EMR in Action, ctd.

Team member Mikel Kinser was at home, where his wife was hosting a couple’s baby shower for one of her coworkers:

“I was outside when I heard a loud crash and my wife yelled from inside for help. I ran inside and found one of her guests prone on the floor next to a chair that had fallen over. My wife said she fell over after saying she was dizzy and had asked for a glass of water.

Her head hit the ground hard and she lost consciousness for a moment. I told my wife to call 911. As the guest started to come around, I began speaking to her, asking her questions. She was A&OX3, not knowing what happened to her, but did know her name, where she was, and what day it was. I also took her pulse and respiration. I began feeding this information to my wife, who was on the phone with 911.

She also had a large bump on her head where she hit the ground, but no blood. She had free motion with her head and neck so I did not feel there was any spinal or neck injury. I checked her eyes for PERRL and all was good. I kept her on the ground where I found her, and checked with her for comfort (warm or cold). Paramedics arrived within five minutes of the call and took over. I relayed the info again to them: patient name, what happened and patient vitals. From there I just observed the five emergency workers. They did an EKG on her (normal) but they did find that when she stood up her BP dropped a lot. She refused transport, and I had to sign as a witness.

She remained at our house until a friend of hers could come and pick her up. We told the friend to keep an eye on her as she had hit her head and could have a concussion. She returned the next day for her car and was fine except for the bump.

Looking back on it, I felt calm going through the steps, but could have done better (I had a BP cuff in my office and I did not think about it until later). I also did not do CMSTP, which I should have. I feel worse for the things I did not do than good about what I did do, because I know from my EMR training what is supposed to be done. I can see that continued exposure to this is the only way to stay on top of it and do it correctly.”

Mission Summary, April

April 2nd
The Hasty Squad received a call on the evening of April 2 and team members were sent to the San Pablo/El Sobrante area where they began a hood-of-the-car search for a mentally challenged 59-year-old male who had left a group home a few hours earlier. The search was conducted from a small parking area, mostly with driving routes, although there was one dog team sent out on foot right away.
      
The subject was found, safe, by an AMR ambulance crew not far from Doctor’s Hospital, within a few hours of mobilization.

Searcher Spotlight(s): The Riggs Brothers

Riggs Casey-MThey are most often referred to as the Riggs, or “the twins” (although they are not the only set of team or even Explorer twins, anymore). Individually, one or the other might simply be called “Riggs,” but people who do that confess to doing so because they have trouble telling Micheal and Casey apart.
         
Various methods have been used to distinguish them: the shape of their glasses; a hairstyle, perhaps; something tied to a shoelace. But often even that fails to make a clear distinction. (And, on at least one occasion, the uniform blouse wasn’t an accurate way to tell, either, because they’ve been known to switch shirts – not on purpose, of course.)
           
When asked to answer the spotlight questions, the first response was a joint one covering both boys. They do, after all, both live in Walnut Creek and are originally from Danville. They both joined CoCoSAR as ninth graders, at the ripe age of 14.
        
Both love hiking and backpacking. Both work on and off at the Brenden Theatres.
        
Neither likes to read, particularly, though Casey will pick up a book on a subject that fascinates him and Michael likes the P.G. Wodehouse books on tape. At 17, they are both looking into the same colleges and plotting a similar path in the world of filmmaking, which includes their recent acceptance into an exciting mentoring program with a professional filmmaker.
            
Riggs Micheal-MBut a little digging determines there are a few variances, albeit subtle ones and not just the physical “my head is more rounded and Casey’s is narrower” types of differences Micheal cites.
         
Casey, for instance, got into making film first. He loves photography and it’s the videography and production end that most grabs him.
          
When Micheal finally caught the filmmaking bug, too, he veered toward the technical end with editing more up his alley. Casey says his plan is to get a master’s degree in cinematography and photography. Micheal will aim toward editing and sound mixing.
        
Asked if they will then work together, Casey says “why not?” since it’s easier to get his brother to do the editing than to hire someone else. You’ve heard of the Coen Brothers, he says, so, “Why can’t it be the Riggs Brothers?”
       
They also love the “culture of the outdoors,” but Micheal says Casey is more of a “hipster” kind of guy but he is all about plaid. Casey will venture farther afield to conduct missions such as building a house in Mexico, whereas Micheal is content to hang and hike around home base.
         
Casey is a little quieter around the SAR camp, a man of fewer words than Micheal. “One of the most valuable things I have experienced in SAR is teamwork,” he says. “Searches and trainings continually show me how working as a team produces the most effective results.”
          
Micheal, on the other hand, is likely to pop up and offer a little speech when the opportunity arises, like at an orientation night. And he is a little more verbose in his evaluation of his SAR experience, so he gets the last word(s):
       
“There are many times, during my SAR training and during some searches I think of something Yvon Chouinard said: ‘Real adventure is defined best as a journey from which you may not come back alive, and certainly not as the same person.’ I may not really be in danger of dying during my SAR experiences, but it has definitely changed my life for the better,” Micheal says. “The mission, the different types of people and the work have given me an experience I would not have had in any other way.”
 

Major Medical Training: Moulage and Volunteer Subjects Still Needed

Screen Shot 2013-05-09 at 8.53.43 AMIn preparation for our annual major medical full-team training in May, we need your help.

1. We still need more volunteer role players.  Please pass along the volunteer flyer to your friends, family, neighborhood group and any other community group you think might have interested takers–book clubs, Rotary, Kiwanis, school groups, etc.

2. We need a few team members to help Catrina apply moulage to our willing volunteers.  If you have a knack for make-up and/or simply like the idea of creating gory injuries, please email Caroline Thomas Jacobs and Catrina Christian.

We have a great round of stations planned, including some new twists and look forward to seeing everyone out there!

Mountain Rescue Group Potluck Barbecue

P1020699

Last night, the Mountain Rescue Group leadership held a potluck barbecue at Castle Rock Park for current Type 1 candidates and anyone else interested in the MRG. Family and friends came along too. Students got a chance to debrief the Advanced Land Nav class, and MRG leadership offered insight and words of encouragement before they embark upon a series of trainings this summer. 

(Photo: Natalie Zensius, Rick Kovar, Patrick Dodson, Rick Najarian and Phil Novak work to assemble the MRG's latest gear acquisition: a mobile Command Post. Photo by Wilma Murray.)

Announcement: Upcoming COCOSAR Rope Rescue Training

USAR LAngleBeginning this month, and for three subsequent months, the USAR/MRG staff(s) will be offering rope rescue training to CoCoSAR team members. This training is open to all team members, regardless of their previous experience. The trainings will be tailored to attendees' skill levels and held in the USAR resource monthly training slots (third Saturday of every month.)

Stay tuned for more details to come and start practicing your knots!

CoCoSAR Advanced Land Navigation Class

Last week Type 1 Academy students began CoCoSAR’s two-evening Advanced Land Navigation class. In the classroom, students learned all the ins and outs of maps and compasses.

Today they were tasked with putting those skills to work as the class concluded with an all-day, solo field test at a secret location. This year, students were joined by current Type 1 team members who were conducting a simultaneous field exercise to refresh and maintain their navigation skills.

Mixed in with the inevitable excitement was some trepidation about what the field-test day might have in store for students; however, graduates of the class reported that it was a fun-filled day and an extremely useful experience.

Class instructors Dr. Mark Sembrat and Jack Peabody discuss the class and how they came to lead it in the following Q&A session. 

How did each of you get so interested/passionate about navigation?

MS: I was involved with adventure racing in a former life and since the course is not marked, you’re very dependent on the efficiency of the navigator to get from point to point.  I’ve seen teams lose races because of mistakes, so I took additional weekend classes to brush up on skills and learn new ones. 

Historically, navigation was a weakness for our team.  It was presented to me that I knew “just a bit more” about navigation and was asked to develop a navigation course for CoCoSAR. Then, with the depth of the team, suggestions by students and proctors, the class, and the result is that our collective skill as a team has just gotten better and better over the past five years.

JP: With a name like Search and Rescue, I always thought that after medical skills, your navigation skills had to be the second-most important item for a team member.  My passion comes from many years as a Boy Scout leader and many more years of being in the wilderness with groups of people in which I learned that good navigation will make the trek more enjoyable and with less drama.

In your experience, are some people just inherently better at navigation than others? How do people who don’t have an inherent sense of direction overcome this?

MS: Some are naturally better navigators than others, but there are a few things to make it easier. Pay attention to the everyday navigation tasks. Learn what your tendencies are and if they are correct or need to be tweaked.

JP: I do not think anyone is inherently better at navigation, only that some people are paying more attention navigating through their day and have more current route-finding skills.  The human brain is good at remembering a story and navigation is about the story of the trip you are about to take by reading a map. See Mark’s “The Six Steps to Becoming a Better Navigator.”

How has technology, like GPS, impacted our ability to navigate?

MS: GPS navigation is easy, plain and simple. We use it all the time in SAR work. GPS uses orbiting satellites to find your location on earth via calculating how long it takes for a radio signal to reach your receiver. You can carry a huge variety of maps in the palm of your hand. Whether you're hiking up a mountain or you're driving cross country with friends, it's much easier to look at a screen that shows exactly where you are than to puzzle out your course without technological aid. If you don’t understand the information it provides, it becomes only an expensive paperweight.

JP: GPS makes locating yourself and getting to locations much easier.  This is all well and good until the GPS device fails, and then it compounds most people’s problems for they now don’t have a map or were not paying attention to how they got where they are and do not know the route to their destination.  So orienteering skills are invaluable regardless of the tools you have.

What’s the biggest difference between CoCoSAR's basic and advanced land navigation classes?

MS: I personally believe focus should be on map-reading skills.  This is useful in maximizing both the GPS and compass. Unlike basic land navigation, advanced land navigation gives people the opportunity to get personal with primarily map and compass where detail is the key.  Mostly what we use in SAR provides an exact location in a UTM format. 

The GPS unit will let you know how much distance you've covered and how much further you have to go. It will even tell you your altitude.It can mark and retrieve location points or waypoints. This ease of use shouldn't be taken for granted, though, since if your GPS stops working you'll still be on the trail, road or out in the wilds. As such, you should have a back map or atlas and stay aware of your surroundings.

The downside of this is that these devices are still electronics, and as such are vulnerable to bad weather, rough handling and even electrical discharge, which can damage even the most modern system. They run on batteries (extra weight) and require good signal strength. GPS is a great tool, but it’s important to understand the strengths and weaknesses and compensate with other techniques.

JP: Basic land navigation is a team-building map exercise to navigate in a car using a Thomas Guide and on foot using topographic maps using the collective wisdom of the group.  These are primary skills for searchers to get to the search and find a subject.  Advanced land navigation is a simulated helicopter drop into the wilderness in which you are all alone with your map and compass skills to navigate a course.  It is the only SAR training in which the individual is NOT part of a team but is on their own using their brain and refined orientation skills.

Why are advanced navigation skills important for the search and rescue team member?

MS: Using a compass is less expensive, does not require electricity, but often requires a map. You need to learn a few skills in order to read a compass properly. Most people know they should always carry a compass, but do they all know how to actually use it? In my pack I carry a Garman Map 60CsX, a Silva Ranger compass, map and grid reader tool for redundancy and to resolve all possible limitations.

JP: As noted above, advanced land navigation is a simulated helicopter drop into the wilderness, which is a real situation MRG searchers face on a regular basis; thus these are skills you must have mastered.

In your experience teaching this class, what do students seem to have the most trepidation and/or confusion about? 

MS: The field portion of advanced land navigation because it’s the only time I know of that as a CoCoSAR team member you’re placed in situations alone, not in teams, not with a partner – no one! You are depending on your brain and skill to pass the class. This can be nerve-wracking for some students.

JP: Looking at a topographic map and visualizing what the terrain looks like and vice versa, seeing the terrain on the map to plan a route. They have the most confusion about how to operate a compass and GPS.

Which books or other resources do you recommend for team members to learn more/brush up on their skills?

MS: Resources are endless on the Internet.  All you need to do is use Google and you can be overwhelmed with information. Admittedly, some is dry and hard to process. I lean more to videos for brushing up on skills. A good book is Wilderness Navigation by Burns and Burns. 

JP: Mark did a good job addressing this already.

In your experience, how does navigation stack up as a perishable skill compared to, for instance, medical training? 

MS: Learning to read maps is critical. Often a good map and the ability to read it is all you need. Build a tool kit of skills and techniques, so you can draw upon and apply more helpful skills for the situation you may find yourself in. Like all perishable skills, practice is the key.

JP: Navigation is about as perishable as medical skills, although ironically you use your navigation skills every,day, but you’re usually on auto pilot, so you are not aware of the process.  The navigation machinery, such as topographic maps, compass use, and operating a GPS is like working with any software, i.e. if you don’t use it on a regular basis, you quickly forget how to make it work for you. 

What are the 3-5 things that you'd like to see every team member know and be confident about?

JP: At Type 3, how to read a topo map to plan and follow a route off streets; at Type 2, how to operate a GPS to record tracks and get to locations or coordinates; and at Type 1, how to figure out where you are and navigate in any kind of conditions and terrain.

For those curious about what the advanced land navigation day entails, below is a video of the 2013 class, produced by Mark Sembrat.

EMR in Action, ctd.

Today, after pulling an all-nighter for last night’s search, team member Wilma Murray was trying to shake the cobwebs by taking her dog for a walk when she was suddenly called upon to exercise her medical skills:

“We came upon a group of men converged on the sidewalk. They were gathered around a young man who sat (in a rather crumpled position) up against a retaining wall. 

The men were asking him if he was all right and what they could do for him. As I approached, I was told one of the men had seen him sitting there an hour before and when he returned, the young man was still in place. I asked the subject a few questions and getting no response, I took a closer look. His eyeballs were rapidly flickering and he was clearly in distress. I asked one of the men to call 9-1-1, asked another to please hold my dog's leash and explained I was trained in first aid. 

I bent down to the subject's level and introduced myself. My request for consent was met with a vague noise I took to be affirmative. I had no gloves with me (lesson learned), so I had to barehand it. I continued to try to get a response from him and was able, after repeated tries, to get his first and last names. His pulse was 120, respiration 24, forehead cold and clammy but face very hot. But it was the lack of awareness and the rapidly moving eyeballs that most concerned me. 

I saw no visible mechanism of injury or blood and did not conduct a head to toe (another lesson learned) as I instead busied myself with trying to get him comfortable leaning against me while trying to elicit information from him. One of the men handed me a bottle of water and I was able to get the subject to sip a few times. When help arrived, I gave the responders the subject's name, his vitals and told them what I had observed. 

It took six strong men to lift this very thin young man onto a stretcher.  The subject then began to seize and they had to strap him down before loading him into the ambulance. I have no idea if he will be all right, but I can only hope.

Once again, SAR training proved invaluable, but I was made painfully aware of how easy it is to make mistakes or not be thorough enough in a real-life situation. It only encourages me to practice, practice, practice. The good news is that my training kept me calm throughout the whole experience. Thank you SAR!”
 

April Hasty Squad Training

Hasty Tng Danville April 2013 030The Hasty Squad had an excellent training on a beautiful Wednesday day and night in Danville. The training was a mock search for a missing at-risk autistic 16 year old. There were 33 searchers in the field, with another 12 as role players and proctors.

The teenager went missing after leaving his house for school in the early morning and it was reported that he never attended any of his classes. The search began at the subject’s house where team members met with a Danville PD IC officer and the subject’s mother, played by team member Nancy Hart. There they had a briefing from the IC, a search of the subject’s house,and interviews began. CP was set up at a nearby San Ramon High School and field and bike teams were soon sent out.

Information was discovered on the subject’s Facebook page that led searchers to his tutor and a friend at a nearby Yogurt Shack. From the tutor, it was learned that they both had an argument over test preparation that morning and the subject had a “stress” episode and left campus to head to an unknown location.

Soon thereafter, the father of the subject called from overseas and gave information of a past hike the two had taken on a nearby trail in Las Trampas.  The missing subject was found by a bike team. He was injured, but in overall stable condition.

Thank you to our proctors and role players:
Nancy Hart, Patrick Walker, Daniel Rathert, Richard Najarian, Kang Lim, Steve Filippoff, Chris Young, Rick Kovar, Frank Moschetti, Dale Myer and Bryan Walley.

Thank you to our Hasty drivers:
Diane Blue, Jack Peabody, Ed Griffith and Patrick Dodson.