3/18/2012

Patient Packaging in the Backcountry 16 Steps for a Successful Evacuation

By Paul Marcolini
3-14-2012

During a recent Franklin Search & Rescue training, Paul offered the following sequence.

1 Identify the type of injury= package the patient on her back or side (this is an EMS decision)
2.  Spine stable/injury?  If spinal, make litter and patient one unit
3.  Build from patient-outward
4.  Anticipate rig for medical needs- vomit, blood pressure, stethoscope, etc. 
5.  Get patient out of wet clothing down to long underwear layer
6.  Provide for bathroom needs, use a depends, or makeshift diaper
7.  Vapor barrier (VB) for warmth 2 lg. plastic garbage bags can make the patient damp from perspiration but warm. Paul uses a VB into 70 degrees F. range
8.  Add the bulk warmth layer, sleeping bags, Wiggies Bag, blanket, etc.
9.  Add a Vapor barrier over outside of package (burrito wrap) you can use a tarp, tent fly, garbage bag, etc.
10.  The 4 parts of the package are: dry clothing, inner VB, bulk insulation, outer VB
11.  In the litter, attach webbing to the litter above the shoulder make an X, tie around belt area to prevent patient from sliding forward.
12.  If injury permits, use webbing to make a stirrup for the feet to prevent sliding in the litter or use an improvised seat harness if a leg or foot injury.
13.  Webbing x over pelvic area.
14.  Address the 3 weight centers: head, chest, and pelvis
15.  Fill the voids along the body between the patient and the litter with foam swimming noodles or use spare (patient) clothing.
16.  Voids/spaces to address: under knees, small of back, shoulders

An unused blood pressure cuff can be a great adjustable ‘small of back’ support.

Gear to have in your litter kit before you leave the parking lot: garbage bags, foam sleeping pads, depends, foam noodles, webbing

 Paul Recommended that the team carry 8 pieces of  9’ foot webbing or spider strap.

Rescuers, should always use patient gear from their pack before using team gear (sleeping bag, sleeping pad, clothing for padding, etc.)


              

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