Slow and Steady

patrick walkerBy Patrick Walker

Early on a misty June morning in Redwood Regional Park, in the hills between Oakland and Moraga, my dad and I were running ahead of the pack on a 20-mile run with my Boy Scout troop. This annual run helps us train for a summer High Sierra backpacking trek.

We were about 12 miles along and passing through a grove of ancient redwoods, quiet and still in the fog, when I noticed in the distance someone hunched on the side of the trail. It didn’t look right.

As I drew closer, I saw a person sitting with legs crossed, his head bowed and hidden inside a cinched hoodie. My SAR instincts and training immediately took over. I stopped a few feet away and asked him if he was OK. He did not respond. I spoke louder and authoritatively. “Sir, are you okay?”  He shook his head.

I asked him to remove his hoodie so I could see him and with slow, deliberate movements he obeyed my request. He was a Caucasian male in his mid-20s, unshaven and bewildered.

 “Can you talk?” I asked. He responded with a scarcely audible, “I think so.”

“Are you hurting?”

“I’m cold. Very cold.”

I asked how long he had been there. He said he came to the park the night before to “clear his head,” became disoriented when it grew dark and lost his way. He wandered in the night and eventually gave up trying to find his way back to his car and eventually found a place to sit down. He had endured a very cold and lonely night and was shivering, hungry, cramping up and confused.

I told him I have had medical training and could help him. For the first time, he looked up and offered a slight smile.

I asked if anyone would have reported him missing. With a touch of melancholy he said, “No one is expecting me back except my boss.”

I asked him to stand up. He was cold and stiff.

A couple of miles away was a Cub Scout camp where I knew they had fire, food and warmth.

“Can you walk?”

“I can try.”

Slowly, we began our trek. After a while, we passed members of my Boy Scout troop running along the path. They were surprised to see me going the opposite way. I told them that I was taking a break from the run to help someone. When I encountered the leader of the troop, he said, “Geez, Patrick, you find lost people even when you’re not looking for them!”

Our journey was painstakingly slow as he clearly was not well physically and maybe mentally. I was glad my dad was with me because I’m not sure I would have been comfortable alone with him. I suspected drugs or alcohol may have been an issue and he could have been suicidal.

As we walked slowly beneath the redwoods, he spoke. He said he felt lucky that we found him, and he said he appreciated our helping him. He asked my name and said his was Jeremy (name changed for privacy).

A half-hour later we made it to the Cub Scout camp. The troop had a fire blazing, hot chocolate and hot food, and the Scouts were generous in sharing it with Jeremy. I left him there with my dad, and then ran several miles further on to where a ranger lived. After explaining the circumstances and Jeremy’s current status, the ranger said he would take over and transport him to medical treatment.

I returned to the camp and Jeremy was seated by the campfire with a cup of hot chocolate, now warmed up, even smiling. We said our goodbyes and I rejoined the 20-mile run.

I was now in last place instead of first, but I knew that what I was able to do for a fellow human being – thanks to my training and experience on COCOSAR – was far more important than winning a race.

Danville Hot Summer Nights Medical

On July 17, 2014 Contra Costa County SAR was on scene and prepared to provide medical aid and assist with missing or lost children at the 20th annual Hot Summer Nights in Danville. The event was located on Hartz Ave in the heart of beautiful historic downtown Danville. The show stretched from Faz's restaurant on Hartz Avenue north to San Ramon Valley High School and extended down many of the side streets as well.

There were rare, one-of-a-kind collector cars, along side the most powerful hot rods and muscle cars from the 1960's. Also on display were custom designed cars from some of the world's most famous automobile designers, and beautifully maintained classic originals.

Check out the video of some of our team members:

 

Archived Medical Articles

Round-up of published medical topics
Several past editions of The Callout, in its prior incarnation as a newsletter, feature great articles and guides for the medical skills required for Emergency Medical Responders, a certification required of all CoCoSAR Type II and Type I team members.

Compiled below is a list of topics and articles with links to the newsletter. The original author, if available, is also noted. (Please note: requires login to the team members' website to view these articles.)

Step-by-step illustrated guides

Head-to-Toe Assessment, April 2011, Page 8

Bleeding Control and Bandaging, May 2011, Page 8

Splinting and the Sling, May 2011, Page 9

CPR

New CPR Procedures, June 2011, Page 10 

CPR and AED FAQS, by Carol and Mike McMillian, February 2012, Page 11 

Vital Signs

Blood Pressure Basics, by Laura Carmody, RN, October 2011, Page 7 

Blood Pressure: A Closer Look, November 2011, Page 12 

Oxygen

SAR Oxygen Pack, by Mike McMillan, August 2010, Page 11

The Little Green Bottle, by Ian Snelson, August 2010, Page 12 

February Full Team Training

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CoCoSAR’s Mountain Rescue Group organized the February full-team training, a mock search in Mount Diablo State Park. “If it ain't raining; it ain't training,” said Chris Coelho, MRG sergeant, as dark gray storm clouds massed overhead and searchers gathered, bright orange and hooded, at the staging area.

Staging did not stay full for long because the search ramped up very quickly. Teams deployed to scour Mitchell Canyon for two missing subjects. “We put 52 searchers in the field within the first 30 minutes,” said Caroline Thomas-Jacobs, demonstrating an adjustment made by Command Post staff, following the mock night search training, in November 2013.

The first subject to be located, played by team member Natalie Zensius, required extraction by a technical rope rescue team. “I had a unique opportunity to experience what it feels like on the ‘other side’ and be rescued,” she said. “In less-than-stellar conditions, I was quickly warmed and stabilized so that I could be packaged and transported down the mountain.”

Shawn Inks, handling communications for Team 4, located the second subject. “I turned around and saw him,” he said, “but it was kind of lucky. The trail was muddy and treacherous, so we were mostly looking ahead and down.”

Weather was a major factor, hampering radio communications, as well as visibility and trail conditions. “If we had to search Mount Diablo in the rain, this is exactly what it would be like,” said Reza Farasati. “The problems we have today are the problems we’d have to overcome in a real search.”

Wilderness Emergency Medical Responder Class

By Joe Keyser

This winter, 16 team members completed the wilderness upgrade to CoCoSAR's Emergency Medical Responder course.
 
This is a hands-on 30-hour course that focuses on applying the medical skills we learned in the EMR course to a wilderness environment. The course tries to answer the question: What do you do when there is no 911 to call? When YOU are 911?
 
Students studied a wide variety of subjects, including patient assessment in the wilderness, environmental illness, musculoskeletal injuries, altered levels of consciousness and many others, with a focus on extended patient care and long difficult evacuations. Evacuation decisions, or how to tell "big sick" from "little sick" were a special focus. The class also spent several hours practicing making improvised splints, litters, and bandages out of tarps, trekking poles, and other items commonly in a backpack.
 
The class had students responding to multiple simulated wilderness medical emergencies. On the last day, the class participated in a simulated mass-casualty incident. This training tested the students' assessment and treatment skills as well as their management and communication skills.
 
Special thanks to: Walt Eichinger, Todd Rogers, John Banuelos, Larry Fong, John Venturino, Mike McMillan, David Hoyt, Laura Carmody and Jim Gay for their help proctoring the class.

Mount Diablo Challenge Medical Detail Recap

Mount Diablo Challenge

On October 6th, 2013, CoCoSAR provided medical support for the Mount Diablo Challenge. This was the annual bike ride up Mt. Diablo, an 11.2 mile timed bike ride, starting at Athenian School in Danville and climbing up Southgate Road 3,249 feet to the summit of Mount Diablo. Approximately 1,000 cycling enthusiasts competed. 

More than 25 CoCoSAR team members staffed 6 medical stations located on Mt Diablo.

A CoCoSAR Training We Couldn’t Pass Up

On the weekend of October 26th Urban Shield 2013 will be taking place across the Bay Area. Urban Shield is a comprehensive full-scale, regional preparedness exercise. It encompasses real world scenarios to assess the Bay Area Region‘s response capabilities related to multi-discipline planning, policies, procedures, organization, equipment and training. Urban Shield tests regional integrated systems for prevention, protection, response and recovery in our high-threat, high-density urban area.

This year Contra Costa is the lead participant under the Emergency Management Area Command in Urban Shield.  As such, we will be the lead Emergency Operations Center and Coroner responding to a mass fatality incident—a simulated train collision in Martinez. This will be a multi-County Emergency Operations Center functional exercise in the morning with a Portable Field Morgue and Mock Family Assistance Center Demonstration in the afternoon. 

The afternoon Demonstration will simulate a full activation of a Disaster Mortuary Operations response Team (DMORT), including

  • temporary field morgue facilities
  • victim identification & processing
  • forensic dental pathology
  • forensic anthropology methods
  • DNA processing
  • radiology
  • disposition of remains

We expect up to 200 representatives from across the Bay Area and California Coroner’s Offices, fire, law and public health to attend the Portable Morgue & Family Assistance Center Demonstration.

While this is outside of the normal scope of the SAR mission, if we were to experience a large scale incident of this nature, there is a good chance the SAR Team would be involved in one way or another.

Due to the unique opportunity to work directly with our regional, state and out-of-state partners, CoCoSAR will be integrating our monthly full team training resources into this regional exercise. Supporting this exercise will give us the opportunity to get hands on experience setting up large-scale, federal disaster response assets, observe–and possibly participate in–regional mutual aid EOC coordination, familiarize ourselves with portable field morgue resources, as well as develop relationships with our regional and out-of-state partners.

CoCoSAR Team members can sign up at http://contracostasar.org/Detail/Search/urban.

EMR In Action, ctd.

Team member Will McCammon had a recent medical experience:

I was on my way to a Sunday afternoon shift at the County Fair when I came upon a single-car accident on Highway 4. The car had flipped over and the lone occupant was lying on the side of the road surrounded by a small group of people.  As I didn’t see any first responders on scene, I pulled over to see if I could help. 

A big thank you goes to the EMR training staff for constantly stressing the basics because as I got to the subject, I had my gloves on, was asking if 9-1-1 had been called (it had) and was looking for mechanisms of injury (MOI). While the car was an obvious MOI, I wasn’t sure if the subject had been thrown from the car, had gotten out on his own, or was helped out by bystanders.  

The subject was groaning (ABCs – check) but wasn’t responsive to verbal commands (A&O = 0) and only responded to painful stimuli. Bystanders indicated that he only spoke Spanish and they had pulled him from the car. My first thought was C-spine issues and that he should have been left where he was.

As I was thinking this, an off-duty EMT arrived and asked if he could hold C-spine, which I had him do. A second off-duty EMT (who spoke Spanish) was right behind him and attempted to communicate with the subject (get him to stay conscious and stop moving).  During the few moments before the ambulance and fire personnel arrived on scene, we took vitals (high pulse and rapid respirations) and ascertained that he was injured both on his right side and pelvic area.  

As soon as fire and ambulance responders arrived, everything kicked into high gear. They grabbed C-spine and quickly moved into assessing the patient. Within one or two minutes, they were setting up the patient packaging gear and I found myself applying the skills we train on so often. The only variation with our training was the use of Velcro with the cheese blocks and not tape (I am a convert!) and the need to maintain one leg at a 90-degree angle on the board due to injuries.

Although I wasn‘t tracking our time, I believe the total packaging time was around five minutes. This says something about constant training! The subject was loaded into the ambulance and I was able to head off to the County Fair for the rest of my day.

Reflecting on my first medical experience taught me several valuable lessons:

·       Always be as prepared as possible by having BSI and basic equipment such as a CPR mask readily available – I was heading to the County Fair, so I was geared up.  I can’t count on that in a future event unless I plan for it.

·       A big thanks to the EMR training team and their training process – BSI, scene safety, calling for help, ABCs, etc. rapidly came to mind. What wasn’t so easy was when the process didn’t follow our standard scenarios (patient speaks English and is awake, etc.). I need to mentally rehearse and practice thinking outside the easy patient assessment routines and prep for when the process breaks down. This includes ascertaining available help and skills with bystanders. (I was fortunate an EMT was on-hand to hold C-spine.)

·       Practice, practice, practice – My day job does not provide me with any training in the medical arena, so it’s up to me to develop the skills to feel comfortable and prepared if and when the need arises.

AmGen Medical Detail Recap

It's not every day that CoCoSAR gets front-row seats to a major sporting event. The near-final, seventh stage of the Amgen Tour of California afforded our team the ability to see the “Greatest Cycling Race in America” while practicing patching up some road rash.

With 5,000-plus cyclists (including the crowd), thousands more onlookers, and some steep drop-offs that would make your Camelback pucker, team members provided on-scene medical support by staffing three aid stations and several roving patrols. 

The day was beautiful and the teamwork was even better as the team adapted, improvised and overcame a variety of obstacles from last-minute operational changes to difficult communications. Of course, CoCoSAR pulled it off without a hitch with both style and flare (note the pictures).

Thanks to all those that participated, especially Robert Harrison, our new medical sergeant, for whom the SAR-gods chose this as his first event.