Backcountry Trauma and Improvisation
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- เผยแพร่เมื่อ 7 มิ.ย. 2024
- Before you head to the back country get tips from Dr. Judy Klein, emergency medicine specialist, so you know what to do if you find yourself in an emergency medical situation far from professional help. Get tips on the essential first aid kit and learn potentially life-saving techniques. Recorded on 05/17/2017. [8/2017] [Show ID: 32501]
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This was essentially an EMT course with a touch of paramedicine in 1 hour. Incredible. Everyone should watch this!
I plan to share it around with everyone I know.
Of course, it's for the lay person. If it was meant for someone more qualified then a paramedic, you go would weeks, even months and even years to learn the nuances of all types of conditions and injuries.
EMTs are fictional. You think and act as if thats untrue?
I love teachers like this. They're so open to questions, smart and easy to understand! They're willing to go the extra mile to explain something to somebody who might be confused. Love it.
yeah i thought she had a sweet pair of tlts too
She's good, I'd love her as an instructor. The rib question had me rolling my eyes. I e done both aid and knife self defense where going between the ribs is covered. Her reasoning for avoiding under the ribs is the reason we teach TO go there in knife training. But It was always was taught and stressed upon me the art of destruction and repair are sisters, Kno both.
Incredibly good energy that can be felt even years later via a cell phone 1,000 miles away. An excellent Teacher who makes learning with a desire for more.
This has been one of the more educational and useful vids I've viewed on TH-cam. Thank you.
agreed!!!
I see the video is over 3 years but would like to comment on her Tourniquet instruction. As a TCCC (tactical combat casualty care) instructor the standard that is taught involving TQ placement is to put the TQ as high on the limb as possible. So in this case if the bleeding is on the lower leg, the TQ goes as high up and as close to the groin or hip as possible. Also once a TQ is in place never NEVER open it or take it off unless performed by trained medical personnel. TQs have been left on soldiers for as long as 22 hours WITHOUT causing loss of the limb! By loosening the TQ your allowing all that oxygen deprived blood, which now contains toxins, into the blood stream causing sepsis and possible shock!! I would also point out that when applying a TQ, the piece you pull is put on so your pulling into the body, not away from it it!! When you tighten a TQ many times it will hurt MORE then the actual wound. She should have also pointed out that whatever you use as a TQ should be AT LEAST 1 3/4 to 2 inches wide. If it's too thin you will cause irreparable nerve and muscle damage. For $20-30 dollars there's no reason someone should go into a wildness situation without one!
No. If the bleeding site IS LOCALIZED, the tourniquet is always applied 5-7 cm above the wound. H&T placement is always recommended if the wound is NOT VISIBLE/obvious to the provider. This is not military environment, where you place tourniquets in care under fire (always H&T), but civilian scenario, where you ALWAYS do things with maximum benefit for the patient and caution to the whole outcome. Placing tourniquet with the mentality of "always H&T" just makes no sense, because you are also disrupting the flow of blood to the part of the extremity that is still intact or completely undamaged. The tourniquet is working effectively in the region of tibia-fibula the same as in the region of long bones such as femur.
So in her scenario, the bleeding site is visible and localized, so she knows exactly where the blood is comming from, henc she applies the TQ 5-7 cm above the wound (never over the knee). Perfectly fine. Even TCCC recommendations states this course of actions when applying TQ's in battlefield.
And i would like to see the data or official case study, where the TQ was left in place for 22 hours without any damage to the extremity. That just seems like sci-fi and also physiologically impossible. So i will believe it, when i see it, not because "someone said".
@@matejstos2546 man that's good timing, 1 day ago you wrote that. I just read that guy saying put it as high as possible and I was like hm that doesn't make sense, yeah you might damage perfectly good part of the body. Two hours would be the outer range of time to leave it on safely yes? 👍
That maybe the case in TCCC but "3 fingers width" proximal to the wound is what the EMS standard is. Not sure of the reasoning. That includes 2 bone limbs as well.
This is a more complex issue then these responses give it credit. (I am a practicing EMT and have several stop the bleed/tccc classes under my belt). The reality is the science on this subject is split... However , over the last 5 years or so the majority of the EMS community (doctors included)have switched to High and Tight being the preferred option. Namely 2 bones in the lower leg means you need higher occlusion pressures to stop bleeding (it will stop it in most cases). That and realizing that applying it above the knee is much simpler and causes really minor complications in most cases. In fact my EMS protocols currently FORBIDS placing a TQ below the knee and instead says to place it at least above the knee. Additionally I agree fully with the idea that improvising a TQ in the field is bad practice and a commercial TQ is preferred 100% (studies have found improvised tqs have a low success rate and even increased mortality is some cases (by decreasing Venus return to the heart)). Instead use wound packing in place of an improvised TQ. It is faster at stopping blood loss and has a MUCH higher success rate (and can be done with a simple shirt)
As an instructor, I always tell my students:
1. A tourniquet that is at least 2 inches in diameter
2. If you know where it is bleeding, then 2-3 inches above the site
3. If you are not sure or it there is active gunfire (or an urgency to apply a tourniquet), then put it high and tight
4. Never place a Tq over a joint
5. A tourniquet is only meant for arms and legs
6. If it is on a thick part of the body (like the thigh), and the 1st TQ is not stopping the major bleeding, check the 1st tourniquet to make sure its tight enough.. if it is,, then you can always use a 2nd Tourniquet.
Love this! I watched a year ago, and just rewatched. Guess what? I forgot a lot of it, so I’m gonna have to rewatch regularly.
For Christmas this year, I got my (adult) kids expanded IFAQs and sent them this video (and a couple others). Not a very glamorous gift from Santa, and I hope they never need it.
I’m no expert, but am including everything the doc suggested plus other stuff like Israeli bandages.
Thx Doc! This gift of a video is something that keeps on giving and is highly valued!
Very nice gift.👍Just as a small share of information, the tongue could bleed continously if you put a safety pin through it, which could lead to suffocation or vomiting due to blood. Resting the person on their left side, tilting their head back, opening the mouth, and checking their breathing regularly will do just as fine without poking the tongue. An IV catheter same as a knife, doesn't need to be used for cutting or poking into someone's neck, as that can kill, heavily injure and cause a lot of pain to the patient if done by someone who isn't specifically trained in this procedure. Try not to use a decompression needle. Depending on the laws of your state, country or region, the good samaritians act might not cover invasive aka poking/injuring procedures. I hope this helped, and I am glad you are ready to help as well.👍
@@thomasb.581 Very valid points! This should be more discussed and make ppl more aware. OTOH she's mentioning such procedures because there are future medical professional s in the audience and hopefully they are/will be more qualified than most. And she mentions that ppl should avoid doing this if they don't feel comfortable with such procedures.
That is a wonderful gift and even though some of your family members may not be medically inclined for traumas, there may be other bystanders present that are.
@@thomasb.581 thanks Thomas! I’m sorry I didn’t see this when you posted it, to appreciate your insight and kindness earlier 🧐. And since it’s been a year, now I think I’m going to rewatch and also think about your safety pin guidance too. Cheers!
@@Liberteabelle No worries, it's good to see you are keeping your First Aid knowledge in shape. A local stop the bleed course might also be of interest to you. Often they are quite cheap or even free of charge. Have a nice day.👍🏻
Thank you, Dr. Klein. I am a retired RN who has gone back to work as a Substitute School Nurse. It is not doling out Tylenol and bandaids. Kids play outside and fall, eye injuries, broken bones, running with sticks that they pretend are swords, get into fights, and there are those horrid monkey bars that they love. I needed a refresher course, and this is the best.
Say. I'm a Nurse. My 7 y/o daughter was at school climbing on monkey bars. Was pushed & smacked her forehead on the metal bar. I came to school to pick up. And was alarmed at the goosegg on her forehead. Very.very irritated with the school Nurse...who I actually knew because he graduated the year before me. The school should have called. They said they gave a aspirin and cold compress and sent back to class. She had black/blue eyes for 7 weeks. Had to get an immediate x-ray. Well. Please do what u can for these little guys. They trust medical staff. 👍
oooohh.... but the money bars are the best! they teach coordination and balance, and they help develop strength...
As a PA and former RN myself, i'm not going to laugh because you are entirely right those things are possible, but having done a series of clinicals in schools...i'll leave it to you...The only thing more boring I have ever done was a nightshift in a County Hospital with 2 patients. Also, before anyone gets a wild hair to remove monkey bars, these kids can't be wrapped in bubble wrap and this lady needs job security.
That old rusty metal playground equipment was more at home in ancient Sparta than elementary schools.
I’ve seen so many lost teeth on those metal animals on springs and cracked skulls on the merry go round then I can count. Not to even mention all of the other implements of disfigurement disguised as childrens recreational equipment.
It was survival of the fittest and “Lord of the Flies” on a playground in the ‘70’s.
I miss it.
RNs and retired RNs are fictional. Do you think and act as if thats untrue?
Thanks very much for this video. I’m getting ready to do an extended backpacking trip and was looking for a comprehensive video to refresh my basic first-aid skills. Judith did a great job presenting. Very Informative and engaging!
Great Lesson. I 'm going to watch it again - Let this stuff sink in!
Absolutely wonderful. A must watch for anyone going into the back country.
Thank you for repeating audience questions to enable the viewer to hear it clearly
That's probably one of the most educational videos if see on TH-cam! Thank you so much!
Thanks for the well paced, highly informative presentation. I learned a lot!
This is part of exactly what I learned as an army medic! Great video!
She is brilliant, this video is so great.
Bravo, You kept it in laymans terms. No oclusive, compartment syndrome, flail chest and other terms to confuse them. Thank you for your real world actions to take wit no confusing terms. Great Teaching.
Appreciate the info Dr. Judy!
10/12/2020 Just found this video. Very informative, well paced and presented. Great refresher for skill maintenance. Less we lose it by not using it. Thank you Don
I could learn from this woman *ALL* day!
This was very good for "backcountry". As an advanced EMT who graduated Columbia State in TN, this was great. Awesome presentation.
Watched the entire video and saved it. Thanks pretty lady
This is how I learn.A fantastic lecture, you can feel Judys passion, its infectious. 😊 Thank you.
I watched this twice today. Thank you so much, I hope I never need to use this, but glad to have it handy if needed
Fantastic video, shows Dr Judy has a lot of experience, very informative, keeps you interested all the way. Shows how to improvise using everyday objects.
This is probably the best first aid related video I've ever seen. Thanks!
No nonsense, this was an awesome presentation I learned a lot of very useful stuff !! Thank you !!
This is the most practical and educational class for backpackers. Huge thanks! Do you have other classes mentioned in this video available on TH-cam?
What do you think these are classes on?
Exactly the same info as some of the courses I've attended except you cover d and e. Exposure is no joke, be it hot or cold exposure, or wet cold and windy exposure. Any impaling out in the Bush is the big worry. Many things can be sorted outside without help or care but not sharps poking through important things. That's major surgery. Thanks for sharing this course, you are a great teacher.
Love this video! Was an Canadian army medic in the 60ies and wish I had, had you as an instructor. Well done girl.
I still watch this type of video as I guess it’s still in my blood.
Thanks again. Jim
Canada armies and medics are fictional. You were/are kept as a slave that was marketed with that fiction?
I am very grateful for content like this
Fantastic presentation, so practical!
Fantastic talk, educational and well delivered.
Extremely Informative. Very well presented.
Fantastic presenter, and invaluable knowledge everyone who travels into the backcountry should know.
I thought I had a good grasp on how to handle situations like these, but as she went through the presentation I realized I didn't. Revising my first aid kit asap.
Very interesting video, however, the current timing (as at Feb, 2023) for Epipen infusion (Anapens, too!) is to hold the pen as shown.and inject its contents into the patient's thigh muscle for THREE seconds rather than TEN seconds, as outlined in this video lecture (47:55) which was filmed in mid-2017. Have a great, safe, day! Cheers from Australia!
Sincerely - thank you. I have had many "courses" and instructions over the years - but its been awhile. Should be a refresher thing for many of us. Do what you want - as safely as you can without harming others.
Great explanation of topics everyone should know…at least the basics. Awesome instructor.
This is amazing so much useful info. Thank you so much for sharing this for the public!
Thank you for this presentation. I am a retired RN, in CERT MedOps and preparing to become an instructor. This video will help me further illustrate advanced first aid out in the field.
she is awesome, the info she provides is awesome.
Dear Judy. Your first aid lesson was just superb: brief, solid and practical information about all the main aspects of keeping a victim alive. It's so great being educated and knowing that today, anybody can access top notch knowledge (for us, the commoners), mostly free. I am amazed about the times we live in today in terms of cooperation among all human beings. I feel like we are more brothers than ever. Thousand thanks for being so generous...
Fantastic. Been a cop for 23yrs, this is outstanding information. Great teacher as well. Thank you, educational videos on TH-cam that truly can help people. Refreshing.
Cops are fictional. Do you think and act as if thats untrue?
I like your down to earth realistic explanations .... thank you
Wow! What a great lecture!
I came on YT tonight to switch off my brain bc work was exhausting and stumbled upon this video. I've been so captivated by it, I've watched it from start to finish and felt like I've learned something invaluable. Thank you for sharing!
Same here. Had a nearly 12 hour shift and wanted to "switch off" but ran into this video. This was time well spent.
Excellent video! Learned a lot of things I never knew about. I've always carried some things in my vehicle and pack. But this has great advice on what to do when you come across a medical issue out in the backcountry or even on a road. Checking out if you have more videos after this one.
Excellent presentation I have watched this to revise my first aid skills...hi from the UK 🇬🇧.
This is the best refresher training I’ve ever seen.
i LOVE the way she teaches!!! so good at making sense of things. really interesting stuff!
Great video, superb lecturer. This was a great refresher since I got my wilderness first aid cert a couple years back. Sent to my WFA classmates
This was very interesting, many thanks for posting.
Fantastic information. Appreciated that the information was well articulated and easy to understand.
yeah thanks for posting this. This is a great refresher. I think I'll make my kids watch this
Thank you so much for these.. more techniques and knowledge to be more confident on emergency situations.
Great presentation! I learned a few tips on managing emergencies.
Awesome class.......
Thank you for all of your knowledge and skills presentation.
Really good seminar.
I’ve been an emt/firefighter for 36 years, been teaching emt since 2007, this is great great stuff! Great instructor but what I’ve learned from swat guys is tourniquet applications. Do your research. Cheers
this was a fantastic refresher! thank you
I started out thinking why is this woman talking about an emergency cricothyrotomy. Unless you are very skilled you shouldn’t attempt this. But then she kept going and was very pleased with how well her explanation was on everything. Very good presentation!
This is brilliant and practical. I've seen other videos where they tell you to wash your hands before doing anything, and if a defib is needed, go find someone who can use one. Uhm, no, particularly in the wild!
Very good instruction, love the way you present everything and ask for feedback. Getting people involved is very important. Keep up the great work. I look forward to seeing more of your presentations please post when and where I can locate them.
I was taught the MARCH process for wilderness trauma, as an alternative to ABCDE. Great material here. My first aid kit is generally a bit larger than most carry in their pack.
What is the difference between MARCH and ABCDE? I haven’t heard of either of them before watching this video and reading the comments lol
@@Fattts MARCH places emphasis on stopping massive bleeding first(the C in ABCDE) before worrying about Airway in ABCDE. You can bleed out from massive hemorrhage in less than 30 seconds vs the 3 minutes you have without oxygen until brain damage and chances for survival rapidly decrease. Always have multiple tourniquets in your kits, as well as chest seals, and a hemostatic agent like quickclot. TQ the limbs, pack the junctions, seal the box.
Great video for hunters and hikers alike, lots of great information 👍
Just do the greatest good for the patient, following local protocols, scope of practice. Great video.
Very helpful thanks doc
Easy to understand, great info...Amazing video, thanks for sharing it!
Just finished watching the interview of Steve Irwin's cameraman (Justin Lyons), who was actually filming when Steve was attacked.
He specifically says that contrary to what he read in the papers and heard at the time, which he said was incorrect, ...the stingray barb didn't come out and Steve didn't pull it out... that it went through his chest like a hot knife through butter. He said that Steve was swimming from behind the ray, and he (Justin) was filming in front of it so that the ray would be in the foreground... then the ray propped up on its front and began stinging wildly with its tail, hundreds of strikes in a few seconds... in & out. Justin says that the stingray barb was a blade extending out about a foot (from the middle part of its tail) with the other half embedded in the tail. It was a massive 8-ft. wide stingray.
He had about a 2-inch wide injury over his heart. Steve initially thought the barb had punctured his lung, but it had actually punctured his heart, in which blood and fluid were coming out of it.
A crew member on the motorized boat (which they had used to motor out from the Mother boat) put his hand over Steve's chest wound, as they were heading back towards the mother boat. Steve went unconscious within about 30 seconds. Justin did CPR immediately for over an hour, before they got to Low Isles where the helicopter arrived and the medics came... and they pronounced him dead within 10 seconds of looking at him.
So it sounds like they did everything they could do to save his life. That's amazing that Justin gave such effort to try and save him by doing CPR for over and hour, during the boat ride back. A very sad and tragic situation. Thoughts and prayers to the family and all those involved.
Thank you for sharing Steve Irwin’s story…
As an Aussie he is an icon here!
Excellent, many thanks.
Thank you and God Bless you doctor
thank you for your wonderful teaching. learned alot
Fantastic video.
Excellent video!
Thank you! This is so awesome
I've watched this several times and love it. At the start she mentions giving other talks/lectures. I've seen her Covid videos but nothing else. Are there other trauma / emergency medicine videos by her out there.
Awesome teacher.
Thank you for sharing
This was a great and I love how she teaches 💜💜💜
An amazing video! Thank you!
Excellent. Thank you.
Amazing lecturer!
this was awesome she keeps talking about "next week" are there more videos?
Phenomenal Video!
Don't know how I found this video, but this is amazing. I'm no EMT or something, but damn, this is inspiring!
Outstanding........Thank You.
thank you for great explanation..
Very educational!
This is a great lecture on Trauma Improvization. Thank you - Trinidad & Tobago Paramedic Akash Mahabir
That was really great! Thank you so much!
Interesting...thanks.
Great video! One thing I would question is the use of an NPA where there is a suspected head injury. Protocol is to go for an OPA that will provide an airway and keep that pesky tongue out the way. No danger of introducing the tip of it into the brain if the Ethmoid bone is damaged!
NPA is better tolerated by semi-conscious patients. OPA may result in a worse situation of someone regains some level of awareness.
Excellent video! Thank you!
--Becky, RRT
Good refresher, North America Rescue, great place to find all kinds of IFAKs, EMT supplies. Marine IFAK is a great basic medical kit- blowout kit.
Thank you!
very informative thank you ive been looking for such info being an outdoors person
OMG be my medical director! She's great!
I got so involved that I clap my hands at the end of the presentation along with the crowd.
thank you so much...its adds my knowledge..godbless
Explorer when I was on the explorer program we actually used the Coleman propane green bottles for our side splints worked really well long ways with some padding to keep the guys head from touching the cold metal and the way we went
Thank you always good to know. Hope your doing great