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Basics
When a skydiver is injured there are essential things that can and
should be done to stabilize the injured jumper, even before the
ambulance arrives. Every situation is different, an accident can
occur in all types of environments and can involve multiple serious
injuries or minor cuts and bruises, so there is no way to prepare
for every possibility. Honing some first aid skills you may have
and developing a strategic treatment plan may make a difference
the next time you are witness to an accident.
Call 999
Once people have arrived at the scene, one person should take charge
and designate what should be done. The very first thing that should
be done is to call 999. If there are people around designate one
person to do so. Someone should be sent to manifest to gather information
on the person such as health insurance information and emergency
contacts. When calling 999 (911 in the USA), try to have some basic
information to give such as the type of injury, whether or not the
person is awake and breathing and the location of the accident.
What do you do if you are the only person at the scene? Every situation
is different so there is no one answer, however if alone without
medical supplies, usually the best thing to do is to first go for
help.
First Aid Kit
Most drop zones have first aid kits, some better than others. As
a minimum, some dressings, splints and gloves should be available,
try to remember that everyone should use gloves where blood is involved.
A first aid kit with portable oxygen and a bag to ventilate a person
who is not breathing may be life-saving but is not always available.
As a minimum there should be a CPR mask available in the case CPR
is necessary.
Stabilise the Neck
Someone should be chosen to stabilise the person's neck, they should
not let go until the paramedics arrive. A violent impact may break
a bone in the neck and turning the head could severely damage the
spinal cord. Even if the person is awake, someone should stabilise
the neck. They may not be aware of the severity of their injury
due to shock and may try to turn their head. When stabilising a
neck in the field the best way to go about is by grasping either
side of the head with your hands.
Moving the Patient
It is common practice that the person at the head is in charge of
any moving of the patient and you may be asked by the paramedics
to continue to hold the head after they arrive. In that case, when
rolling a person to place a backboard under them there are specific
steps that need to be taken. First, let everyone know that the person
is going to be moved and you will give the count. Make sure that
sufficient help is in place to move the patient and people are distributed
from head to toe. Make sure everyone is ready and knows which way
they will be turning the person and from which side the backboard
will be placed. Then count "Up on three - one, two, three";
at this point the person should be turned up on their side and the
backboard slid under them. Before lowering the person back down,
check again that everyone is ready and give another count, "Down
on three - one, two, three", then lower the person onto the
backboard. Be sure when turning the patient to keep the head and
body in line at all times.
ABC
The common first aid pneumonic that most people are familiar with
are the ABC's. This stands for Airway, Breathing and Circulation.
A full explanation is outside the scope of this article but it is
covered in any CPR course. If you are uncurrent in CPR certification,
pull out your old material and review it. For those not certified
in CPR a course is strongly recommended. Knowledge of CPR is an
invaluable and life-saving tool if used only once, so look into
a nearby course.
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Make Them Comfortable
When a fallen friend is lying on the ground try to make the person
as comfortable as possible but do not endanger their health. If
someone is on uneven ground do not try to move the person simply
because they are uncomfortable, you may further damage an already
injured neck or back. However, if the sun is in their eyes, a person
standing in the right spot will be able to block the sun, and this
may be a big relief to someone who is hurt, scared and lying flat
on the ground. Never give a person anything to eat or drink, no
matter how much they complain or beg, the person may need a trip
to the operating room and anesthesia puts them at risk for aspirating
their stomach contents into their lungs.
Provide Information
Although paramedics will want to ask their own questions, the hospital
emergency personnel may appreciate any information you can provide.
Usually there is some time between the accident and the arrival
of the ambulance. If the person in charge is comfortable doing it,
there is some important information that you can obtain from the
injured skydiver. Find out their name, age, any serious medical
problems and medicines that they might be on and write it down on
a piece of paper to give to the paramedics (sometimes manifest will
have most of this information). Talk to witnesses so that you can
describe the accident to the paramedics, understanding the mechanism
of injury aids in the treatment of the victim. Know the location
of any injuries that the person may be complaining of such as chest
pain, back or neck pain, leg or arm pain or deformed limbs and whether
or not the person lost consciousness.
Open Wounds
Maybe a person was cut-off, their canopy collapsed or they hooked
it too low, in any event a common result of bad landings are damaged
extremities. Most times a severe injury is obvious - a bone protruding
through the skin or a severely mis-shapen limb; other times a snap
may be heard or a large bruise is seen that forms within minutes.
Do not ever try to put a bone that is sticking out back under the
skin. An exposed bone needs to be thoroughly washed in an operating
room before being put back in place. Most paramedics will want to
see the injury, so just cover it with a sterile bandage if one is
available until the ambulance arrives. However, if the person needs
to be transported to a hospital without the aid of an ambulance
any open wounds should be covered and the injured arm or leg should
be immobilised.
Splint
To immobilise an injured arm or leg you should make a splint. Some
DZ's have first aid kits that include commercial splints, otherwise
you may have to be a little creative. If the bone is exposed or
the skin is cut, attempt to cover it with sterile dressings. Next
place the splint on the extremity and wrap it with either an ace
wrap, tape or other material; sometimes even a shirt cut into strips
can be used to tie the splint in place. Make sure that it is snug
but not too tight, this may cut off circulation and make the toes
and fingers numb. Good materials for splints are sticks, cardboard
or anything else that will provide support.
Dislocation
Most joints can be dislocated, the fingers, elbows, shoulders, knees,
hips, and ankles. The most common dislocation is the shoulder. Putting
a dislocated joint back should only be done by a physician because
of the risk of damaging the joint, nearby nerves and blood vessels.
You may find some people who have had multiple dislocations and
can put the shoulder back in by themselves. If you need to transport
a person with a dislocation to a hospital you should immobilise
the joint. A good way to immobilise a shoulder is to use a sling
to support the arm then wrap a towel, shirt or ace wrap around the
arm and body to keep the arm from moving - called a swathe.
Blood
After an accident the person may be bleeding, and sometimes profusely,
especially if they are cut on their face or scalp. People can be
overwhelmed with large amounts of blood but remember that the best
way to stop bleeding is direct pressure. If there is a major cut,
grab a towel or shirt, or hopefully something more sterile if it
is available; press on the wound and hold pressure. More times than
not you will be surprised how small the cut actually is.
Use RICE for Sprains
Another common injury with botched landings are sprains, most often
the ankle. If this is the only injury it rarely justifies an expensive
ambulance ride but things should be done right away. The simple
pneumonic for minor sprains and strains is RICE, which stands for
Rest, Ice, Compression and Elevation. The patient should sit down
and rest up, a bad sprain may take up to 10 weeks to fully heal.
Ice is great in the first 24-48 hours as it acts as a pain killer
by making the area numb and helps decrease inflammation. A compressive
dressing, such as an ace wrap should be applied to help control
swelling but do not apply it so tight that it cuts off circulation.
Elevation means trying to get the injured part above the level of
your heart to decrease the amount of swelling, so prop your foot
up on a few pillows. If the ankle is not getting better after a
few days or is getting worse, it may be more than a sprain. In that
case the person should seek medical attention as they may have a
tear of one of the ligaments in the ankle or a fracture.
It is impossible to discuss every possible
scenario that you may encounter while skydiving. Consider grabbing
some friends and taking a CPR or basic first aid course, maybe during
the winter when the weather is unco-operative for jumping. If someone
is hurt and you feel comfortable helping, do so - but if someone
asks you to do something that you are not comfortable with, let
them know and they can find someone else. Be considerate next time
someone is lying on the ground; thirty people looking down on you
can be quite intimidating so if your help is not needed step back
and let people tend to the fallen victim. Unfortunately skydivers
will get hurt, injuries are part of the risk we assume for being
able to experience the freedom of flight, although we try to keep
injuries to a minimum when it does occur, being prepared is the
best medicine.
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