FIRST AID AND EMERGENCY PROCEDURE
4.1 ‘IMPACT WITH THE GROUND’ FIRST AID PROCEDURE.
4.1.1 YOU:
On reaching the scene of an accident:
a) Remain calm and composed.
b) Ensure both your own and that of your patients safety, i.e. the potential of the glider to cause danger by crushing, ground looping, or dragging should be dealt with.
4.1.2 CASUALTY: Remember Airway,
Breathing,
Circulation.
These are the priorities since survival depends on them. Remember also that the patient, who may have spinal injuries, should NOT be moved.
4.1.2 1) Open airway:-
Tilt head backwards using the heel of one hand on the forehead and the fingers of the other lifting the chin. Check for any foreign matter such as broken teeth, dentures or vomit.
2) Breathing:-
Assist breathing by loosening clothing. If casualty stops breathing give mouth to mouth ventilation, Send a RELIABLE bystander for an ambulance and instruct them to return once they have done so. If they do not return, send somebody else to make sure an ambulance has been called.
3) Circulation:-
If the casualty has no pulse commence C.P.R. (Cardio Pulmonary Resuscitation.)
For one firstaider the rate is 2 breaths to 15-heart compression’s.
For two firstaiders the rate is 1 breath to 5-heart compression’s
The above techniques must be learnt from a qualified first aid instructor and then practised. The Red Cross and St. Johns Ambulance run courses regularly.
4.1.3 Recovery Position:
Once the casualty is breathing spontaneously place in the recovery position if spinal injuries are NOT suspected (laid on side, bent upper leg, straightened lower - if possible with the head slightly raised.) Monitor carefully the state of unconsciousness.
4.1.4 Bleeding:
Arrest severe bleeding using direct pressure on the wound if there are no foreign bodies present. Do not remove any foreign bodies. Elevate if fractures are not suspected.
4.1.5 Examination of Casualty:
Make a careful examination without moving the casualty, working from head to feet. Do not remove helmet. Do not remove clothing but feel inside, moving your hands down either side of the body simultaneously to make comparisons. If the casualty can talk ask where any pain is.
N.B. Although the casualty may indicate the area of pain, always check the rest of him / her to occlude more serious injuries.
4.1.6 Fractures:
Immobilise and support any injured limb. A common hang gliding injury is a fracture above the elbow in which the forearm should be tied to the body with a sling.
4.1.7 Send for Help:
If the accident is in a remote or inaccessible area it is useful when telephoning the emergency services on 999 to ask for SEARCH AND RESCUE. They will have the specialised rescue equipment and training necessary for the job. It is possible to contact the Cleveland Search and Rescue Team direct.
The Police have a complete list of call out numbers and the rescue teams (although voluntary and a charity) are attached to the police.
Remember that emergency services will require the location of the accident, the sheet number, the six figure grid reference and local name should be given if possible. If using a mobile phone the operator may not be from the immediate area and will not be familiar with local place names. Give the area first, e.g., “North York Moors”
While waiting for help to arrive provide warmth and comfort but give NOTHING to eat or drink.
4.1.8 FURTHER GUIDELINES
I) If forced to remove the casualty from the glider be very careful to keep his or her neck and spinal movements to an absolute minimum. (No extension, flexion or rotation of the spine.)
iv) If the casualty has suffered concussion but seems to be recovering watch for and be aware of compression which often follows soon after (a swelling of the brain within the skull - more serious than concussion). Treatment is the same as for concussion - keep the airway clear and if breathing becomes difficult start artificial respiration. Any head injury - even mild concussion - must be given a check up in hospital.
v) Splint broken limbs, should movement be necessary. Use glider parts other limbs etc, as splints. Do not try to move broken limbs without support.
vi) The above notes are for information only. The North Yorks Sailwing Club and indeed the BHPA advises pilots to take part in a recognised Basic First Aid course. It is hoped that the Committee will arrange such a course on a regular basis.
vii) An Air Ambulance Helicopter has been based at Durham Tees Valley Airport since July 2002. The use of these helicopters is becoming the norm for getting a severely injured casualty to hospital in the quickest time possible. For a hang gliding / paragliding accident this will usually mean a 5 min transit from the airport and a 5 min flight to James Cook Hospital in Middlesbrough. If a helicopter is inbound, it is important to STOP ALL flying and move canopies & hang gliders well away from the scene. Also, warn the general public to stay well back.
4.2 POWER LINES
Power lines are an obvious danger to hang glider and paraglider pilots but are not always easily seen. This makes them a particular hazard when landing out in unfamiliar territory.
There are over half a million kilometers of overhead electric power lines in the mainland of Britain. Most are un-insulated and carry up to 400,000 volts along conductors supported on wood and other poles and on metal towers (pylons).
The safest way to avoid contact with overhead electric power lines is not to fly under or near them. Always observe the following precautions – your life may depend on it.
Power lines are difficult to see during the day. In the countryside you can assume there will be a supply to and from most buildings, including barns and farm buildings. Be very careful when flying late on an evening when the sun drops behind the hills or in hazy conditions.
If a Hang Glider or Paraglider is tangled in electricity wires stay clear and call for expert help.
If wires are damaged by a Hang Glider or Paraglider:
- Stay clear and call the electricity supply authority. NEDL 0800 66 88 77 (24 hour a day)
- Even small wires can carry lethal voltages and these can extend into the ground around the end of a broken line – sometimes up to several meters.
- Never try to ‘rescue’ a Hang Glider or Paraglider with a wooden pole or other ‘non-conductor’ – under some weather conditions; many materials will conduct high voltage electricity.
- Shocks A person touching an electrically grounded object whilst being exposed to the field may experience small, harmless shocks (micro-shocks) from electrical discharges.
- A person who has experienced an electric shock may not have obvious burn marks or wounds, but could have extensive tissue / organ damage under the skin.
Get medical assistance fast.
Be careful when flying at Saltburn, the take off above the Ship pub has a power line running behind the take off area. Consider what actions to take on launch if you have little or no penetration. What would you do? Where would you go?
4.3 HYPOTHERMIA(Low body temperature)
Normal Temperature 37 ºC
Mild Temperatures 35 - 34 ºC
General slowing down of movement and thought, shivering, monitor behavioral irregularities, peripheries cool, heart rate normal, respiration normal.
Moderate Temperatures 34 - 32 ºC
Marked slowing of movement and thought, increased shivering (at this stage shivering may diminish as the body temperature falls), marked behaviour irregularities (e.g. confused state), cold skin due to surface blood vessels constricting (vasoconstriction), skin colour white or waxy, heart rate lower than would normally be expected, with possible irregular rhythm. Respiration tends to drop and become shallower.
Severe Temperatures 32 ºC or less
Movement ceases and consciousness starts to diminish. Shivering is absent. If conscious the casualty will be totally confused and irrational. His response is very sluggish or absent, skin feels cold and will have little colour. His heart rate will be low and in some cases very difficult to detect. Respiration will be shallow and irregular.
Treatment
Prevent further heat loss. Stop further physical activity. Stop heat loss by insulating the casualty from the ground. Shelter the casualty to prevent heat loss by convection (air movement). Increase the surroundings air temperature to prevent heat loss by radiation. Promote re-warming by using clothing sleeping bags, person-to-person contact. If conscious give warm not hot drinks, high-energy food i.e. Mars Bar/Kendal Mint cake.
Do NOT give ALCOHOL.
Remember, it is no use placing a hypothermic casualty in a sleeping bag / bivi bag on his or her own. They will only raise the surrounding air to their own depressed temperature.
Complications
Rough handling may lead to ventricular fibrillation (the heart will flutter and not pump), leading to DEATH. Rapid re-warming may be as dangerous as rough handling or not doing anything at all. Do not assume death in hypothermic causalities. Casualties have been known to come round in the mortuary.
A SAR exercise at the Model Ridge.