Focus on: Personal survival

Survival of our lost victim Patient care & packaging Transport and carry outs

A survival situation is one in which an individual’s very existence is threatened.

Some kind of action is necessary to alleviate a threat to life

1. The will to live / Positive Mental Attitude 2. Air 3. Shelter/Protection from environment 4. Rest 5. Signals (If you expect to be found) 6. Water 7. Food

The necessities of life

►Can make decisions ► Can improvise ► Can adapt & overcome ► Has patience, calm, cool, collect ► Is prepared – Hopes for the best but prepares for the worst ► Knows own special fears and worries, and most importantly, knows how to control them

Comfort Zone

Training can expand your comfort zone

The human body has some basic requirements

Air/Oxygen (in with the good air/out with the bad)

Fuel – (Food/nutrients) Temperature regulation

Other gauge similarities: Oil PSI – Blood PSI Fuel – How much energy is available? Temp – Too hot/too cold…..just right? Odometer – Age

Transmission/tires – Muscle strength/shoe condition

Steering – Motor skills & function

Thermostat = Hypothalamus gland

Radiator = Skin, breathing etc.

Is there prior damage to the vehicle?

is a roughly 24-hour cycle in the biochemical, physiological or behavioral processes of living entities

thermia Temperature - thermal, thermometer, 1 “Therm” = 100,000BTU, thermal vent, thermocline, Thermal underwear

LOW HIGH or

Hypothermia is defined as any body temperature below 35.0 °C (95.0 °F).

defined as a rectal temperature of greater than 37.8 °C (100.0 °F).

Heat cramps usually affect people who sweat a lot during strenuous activity. This sweating depletes the body's salt and moisture.

The low salt level in the muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion.

Recognizing Heat Cramps Heat cramps are muscle pains or spasms – usually in the abdomen, arms, or legs – that may occur in association with strenuous activity. If you have heart problems or are on a low sodium diet, get medical attention for heat cramps.

What to Do Stop all activity, and sit quietly in a cool place. Drink clear juice or a sports beverage. Do not return to strenuous activity for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke. Seek medical attention for heat cramps if they do not subside in 1 hour.

Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures

and inadequate or unbalanced replacement of fluids.

Heat exhaustion symptoms Warning signs of heat exhaustion include: heavy sweating Paleness muscle cramps tiredness weakness dizziness headache nausea or vomiting fainting

The skin may be cool and moist. The victim's pulse rate will be fast and weak, and breathing will be fast and shallow. If heat exhaustion is untreated, it may progress to heat stroke

What is heat stroke? Heat stroke is an abnormally elevated body temperature with accompanying

physical and neurological symptoms. Unlike heat cramps and heat exhaustion, two forms of hyperthermia that are less severe, heat stroke is a true medical

emergency that can be fatal if not properly and promptly treated.

Different people may have different symptoms and signs of heat stroke. Common symptoms and signs of heat stroke include: high body temperature the absence of sweating, with hot red or flushed dry skin rapid pulse difficulty breathing strange behavior hallucinations confusion agitation disorientation seizure coma

98.6 Normal body temp 96.8 BP up, pre-shivering 95.0 Maximum shivering 93.2 Amnesia, poor judgement, tach leading to bradycardia 91.4 Apathy, cold diuresis, decreased respiratory volume 89.6 Stupor, 25% decrease in oxygen consumption 87.8 Shivering ceases 86.0 Atrial fib, pupils and cardiac output 2/3 of normal 85.2 Steady decrease LOC, pulse, respiration, pupils dilated, paradoxal disrobing 82.4 50% decrease oxygen consumption, pulse. Hypoventilation 80.6 Loss of reflexes and voluntary motion 78.8 Major acid base disturbance; no reflexes or response to pain 77.0 Cerebral bloodflow 1/3 of normal, cardiac at 45% of norm 75.2 Significant hypotension and bradycardia 73.4 No ocular reflexes 71.6 Max risk of V-Fib; 75% decrease in oxygen consumption 68.0 Lowest electromechanical cardiac activity 66.2 Electroencephalograph silencing 64.4 Asystole 60.8 Lowest adult accidental hypothermia survival 59.2 Lowest infant accidental hypothermia survival 50.0 92% decrease in oxygen consumption 48.2 Lowest therapuetic hypothermia survival

Mild Moderate

Severe Moderate

Mild

Mod

Sev

Wilderness survival unlikely

Shivering is your body's automatic defense against cold temperature — an attempt to warm itself. Constant shivering is a key sign of hypothermia.

Signs and symptoms of hypothermia include: Shivering Clumsiness or lack of coordination Slurred speech or mumbling Stumbling Confusion or difficulty thinking Poor decision making, such as trying to remove warm clothes Drowsiness or very low energy Apathy, or lack of concern about one's condition Progressive loss of consciousness Weak pulse Shallow breathing

A person with hypothermia usually isn't aware of his or her condition, because the symptoms often begin gradually and because the confused thinking associated with hypothermia prevents self-awareness.

► Decreased heat production ► Impaired Thermoregulation ► Increased Heat loss ► Other Associated Clinical States

Endocrinologic Failure Hypopituitarism Hypoadrenalism Hypothyroidism Lactic Acidosis Diabtetic & alcoholic ketoacidosis

Insufficient fuel Hypoglycemia Malnutrition Marasmus - a form of severe protein-energy malnutrition characterized by energy deficiency Kwashiorkor - a form of malnutrition that occurs when there is not enough protein in the diet Extreme physical exertion

Neuromuscular physical exertion Age Extremes Impaired shivering Inactivity Lack of adaptation

Peripheral failure Neuropathies Acute spinal cord transection - commonly associated with cervical spine fracture Diabetes

Central Failure/Neurologic Cardiovascular accident Central nervous system trauma Toxicologic Metabolic Subarachnoid hemorrhage Pharmocologic Hypothalmic dysfunction Parkinson’s disease Anorexia nervosa Cerebellar lesion Neoplasm (Tumor) Multiple sclerosis

Environmental Immersion Nonimmersion

Induced Vasodilation Pharmocologic Toxicologic

Erythrodermas Burns Psoriasis Ichthyosis - dry, thickened, scaly or flaky skin Exfoliative dermatitis

Erythrodermas Burns Psoriasis Ichthyosis - dry, thickened, scaly or flaky skin Exfoliative dermatitis

Iatrogenic -resulting from activity

of physicians

Emergency Childbirth Cold Infusions Heatsroke treatment

Immersion

Multi system trauma Recurrent hypothermia Shapiro’s syndrome -a rare disorder consisting of

paroxysmal hypothermia (due to hypothalamic dysfunction of thermoregulation),

epilepsy Infections Pancreatitis Carcinomatosis

Cardiopulmonary disease Paget’s Disease - chronic disorder that typically

results in enlarged and deformed bones

Shaken baby Syndrome Hodgkin’s Disease Shock Sickle Cell anemia Sudden Infant Death Syndrome

Normal Vasoconstriction Shunting to the core (Vital Areas)

The core senses volume increase Diuretics produced to decrease and balance volume Extremities now have “bankrupt” stagnant blood (PH balance issues) and waste products

Vessels in extremities dialate releasing bankrupt blood/waste products (and different PH balance blood) Blood volume lowered during event is now redistributed, hypovolemia Extremities now have “bankrupt” stagnant blood and waste products

Frostbite involves the freezing and destruction of tissue. Frostnip is a superficial cooling of tissues without cellular destruction.

Chilblains are superficial ulcers of the skin that occur when a predisposed individual is repeatedly exposed to cold. Trench foot or immersion foot is due to repetitive exposure to wet, non-freezing temperatures.

Important to remember for:

Clothing & Shelter

BEST

WORST

Shell “Fluffed” material

Undergarment

Undergarment

Undergarment “Close to skin layer”

Normal clothing layer Insulating layer Shell layer

“Layering” allows adaption to changing environment & body needs

AVOID 100% Cotton clothing or other materials that do not dry easily

Read labels!

A quick plunge into water or sweating during a mission can lead to hypothermia in the right conditions.

Pt. assessment & care must be maintained during the transport

For concerns of hypothermia, you are essentially building a portable shelter for the victim

Carriers rotate position from back to front. Each person carries through 3 cycles. The front carrier moves to the rear of the pack to rest

Match heights of carriers Coordinate the switch

Carriers stay in place when basket handling The basket is moved up the chain After carrying, moves to top to prepare for next hand off

Coordinate the movement

Some embankments or areas may be slippery and foot slippage and falling could injure rescuers and the patient

Minimum: 2 carabiners 2 Prusiks 2 Pieces of webbing 1 Rope

Bachman knot Minimum: 2 carabiners 1 Pieces of webbing 1 Rope

During low angle movements up (steepness/slippery etc.), you may need some assistance that can be provided by equipment from your SAR pack

A tree is used as a friction device to ASSIST the downhill load

A second tree is prepared, the load switches to the next tree

During low angle movements down (Slippery/loose soil-vegetation), you may use natural objects as a friction device

This rope is moved further down to prepare for the next swap off