A Properly Prepared Patroller
By Steve Shotz
Your role as a first responder depends upon your level of first aid training. In order to be protected by the Good Samaritan statutes, you must stay within the scope of your training and must not accept anything of value in exchange for your first aid service. I recommend that patrollers ultimately obtain Emergency Medical Technician (EMT) level training by completing an EMT course (check your local county Emergency Medical Services authority), an advanced Wilderness First Aid course, or the Outdoor Emergency Care course.
Your choice of what to carry when patrolling should be influenced by:
- Your training and authority to use a particular piece of equipment
- The size and weight of the pack you are willing to carry
- The particular needs of your patrol area and the season
- How much you are willing to spend
The Pack
Some patrollers prefer backpacks, which carry both gear and water. Backpacks tend not to be internally organized into compartments and can obscure jersey graphics, such as the NMBP Cross. Others prefer waist belts, which are designed to carry only supplies (www.harperpack.com, www.life-assist.com) but do show the NMBP jersey insignia and have highly organized internal compartments. Either type should be water resistant, durable, well-organized, and able to carry everything you need.
The Contents
Table 1 contains a list of recommended items. These should be modified based on specific needs and training. Items with asterisks (*) require special training to use. Purchase supplies at survival and camping stores, or from medical and EMT supply outlets. Most items are cheaper to buy in bulk, so it is best to pool resources with other patrollers or buy in bulk for your patrol group. Every patroller should also carry essential survival gear in addition to a medical kit.
A Few Suggestions
Here are a few specific products I suggest (I have no financial interest in any of the listed items).
- * Brave Soldier antiseptic/anesthetic spray and ointment. As with any disinfectant or antiseptic, make sure you ask the patient about his/her allergies. You may wish to allow the patient to apply the product him/herself. Follow your training and local protocols.
* Instead of commercial muslin triangular bandages, which are too flimsy and small for many applications, cut an old, clean bed sheet into a square with about 40" sides, cut in half diagonally for a nice, large bandage. Use the thinner roller gauze instead of bulky gauze (kerlix) because it takes up less room in your pack.
* Occlusive dressings are used for sucking chest wounds and can be made out of anything that is flexible and won't let air pass, e.g. a 4" square of tin foil, petrolatum gauze, or plastic wrap. If you want a specialty product, the Asherman Chest Seal works well for this purpose (www.life-assist.com).
* Military and medial personnel use Celox powder to stop severe arterial bleeding. It's about $18 for a small packet and requires special training to use but is life-saving.
* Chemical heat packs are useful in cold climates. Grabber Mycoal makes a variety of sizes available online and in sporting goods stores.
* SAM splints are wonderful, lightweight, malleable splints that can be used for many purposes.
It's always a good idea to talk with local paramedics and emergency department staff about their preferences for field treatment. They will give you valuable info about what to do and what not do in the field in order to be consistent with local medical protocols.
These suggestions are generally based on the National Ski Patrol's recommended aid pack as outlined in the Outdoor Emergency Care text and are adapted from personal experience. If you have any tips to share from your own experience, please feel free to contact me.
is an Emergency Medical Technician
and an Outdoor Emergency Care instructor for the National Ski Patrol. He
welcomes your questions on first aid practices.
| Table 1 | ||
|---|---|---|
| Qty | Item | Rationale |
| 3 | Pair non-latex (nitrile) gloves | Non-allergenic protective gear |
| 1 | Small bottle alcohol hand cleaner or Vionex hand wipes | To disinfect hands in the event of body fluid exposure |
| 1 | Bottle Brave Soldier First Defense | Antiseptic/anesthetic for wound cleaning |
| 1 | Flat surgical mask | To protect from exposure to body fluids |
| 1 | CPR mask with 1 way valve and filter | For rescue breathing |
| 1 | CPR shield | As a back up to mask |
| 3 | Large triangular bandages | For slings and cravats to secure splints |
| 10 | Sterile 4x4" or 3x3" gauze pads | Bleeding control |
| 1 | 5x9" trauma dressing or Kotex pad | Control heavy bleeding |
| 3 | 3" diameter roller gauze | Secure dressings and splints |
| 1 | Roll 1" adhesive tape | Secure dressings and splints |
| 1 | Pair paramedic shears | To cut clothing and materials |
| 1 | Penlight or small flashlight | Check pupils, illuminate wounds |
| 3 | Tongue depressors | Finger splints |
| 1 | Tube of Glucose paste, Gu, or Cliff Shots | Diabetic emergency, hypothermia, bonking |
| 1 | SAM splint | Splint fractures |
| 1 | Mylar "space" blanket | Protect from sun/wind/cold |
| 2 | Chemical heat packs | Generate heat in cold climates |
| 3 | Cotton swabs | Apply ointments, remove foreign objects |
| 5 | Packs of antibiotic ointment | Infection prevention |
| 5 | Antiseptic wipes (benzalkonium chloride) | Clean wounds |
| 6 | Large safety pins | Secure sling |
| 1 | Tweezers | Remove splinters or ticks |
| 1 | 35 mm plastic film canister or similar | Transport ticks for analysis |
| 1 | 3" elastic bandage | Sprain support |
| n/a | Assorted band-aids | Dressings for minor cuts |
| 1 | Fisher Space Pen or pencil | Writes on anything |
| 1 | Pad of paper | Note personal info, vital signs, etc. |
| n/a | Matches or lighter | Start fire |
| 1 | 2-way radio or cell phone | Communication |
| 3 | Oropharyngeal airways* (S, M, L) | Keep airway open in unconscious patients |
| 3 | Nasopharyngeal airways* (S,M, L) | Keep airway open in unconscious patients |
| 1 | Occlusive dressing (petrolatum gauze, tin foil or plastic wrap 4" square) or Asherman Chest Seal * | Seal sucking chest wounds. |
| 1 | Celox coagulant powder * | Stop arterial bleeding |
Steve Shotz (sjshotz@sbcglobal.net) is an Emergency Medical Technician and an Outdoor Emergency Care instructor for the National Ski Patrol. He welcomes your questions on first aid practices.
