LTCC class teaches vital backcountry skills
There are times when the lesson cannot be taught between four walls. Such was the case this weekend with Lake Tahoe Community College’s Wilderness First Responder course moving outdoors.
Halfway through its 10-class session, the class went hiking to get a real feel for what they could be hit with as a first responder.
In its debut last August on the Mount Ralston Trail north of Camp Sacramento, the class simulated an evacuation of a seriously injured hiker with a touch of reality. One of the students sprained an ankle. The class stopped to tape it, instructor Jim Bitner said Saturday during this year’s fourth class on the Pyramid Creek Loop Trail.
When asked who among this summer’s class has sprained an ankle, four people raised their hands. Sprained and strained ankles and wrists constitute the most common injury first responders deal with in the wilderness, said Bitner and fellow instructor Sallyanne English, who have both received certification from two of the top educators for wilderness medicine — Wilderness Medical Associates and Wilderness Medical Institute.
“Of all the skills I know, I use this one most frequently,” English said.
The key to a successful wilderness experience is stabilizing a patient and reducing pain, she told the nine budding outdoor guides, recreation majors and wilderness enthusiasts.
The emergency medical technician demonstrated how to tape an ankle on Scott Vincik of South Lake Tahoe, whose experience spraining both ankles several times seemed to help when he reciprocated the task on his instructor.
English, in turn, said she was impressed with his performance.
The class kicked off that morning practicing in pairs during the muscular-skeletal section of the session.
English told the class to compensate for the ankle’s natural hiking movement by taping against the way it rolls. She also urged the class to cradle the foot in the caregiver’s lap. If the patient can bear weight on the ankle and feels no tingling — a symptom of compromised circulation — chances are the hiker may walk out of the woods with help.
“How does that feel?” Johnny Longtrail asked Sky Nichols.
“It feels solid,” the South Shore woman said.
Nichols is excited LTCC offers the course.
“I think it’s important to have a class like this in a place like Lake Tahoe.
Most people (out in the wilderness) in Lake Tahoe are one hour away from definitive care,” she said, referring to a treatment center like a hospital or clinic. In the world of medicine, that critical time in which a first
responder works to stabilize an injury is commonly considered “the golden hour.”
Nichols wants to put her LTCC training and her outdoor instincts to the test as an outdoor guide. But most certification courses cost at least four times as much and require moving away during the session.
The LTCC class is no easy ride though. Students must pass with a B or better, Longtrail said.
A quiz, which also encompassed head, neck and chest injuries, capped off the day enriched with Horsetail Falls cascading behind the group as an appropriate backdrop.
Every year, the falls route receives a lot of traffic, and with that come injuries and even death — as with the case of this summer’s fatal plunge by a young woman whose body was found weeks later in the creek’s current.
Student Jeff Parish, who conducts search-and-rescue operations for El Dorado County, responded to the call.
Parish said the area brings a typical scenario of “casual and unprepared hikers.” Beyond the large amount of traffic and rushing water, the route lacks a distinct path — which is littered with rocks over sand that serve
as land mines for turned ankles.
“I don’t think people realize the environment is uncontrolled. Even if an accident doesn’t happen, there’s always that potential,” English said.
The situation is further challenged by changing weather, time delay to a hospital or clinic and limited equipment. Like a scene from the movie “Cast Away,” English encouraged students to use the resources around them.
When the students practiced taping a broken wrist with a pliable splint that comes in most comprehensive first aid kits, English showed the class how to improvise with the poles embedded in day or backpacks and portable seats.
In the wilderness, an open fracture may lead to life-threatening infection or complications resulting in loss of limb before an evacuation can be accomplished.
If this takes hours or even days, the first responder practicing wilderness medicine needs to be in control, calm and honest, English explained.
“I can promise you guys, in an emergency situation there’s a fair amount of adrenaline going,” she said.
Maintaining a low stress level often translates to a calm patient — especially if the injured borders on going into shock, she said.
Then there’s the “never assume” rule that plays a role in how people react to pain.
“Never assume how a patient is doing by the way they’re reacting,” she said.
English also warned that many patients will ask for opinions on their condition.
“Tell a patient what you think. Don’t tell them what you think is wrong. It’s not your job to diagnose. Yours is to treat what you see. That’s really important for liability’s sake. The less you say the better. Don’t tell somebody their bone is broken,” English said. “And don’t just say you’re going to be fine. It gives them a false sense of hope. Be honest.”
Actions speak louder than words.
English said people will put their trust in you as a caregiver and first responder based on your first few actions and the level of confidence.
The LTCC Wilderness First Responder class is scheduled for its next session
Oct. 1. Those wanting information on registration may call the college at 530-541-4660.
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