340Re: [E-Chir] Re: Scenario 3
- Dec 2, 2009Greetings,
Don't take this the wrong way, your very thorough, but you'd call for an
Ambulance for first degree burns and a sprained ankle? As a former
ambulance driver, I'd be a little turned off about that and would the
person hurt really want to get saddled with the ambulance bill?
Russ / Dafydd
> Scenario 3 Response
> Brian the Green
> Approaching the scene look for:
> = is the fire now behaving normally (which is mentioned in the scenario
> that it is)?
> = is there signs of sparks or smouldering on things nearby, such as hot
> ash on the top of tents?
> = Is there the glittering of broken glass?
> = Is the patient talking? (I will assume for the rest of this that he is)
> = Note the amount of wood and where it is.
> = Ask if someone here has a cell phone in case we need 911. If none here
> task someone to find one and return with it.
> = Instruct the people to give ground so the patient can be safely
> = Ask for who in the camp is looking after the fire. Advise them for
> safety reasons to check on the fire and also to see if hot ash landed on
> tents or other things nearby.
> = Approaching the patient ask where are the injuries.
> = Instruct the patient to move farther back from the fire. Observe if they
> are able to do so safely.
> = Assessment showing that he is awake (as the arm is being clutched) and
> talking (assumed for this response). This signals the ABC are okay.
> = Beginning the secondary assessment the patient is found as (assumed for
> this response) to have light burns on his right hand. The hair on the arm
> is singed and the skin appears discoloured. No blistering has occurred.
> = The left ankle is also hurting him significantly. Asking him to try
> moving it finds he is unwilling due to pain.
> = When the cell phone becomes available call 911. Instructing them that we
> need an ambulance. There appears to be first degree burns to the right
> hand and forearm. There is also an injured ankle. Give directions to the
> event include the fire number/address of the site. Advise them it is a
> camping site.
> = Discuss with the operator if they wish us to leave the patient in the
> camp or whether we should move them to the parking lot.
> = If they are not sure it is better to leave the patient in the camp.
> = If relocation is agreed a camp chair should be easily found which
> several people could use to carry him out without needing to use his leg.
> = In either case task someone to go to the end of the driveway with a
> flashlight to guide the ambulance into the site and if need be to the
> Prepare for transport:
> = Counsel the patient that it is best for the burns to be checked out
> professionally at the hospital. For safety the ambulance should do the
> transport so that they can care for the hand.
> = Ask the patient if there is someone who can drive to the hospital to
> bring them back.
> = Also ask the patient if there is someone he would like us to contact for
> Very Important:
> = When the ambulance comes ask them which hospital they are going to!
> = Prepare notes to send the Kingdom Chirugeon regarding emergency services
> being on site. Relay this information ASAP by email, phone etc.
> Related Discussion:
> Big fires and tents:
> There was a flashing surge from the fire. Tall flames can carry ash up
> high enough that the wind can scatter it. Might be a few feet or a few
> tens of feet. It is not unusual for camps have tents within 30ft of their
> firepit and most have tents within 60ft.
> I recall one event when to many pallets where burned at once. This is when
> this important lesson was learned. One person did spot the smouldering
> happening on their tent's awning. Those with tents nearby did a check and
> shaking off smouldering bits.
> While there are safety requirements in some parts of the world for fire
> resistant tents those coatings can become worn with age. A large enough
> heat could overcome the coating and set the tent on fire.
> A particular danger for smouldering is that they might produce heat for
> hours. Usually this is not going to happen with light ash from a flashing
> fire. Still it is important to check. Thus it is possible for the tent to
> have people sleeping in it when it catches fire hours later.
> The ash can also burn a small hole in a tent without starting a fire.
> Holes do not keep out rain very well at all.
> Dealing with too much fuel on a fire:
> a) Put out some of the fire
> b) Put the whole fire out
> c) Remove the fuel
> The safest way to deal with excessive wood (fuel) on a fire is to put the
> whole fire out. Camps should have some means of putting the fire out
> nearby. Water or dirt are usually available. A challenge with the
> excessive fuel scenario is that the people who do that generally did not
> think ahead thus if, big if, they have something it likely isn't enough
> for the now oversized fire.
> With the big fire that had happened the excessive fuel was removed by
> myself. Im trying to recall if we doused at least part of the fire first
> and/or whether they simply didn't have enough water to put out the fire.
> It wasn't obvious to those nearby in the darkness but the gloves I had on
> are actually welder's gloves with a heat resistance. A stick/board was
> used to get a pallet close to the edge. From there, with the known to be
> heat resistant welding gloves, I could lift the pallet clear of the fire.
> Once in a clear spot the pallet could be safely doused, patted down etc.
> Great care was taken while doing this including make sure the space behind
> me was clear.
> Putting the gloves in water also gives you some protection. The water
> evaporation pulls away some of the heat. Recharge the water on the gloves
> regularly. When the gloves feel hot stop to let the gloves cool
> (preferably with more water).
> Why not use the water directly a mug of water will give you several
> soakings on gloves compared to maybe dousing one log on the fire.
> Reminder this was with done with welding gloves to stop the high flying
> ash starting secondary fires on tents.
> I did this knowing for certain they where welding gloved. Do not trust
> non-welding nor period nor "unknown" gloves to do this.
> Nor is this something to be as a regular activity. Rather it was a way of
> keeping of the rest of the camp safe when an emergency developed.
> The far better situation is for those having fires to plan ahead and have
> sufficient fire fighting gear (water, dirt, extinguishers) on hand in the
> first place.
> (Yes, there is of course some question as to whether the gloves should
> have been used at all. The real problem was to much wood on the fire AND
> insufficient proper resources leading to the other tents starting to
> smoulder. No it was not my camp I wandered in to join the party.)
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