent of my injuries ... of
course, from their side, they see me come in and calmly tell them i cut my
leg!! they asked when, and i looked at my watch, checked the stop watch,
and told them to the nearest 5 minutes, that it was 4 hours 25 minutes
previously. seems organized and coherent to me ;-)

i had bruised my ribs underneath my shoulder blade when i go slammed head
first down the river... there was never any visible bruising, and once i
got to the ER, i had an IV pain killer for the stitches, so never felt my
back injury. it wasn't until i stopped taking hte pain killers that i
realized there was a problem. i had expected to feel beat up, and i did,
but i didn't know the extent of the problem... 

> were a conscious patient, did they query you regarding any allergies or
> other existing medical conditions?
> 
> Dave Seng
> Juneau, Alaska


i also have rheumatoid arthritis, and take handfulls of medicine every day
[but i have now been steroid free for almost 18 months] which is more than
just important!! i had to wear a medic alert tag for 14 years due to that
very thing...

i was alert, and able to tell folks that... but my mind tends to try &
ignore muscle/joint pain, so i never felt my back problem... which made me
really feel better, that i had a helmet & thick pfd, or it would have been
more serious... but this was the step missed by everyone, because of my
"alertness" etc, etc... now, had someone patted me on the back, BEFORE i
got to the IV, i might have noticed a bit of a twitch... my wife said the
muscle was standing up 2" [5cm] and having spasms when we got to the ER &
the dr was doing the exam [the 2nd time, one week later] he knew i wasn't
just a druggie looking for more pain killers!! [i do really look like a
60's throw back ;-]#

very good, i'd like to have you on my trips too 8-)

mark
-- 
#-canoeist[at]dotzen[dot]org-------------------------------------------
mark zen                      o,    o__              o_/|   o_.
po box 474                   </     [\/              [__|   [__\
ft. lupton, co 80621-0474 (`-/-------/----')      (`----|-------\-')
#~~~~~~~~~~~~~~~~~~~~~~~~~~~_at_~~~~~~~_at_~~~~~~~~~~~~~~~~~~~_at_~~~~~~~~_at_~~~~~
http://www.dotzen.org/paddler     [index to club websites i administer]
---- A smooth sea never made a skillful mariner.  --  English Proverb


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