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First Aid

First Aid

It seems odd to me that so many websites, magazines and champions of Fieldsports pay little or no attention to first aid. It’s easy to think, it won’t happen to me. We are using high velocity rifles, shotguns, razor sharp knives often in bad light in rough wilderness terrain without easy access to medical facilities or even a means to communicate with them. For me therefore, its imperative that we are capable of providing practical first aid to ourselves and our friends if required.

Before we go any further it’s important that we understand what we mean by ‘first aid’ in this section. What we don’t mean is using anything you will find in a supermarket first aid kit. The life-threatening injuries that we need to consider are referred to as trauma. To treat traumatic injuries, we need to apply ‘real’ first aid. The first aid products found in a supermarket are ok for small cuts and ailments but not for a gunshot wound, deep laceration or broken limbs!

In this modern world however, it seems that the litigation culture has made it unadvisable for people to try and save other peoples lives. I’m sure you won’t sue yourself, so you are pretty safe to administer real first aid in that instance. Due to the current climate however I must state that the information in this section is simply advisory and we are in no way providing you with the necessary skills, or advocating you attempt, to implement the treatments. What we are advising is that you attend accredited training that will provide you with the skills outlined here so that you can apply them safely and proficiently should the need arise.

I will now state on the record that I am only here today able to write this info page due to the fact that I was able to administer a tourniquet to myself for four hours whilst trying to get to a medical facility. Upon arrival I underwent a 6-hour operation to repair severed arteries, nerves and veins in my hand. Since that day I have had to use real first aid on two further game pursuit outings, one where I was accidentally stabbed by my compatriot with a filleting knife in my other hand. On that occasion I damaged the Ulnar nerve and some blood vessels. On the other I impaled my calf in a branch whilst trying to quickly get through some dense woodland growth in pursuit of a shot wild boar. Both of these incidents required surgery, but the first aid applied in the field significantly reduced the impact both could have had on my health and fitness.

So, it can happen to anybody, accidents DO happen. We are engaged in activities that significantly increase the likelihood that it will and unfortunately the severity of the injuries incurred can be life changing.

Aim

The aim of first aid is to save life. To do that, its important the first aider doesn’t become a casualty themselves as that would most likely defeat the purpose! So, the first thing to do in an emergency is to ensure you are safe in your subsequent activities. If saving life is the main aim the second must be to prevent the injury getting worse and to relieve pain. No rocket science here!

Triage

When confronted with a serious injury it is important you triage the situation. As the number of casualties that are likely to present themselves in our pursuits are low the triage process should be relatively straight forward. However, the mantra in my day used to be ‘breathing, bleeding, breaks and burns’. I’m not sure of that’s still taught but the order of priority is still correct I’m sure. Triage is simply the process of determining who and what you deal with in what order. Someone who is screaming and making a lot of noise isn’t normally the most severely injured. The unresponsive unconscious person with either no discernible breathing pattern or one that is irregular is likely to be high on the list, if not at the top. Equally, someone with a ‘gunshot wound might not be making too many sounds but is an obvious category 1 casualty. The bleeding injuries that are classed as trauma are those that are catastrophic. In these cases, the bleeding needs to be stopped as otherwise death will be the outcome. Broken limbs can occur at anytime and in almost any situation. The older we get the frailer we become and let’s face it some of us are getting on a bit! I would like to say that in our game pursuit activities serious burns wouldn’t factor high on the likelihood scale. Unfortunately, our pursuits are not limited to the harvesting of our quarry. Once we have the meat, we need to cook it. My last summer BBQ resulted in one slightly (ok heavily) inebriated guest falling back into a fire pit wearing very little (that’s a different story!) and ended up spending a month in hospital with third degree, full thickness, burns on her buttocks. It can happen at any time.

Action

When an incident happens and an injury is the result, it’s immediate action that will make all the difference. This isn’t the time to be indecisive and be fearful about doing anything. Doing nothing simply isn’t an option. What you can do will be limited. As mentioned earlier the first thing to do is remove the cause of the incident and protect yourself and the casualty from further injury. If a firearm has been discharged causing injury, unload it and place it in a safe area. If it’s a knife wound put the knife back in its scabbard or to some other safe area. If it’s a fall down a steep slope, work out how you can get down to the location of the casualty without falling down the same slope. It's all common sense at this stage.

Treatment for trauma is about saving life. Whilst the casualty might be in pain, relieving the pain isn’t your primary objective. Let’s assume there is only one casualty to keep things simple. When you reach the unfortunate soul, you need to conduct a survey to determine the extent of the injuries. You first priority is to see if they are breathing. If they are groaning or screaming, then they are. If they aren’t, try to get them to speak. If they respond, then they are breathing. If they aren’t breathing, then you are into CPR. You are unlikely to have a defibrillator with you so it’s back to mouth to mouth and compressions. You need to have been taught this and practice it to have any chance of it being of any use. Have you ever thought about why defibrillators have now become an ‘anyone’ can use device located in many public areas? Well, I think I’m right in saying, it’s because the chances of saving someone’s life who is not breathing and has no pulse is exponentially higher if you have a defibrillator. That’s not to say that CPR won’t be of any use, but it is certainly limited. Once the casualty is breathing (again) the next stage is to conduct a full body survey visually and with your hands to see if you can see or feel any blood or swelling caused by broken bones. Injuries have a way of hiding as you may only be able to see one half of the body. I know of a poor guy who was shot on a military range. No one could find the injury, but the pathologist later discovered the bullet had entered under his arm pit and then destroyed his internal organs, with the bleeding nearly all internal.

If catastrophic bleeding is evident then it needs to be stopped. First action is direct pressure with a clean cloth onto the wound. This may well hurt but its absolutely necessary. If after some time the bleeding isn’t stopping, then you need to apply pressure to pressure points. This is where the arteries cross a bone. Failing this then tourniquets come into play. The problem with tourniquets is that if they aren’t applied correctly (normally an inch or two above the wound) and then released regularly (about every 10-15 minutes) there is a real chance that the casualty will have to have the affected limb amputated as it will die. That could well result in litigation. Don’t worry that you may have saved the person’s life! So, unless you are properly trained and confident stay away from applying tourniquets you could do more damage than good.

When someone has a bleeding injury due to something penetrating the skin, if the object is protruding leave it where it is. Do not pull it out. It may well be keeping an artery closed inside the body so pulling it out could significantly worsen the bleed.

Broken bones are either closed or compound. A compound fracture is where the bone is protruding from the skin. A closed fracture is where it hasn’t. Dealing with broken bones is, in our situation, more about pain relief. However, getting it wrong might increase the pain and cause some lifelong damage. It’s unlikely, not impossible, that they will not die from a broken bone so they may have to put up with the pain until you get medical help. It’s likely they will know what position to put their injured limb into for comfort anyway so let them determine how to reduce the pain. A compound fracture (bones roughly broken and pressing against each other) does need treatment however. The most practical thing you will be able to do is secure it with a splint so they can’t move it and make the injury worse.

We’ve mentioned calling emergency assistance. We all carry mobile phones these days but some of the areas where we hunt, shoot or fish are in areas with no coverage. If you know you are going to an area such as this then make sure you have told someone where you are going and at what time you expect to be back within mobile phone coverage. Call them as soon as you are. If, however, you expect to be out of coverage for some considerable time invest in a satellite phone or emergency beacon such as the Spot Nano. They really aren’t as expensive as people make out and might just save your life one day.

Summary

First aid, in Fieldsports, isn’t about a sprained ankle, cut finger, irritation in the eye, hangover or other minor ailment. It’s about serious and potentially life-threatening injury. The risk is amplified because the pursuits are often conducted in the remote wilderness. Your objective is to save life and / or get the casualty (which could be you) to a medical facility for advanced treatment. In my relatively short time of field pursuit activities I have not only been the casualty on a few occasions but have witnessed many more. Injuries have come from all four categories. I’ve been told about people having heart attacks, deep lacerations from field knife work, broken bones from tumbles and 3rd degree burns from enjoying the benefits of game pursuits a little too much. Keep your wits about you and stay safe.

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