Fiction author Robin Brande talks about writing, reading, and other vital matters

First of all, let me honestly report that all these WFRs and our instructors are just so damn cool. I love hanging out with mountain people and river people and generally outdoor people like this. Everyone has a story or two or ten, and it’s great to sit back and wait for everyone to feel comfortable enough to start unfurling them. The ones from the people who do ski patrol are always particularly gruesome, just because skiers can really bang themselves up.

I liked the one about the guy who went over a 40-foot cliff, stumbled a little on the way over and broke his leg, and ended up grabbing a tree branch rather than fall all the way down. So the guy hung there from the tree branch while someone went for help, all the while with pain screeching through his body and his arms having to hold all his weight. Then the rescuers arrived, and it still didn’t get better right away. The cliff had such an overhang they couldn’t haul him back up, so they had to figure out a way to harness him while he hung there–without jostling his leg more than necessary–and still he’s hanging and his arms are giving out and–sheesh. Finally they get a harness around him, but they still need to pull the leg bones back into place to prevent any further bleeding, and then splint it in place–as he hangs there–andem> finally, FINALLY they can start slowly lowering him 40 feet to the ground.

Which is why I prefer the blue runs at ski areas. Black diamond runs in general, and cliffs in particular, just don’t make sense to me–at least not if you’re going over them on purpose.

So here’s a little medical trivia I’ve picked up over the last two days, to sort of stick in the back of your mind:

Skull fractures are our friends: Because closed-skull head injuries are a BITCH. The brain can bleed and swell and there’s nothing you can do about it in the backcountry other than try to get a helicopter in to evacuate that person right away. But skull fractures create openings, and openings allow blood and brain fluid an escape path, and even though it’s gross to see liquid coming out of places it shouldn’t, at least you know the brain is staying its nice normal size. So mop up the blood and still call for a chopper but be happy for what you have.

Or, as it said on the sign inside the coffee shop I went to this morning: Pull on your big girl panties and deal with it.

Insulin kills: If someone is diabetic and hasn’t been monitoring his condition well, and so has started having problems like being disoriented or combative or lethargic–or worse, has already become unconscious–DO NOT GIVE HIM INSULIN. There are so many variables, including what the person has eaten, what the current blood sugar levels are, whether he’s sick from some other cause, that you’ll never be able to guess the right dosage. And you can’t trust the patient to get it right, either, or he wouldn’t have let himself get to this stage in the first place.

So what do you do? Give sugar. Sugar is our friend (don’t I know it–delicious white chocolate macademia nut cookie for lunch). Give that person a little honey, spread against his gum line. Or even better, some cake frosting. Or if he’s sitting up and still able to eat without choking, a candy or some other immediate form of sugar. The brain needs sugar–it doesn’t need insulin. You’ll never go wrong giving a diabetic sugar.

Scabs are not our friends:Wounds heal best when they’re covered. Scabs–while fun to pick–are not a healthy way of healing. You want to soak scabs off with a hot towel (do not immerse a scab in hot water–let’s be nice to our bodies, shall we?) Keep wounds clean, even if it means recleaning them every time the bandage gets wet or dirty, and keep them covered with clean bandages. Your skin will be back to the pink in no time. The body likes to heal, so let it do its job by keeping out any dirt or debris by keeping that bandage on. Agreed?

When it’s cold out, our bodies are not temples, they are furnaces: Feed them. They need sugar and fat. If you’re outdoors in the cold, drink hot chocolate laced with butter. Seriously. Or at least throw in some tablespoons of peanut butter. Hypothermia is a pain to treat, so the key is never to let yourself or anyone with you get to that stage. Keep your clothes dry, even if that means changing your sweaty socks during a break, give yourself adequate rest, and don’t decide that this is the time to lose a bunch of weight on that low-fat diet you read about in Cosmo. Your body is a fuel-burner, so feed it.

Why smokers do so well on Everest: This was a surprise. Apparently there was some myth circulating out there that smokers had a much better chance of summitting. Um, not quite. The real deal, the experts have found, is that people who smoke KNOW they’ve been abusing their bodies, know how out of shape or tenuous they are, and so they compensate for that by taking it extra slowly. Whereas the superfit will charge up a hill and tank halfway there because they’re too overconfident to pace themselves. So no, do not start lighting up to improve your chances in the mountains.

And finally,

Just because someone starts acting like a jerk, do NOT leave him alone: You’re out hiking with your best friend, and suddenly he starts acting a little . . . odd. Withdrawn. Maybe irritable. The normal person in you thinks, “Okay, fine, you big pig,” but the WFR in you has to think, “Hmm. What’s going on here?” Because often one of the early signs of heat exhaustion or hypothermia or acute altitude sickness or lots of other problems is a change in behavior like that. So if you notice your pal is being unusually quiet or jerkish, take the time to check up on him. Has he eaten lately? Had enough water? Are his clothes dry? Is he overheated or overcold? Or has the altitude started affecting his brain?

This isn’t the same protocol as if you’re at Thanksgiving dinner and your sister (say me, for instance) gets up from the table to go into a quiet dark room and have some down time. She isn’t sick, she’s just overstimulated. So please stop talking so loudly.

Not that I ever have to do that. More than once or twice per family gathering.

Okay, and one more for extra credit:

Where do most people choking or having heart attacks die? In the bathroom. Why? Because they’re embarrassed. They’re also in denial that they have a real problem. So they get up from the table and go to the bathroom and pass out, when if they’d just stuck around and mentioned they were having a problem, someone could have helped them.

But again, that doesn’t mean your sister who’s gotten up from the table is choking or having some other serious problem. It’s just that she spends so much time alone and likes the quiet, and that room where we always eat has this echo to it, and . . .

Anyway, there’s your wilderness medical lesson for the day. Hope you enjoyed it, despite the fact that it wasn’t particularly gross. I’ll see what I can do for you tomorrow.

Technorati Tags: Wilderness First Responder, Wilderness First Aid, Backcountry Injuries

Posted on Sunday, March 4th, 2007 at 6:35 pm under Life . Subscribe to responses: RSS 2.0 Comment Feed. Both comments and pings are currently closed.