REI – FURTHER

In my continuing effort to not die while out on the Pacific Crest Trail, or in general, I recently attended a NOLS Wilderness First Aid class, which was hosted by REI, with my girlfriend Cristina. The class was two full days and covered everything from treating blisters to what to do when someone is struck by lightning. Luckily this class was nearby and didn’t require a long drive to some shady place like my ice axe class.

One of first things we learned is how to perform a patient assessment (PAS), which was full of of lists and acronyms. When performing a patient assessment you first want to check the scene, identifying any hazards, determining the method of injury (MOI), put on gloves to protect yourself from any bodily substances (BSI), determine the number of patients and the general state of the patient. In an emergency situation it may be difficult to remember all this so the provided us with our first list, which rhymes! (who doesn’t love a rhyming lists?)

1 – I’m number 1 – Check for hazards to make sure it’s safe to provide assistance
2 – What happened to you? – Try to determine what happened
3 – Not on me – Be sure you have your gloves on
4 – How many more – Look for additional patients
5 – Dead or alive – Don’t say this one loud enough for the patient to hear

Once you make it through the list, guess what comes next? That’s right, another list! The next thing to check the patient for any life threats, after introducing yourself and gaining consent from the patient of course.

A – Airway – Check for anything blocking the airways
B – Breathing – Look and listen to asses breathing
C – Circulation – Check for pulse and any bleeding
D – Disability – Stabilize neck and head if chance of a spinal injury
E – Expose – Expose any serious wounds

Unfortunately the next section isn’t part of a list let alone one that rhymes. First, perform a head to toe exam using your hands (appropriate touching! hands slightly curved and thumbs up (Our instructors explained that none of our scenarios would include any injury to the genitals so we skipped that area, which was for the best.) Talk to the patient asking them if they feel any pain or discomfort as you as you perform your exam. Ask them to squeeze your fingers, push their feet against your hands and then pull their toes against your hands with their feet. After your head toe exam take the patient’s vitals, noting the time they were taken including:

Level of Responsiveness (LOR) – Awake and oriented (AO), Awake and disoriented (AD) or Unconscious (U)
Heart Rate (HR) – Including rhythm and quality
Respiratory rate (RR) – Including rhythm and quality
Skin color, temperature and moisture (SCTM) – Pink / Pale, Warm / Cold, Moist / Clammy

The final part of the PAS is the SAMPLE (Yay! another list!). After asking the patient what their chief complaint is and cause of injury / illness gather the following, asking clarifying questions as they answer :

S – Symptoms – How they’re feeling beyond their chief complaint.
A – Allergies – Food, medication, plants / animals
M – Medications – What they are currently taking and when they last took it, including supplements or performance enhancing / recreational drugs
P – Pertinent medical history – Medical conditions or recent illness / surgeries
L – Last intake / output – What did they last eat / drink and when. When was the last time they went to the bathroom and if there was anything unusual (heh. poop.)
E – Events leading up to the injury / illness – What happened? Did they fall, drink some untreated water, or get abducted by aliens?

If you want to see what a full PAS looks like here is a great video by NOLS. After completing the PAS you will provide treatment and make a decision around evacuation. Even if you don’t know what to do with this information it’s good to gather it if you’re in an emergency situation as it will be helpful when help arrives.

After we learned about how to perform a PAS we got to practice! We split up into groups where one group would play the patients and another would be the rescuers. The instructors would provide the patients with a scenario and pertinent information, sometimes we even had fake wounds. We covered falls, head and spinal injuries, dehydration, shock, burns, infection, musculoskeletal injuries, dislocations, hypothermia, frost bite & non-freezing cold injuries, heat exhaustion and many more scenarios.

On the second day we moved into practicing treatment, mainly around musculoskeletal injuries. I was lucky enough to be the recipient of an arm sling and an awesome improvised leg splint. I will admit, the main reason I volunteered to be the patient in this scenario was due to the fact that it involved laying down and the instructor looked pretty exhausted after demonstrating the improvised leg splint. I did however practice taping up a sprained ankle, which is the most common injury in the backcountry.

In one of the last scenarios Cristina and I were both patients and paired up as a couple. The scenario was that we just flown from Seattle to Denver, hopped into a car and drove up to Pike’s Peak, essentially going from sea level to 14,000 feet in a matter of hours and resulting in altitude sickness. I had walked around a rock to go pee and ended up tripping dislocating my knee. Things got fun when the instructor told us that one of our symptoms was irritability and that we had to argue with each other. Now, I wouldn’t characterize Cristina as an angry person, she is very outgoing, friendly and kind. So, when she started yelling “This is all your fault, I didn’t even want to come on this dumb trip! I hate hiking!!” I couldn’t stop laughing even though I was supposed to be irritable myself, not to mention in extreme pain. I’d try to regain my composure and yell back, saying something like “This wouldn’t have happened if you would have just stopped at a gas station so I could go to the bathroom instead of having to go behind a stupid rock!”. We, and our rescuers, ended up laughing a lot during the scenario, so much so I didn’t even feel any pain from my dislocated knee.

I’m really glad I invested the time to go to the class, I feel much more prepared to help out if I come across an injured person and really glad that Cristina is trained as well so she can help me when I do something dumb like trip over a rock. I’d highly recommend the class if you spend a lot of time outdoors, check the classes at your local REI or NOLS if you’re interested.

Since I’m starting with little knowledge of what I’m actually getting myself into I wasn’t quite sure where to start. First, I bought myself a giant map of the entire Pacific Crest Trail and hung it on the wall. I would glance as it as I walked by but never really took the time to look at it closely. When I eventually convinced myself to study it a bit I found myself feeling slightly overwhelmed, especially when I found the chart showing all the mountains and their elevations. After that point I would have the occasional stare down with the map before it just started to blend into the background and go unnoticed. So while it’s a nice map all it’s done at this point is intimidate me and win multiple staring contests.

I also bought a book, The Pacific Crest Trail: A Hikers Companion. Much like the map it would occasionally catch my eye but I never invested the time to really gain any benefit from it. I would pick it up and flip through it from time to time, never reading a substantial amount, then I got a new coffee table with a nice shelf which the book somehow made it’s way onto and still lives there today. I did however learn that the Mojave is home to 10 or more species of scorpions!

When I would talk to someone about hiking the Pacific Crest Trail and start to thinking about planning again I would tell myself that I had plenty of time to prepare (which I do) and kept pushing it off. That was working great until my girlfriend told me that that there was a free “Hiking the Pacific Crest Trail Basics” class at REI. There was no excuse to pass up a free class. I mean this is something I’m excited to do, right?

The class was taught by “Skittles”, who section hikes the trail as she can and “2Patch” who through hiked the entire thing like I will be doing. So what did I learn? Well let’s start with what I just said, “section hiking” is hiking section(s) of the trial at a time while “through hiking” is hiking the entire trail in one go. The trail itself is approximately 2,650 miles with which will generally take 4 to 6 months, time commitment being one of reasons someone may chose to section hike rather than through hike.

You may also be asking yourself “What kind of names are Skittles and 2Patch?” Rest assured these are not the names they were given at birth or had given themselves as part of some identity crisis. When hiking on the PCT you will pick up a trail name along the way, hopefully I don’t end up with a lame one like “Rupert.” I also learned other vernacular such as NoBo (hiking northbound), SoBo (hiking southbound), hike your own hike, and my favorite….

Trail magic is when you find or experience something totally unexpected that lifts your spirits, 2Patch mentioned finding entire cooler full of beer on the trail. Once this years class (more vernacular, each year is a class. For example, I’m class of 2018.) ends up near Snoqualmie Pass I plan on creating some trail magic of my own. Other terms of note are “Trail Angeles” which will help hikers by offering anything from rides to a place to stay and a hot meal. “Hiker Boxes” are like the leave a penny take a penny tray at 7-11 but for hiking stuff and a box, sometimes you may want to shed some weight by dropping the dehydrated meal you’ve been eating for weeks straight and are completely you’re sick of.

Speaking of meals you may be wondering how I plan on feeding myself over 4-6 months on a trail. The short answer is i’m not entirely sure yet but I did learn about a few different options. I could mail myself, or more likely have someone else mail me, resupply boxes along the way and pick them up when I get into a town or I could simply resupply whenever I come into a town or pick up items at a gas station along the way. One thing that was stressed during the class was the important of snacks, especially Cheetos. I don’t know why Cheetos were mentioned so many times during the class, maybe they are some kind of super food. It’s much easier to eat snacks than it is to stop and prepare a meal. When planning your meals you want to pick foods that are dense in both calories and fat. In the end I’ll probably end up preparing and mailing most of my meals ahead of time but also picking up stuff on the way, I’m sure I’ll be posting about meal planning and sharing recipes. Or, I could be like this guy and just eat McDoubles.

Skittles and 2Patch then went on to talk about different gear they would bring. In short lighter is better, merino wool is awesome (it really is), hike in trail runners and not boots, and try to carry things that are multi-functional. Ideally your base weight, which consists of your backpack, tent and sleeping bag should be is as low as possible, i’m shooting for under 10 pounds. One of my favorite thing they mentioned was a long handled spoon, anyone who has ever tried to eat directly out of a pouch of re-hydrated food can appreciate how brilliant this is. They also talked about housekeeping things like permits, forwarding your mail, setting up auto-pay for your bills, and boring stuff like that. They wrapped up by sharing more about their experiences on the trail and the stories behind their trail names and took time to answer questions. During the Q&A I learned that some hikers will take a side trip to summit Mt. Whitney, the highest point on the PCT at 14,505 feet, which I am now planning on doing as well.

I came away from the class feeling very excited to start planning my trip, less intimidated by the map hanging on the wall…. and craving Cheetos.

Tag: REI

Wilderness First Aid

Start with the basics.