Tourniquets in 'Timbuktu'

Over the last three days I was fortunate to complete a Remote Area First Aid course facilitated by St John Australia. Because I have started teaching my own Outdoor Ed classes this year, I thought this would be valuable, especially for camps. When I arrived I quickly realised most of the other participants were freelance outdoor instructors or tradies working in remote areas. I felt a little inexperienced and out of place as a result, but knew to get experience you need to start somewhere! 

Across the three days there was some repetitiveness across basic first aid courses, which is never a bad thing! I liked that most of the second half of the course were hands-on practical demonstrations and practice runs of a variety of scenarios that we could be faced with though to mix it up. Although the scenarios were as realistic as they could be in an office space, I do think that the course would be much more beneficial, rewarding and enjoyable if they were actually based in an outdoor setting. I was hoping that I would go on a course like this and actually be camping / in a remote area. 

The most lifelike experience was a fake arm with an open wound that water could be pumped through to replicate blood gushing out. On this we needed to practice stuffing the wound to slow the bleeding and encourage a clot and then place a tourniquet. It was incredible how many gauze pads needed to be stuffed into the wound to even slow down the 'bleeding'. I can only imagine if you had to do that for real for someone!

There is an array of evidence to show that the more people know, the more confident they feel and the more empowered they feel to respond to a medical emergency. As described by First Aid Melbourne, "a study conducted by the Red Cross showed that a staggering 59% of deaths from injuries could have been prevented if only first aid had been given in the first few minutes of the incident before an ambulance arrived". So, even though I feel I still know very little there is to know about first aid in the grand scheme of things, every little bit helps. I've been lucky to only have been involved in a couple of responses that would be considered mild, and hope I never have to respond to someone in a critical or dangerous scenario. Therefore, I encourage everyone to complete at least a basic first aid course - please don't hesitate! 

I do hope to get the opportunity in the future to learn about more preventative strategies, as the last few days have mostly had a focus on responses. I have heard about a course based around preventing fatalities in the outdoors that I may try go to - watch this space! Finally, as I have previously blogged about, first aid is more than a broken leg - mental health first aid is another great course to complete.

First Aid Is More Than A Broken Leg

Over the last two days I have completed a Youth Mental Health First Aid Course facilitated by Mental Health First Aid Australia. This is something I had heard about several years ago but the stars never aligned for me to complete a course. I was grateful to finally get the opportunity to attend. 

The other participants actually ended up getting COVID or being sent into isolation, so I ended up being the only one! This meant for a great 1:1 experience, but I also felt that I missed out on conversations with others a little. One thing I like about attending PD is to be able to compare stories and experiences with others. There was lots of scenario based learning across the two days though, which helped to solidify the learning a little.

This specific course was designed for youth because the median age for depression is 25, the median age for anxiety is 15, in 2020 480 Australians under the age of 24 died by suicide and 1 in 4 people experience a common mental health illness in one year. These stats really surprised me and were quite confronting. This really reinforced the importance of quality mental health education in schools (as well as the importance for as many adults as possible to be mental health first aid accredited). Check out some of my previous posts related to mental health here. Just like physical first aid, mental first aid should help people to have preventative strategies, rather than an ambulance at the bottom of the cliff. 

Beverley introduced me to the mental health continuum below. She encouraged me to consider these questions while observing young people; 
- To what level has someone moved towards 'illness'? How long have they been at this point of the continuum and how quickly did they get there?
- Are they bouncing back to 'health', staying where they are or moving closer to 'illness'? 
- Does the place on the continuum change at school, home and/or hobbies, or remain much the same?
These questions can help to gauge a students 'wellness', but also help to form a conversation with them and/or their caregivers. It is also very important to note that mental health is not the same as mental illness.

One thing that stuck with me, which shouldn't be surprising, was the comment "the more that we can support the brain in any illnesses they are presenting, the more likely they are able to learn". When we are having challenging mental days as adults, we generally aren't as productive, might not focus much or could have a shorter wick than usual (these are certainly my observations of myself). So of course if a student is feeling stressed, down, anxious or all of the above then they too may not be as productive as usual, may not be as focused or have a shorter wick. Teachers can see these as signs of disrespect or defiance, but really they may be signs that the student needs some support in that moment. Signs to look for and to ask the student about.

Here are several points that left me thinking a little further and for you to also ponder;
- Teachers should be modifying tasks like we would in a practical sense. We wouldn't ask someone with a broken leg to play a sport, so why would we ask someone with anxiety to 'keep on trying'?
- Empowerment is important for young people to make their own decisions about themselves. the feeling of powerlessness can significantly impact on mental health, so people need opportunities and tools to make decisions for themselves.
- "It is important that during the first response [to the person] we do it well, so that there is a positive result for them long term".
- Dendrites in the brain are responsible for neuro pathways and severe mental illnesses can impact on these pathways such as thickening them. Medication can help with repair of these dendrites, which can then help someone to have clearer thought processing and decision making. BUT medication is NOT the first answer for majority of people.
- We can recognise in student language, artwork, texts, interactions etc possible expressions or depictions which may indicate the student needs support.

Finally, the acronym ALGEE was referred to several times throughout the course. Like the WARM acronym for restorative conversations, ALGEE is a structure to create a conversation  and an action plan with someone as a mental health responder. To gain my accreditation, I had to demonstrate this structure through practice discussions in a range of scenarios. 

Even before completing this course I knew student mental health was just as important to understand and know how to respond to as physical health. Now, I feel even more so. It blows my mind that physical first aid courses are compulsory for all teachers in South Australia but mental health first aid is not - here's hoping that changes in coming years and that NZ mandates too!

In Case of Emergency

Two years ago I trained to become a pool lifeguard. Part of this process involved completing my Basic First Aid certificate, which is due to expire next month. Today I was fortunate enough to spend the day renewing my certificate, which I think is incredibly important for all teachers, particularly teachers in the HPE field.

Throughout the day we had theory lessons which we then implemented into realistic situations or scenarios we may find ourselves in, in the workplace. These included cuts, breaks, sprains and burns at a low priority level, through to open wounds with things sticking out of the body.

The most serious part was the revision of DRABC, and the ability to provide CPR and the use of an AED. I feel much more confident with my ability to provide first aid to people in a variety of situations until Emergency services have arrived, which may save a limb or more seriously a life in the future.

A basic rundown of DRABC:

Danger: Assessing the situation of any dangers which may be present at the scene of an accident such as people, equipment, vehicles, gases, liquids etc. The most important thing to remember when wanting to help someone is not putting yourself in danger to do so.

Response: Check whether the patient is responsive to you; can they hear you talking? Do they groan/twitch when you squeeze their fingers? Can they open their eyes when asked? If they are completely unresponsive, always call for an ambulance, and an AED.

Airways: Tilt the head back slightly and open the mouth; check the airways are not obstructed by anything (liquid or solid), clear if necessary.

Breathing: Put your ear close to the patients mouth - can you feel their breath on your cheek? Can you feel them breathing? Can you see their chest rising and falling?

Circulation: Feel for the pulse, check response to squeezing fingertips (does colour come back)

MOST IMPORTANTLY: If you don't know what is wrong, always call for an ambulance!!