January 2024

Given Australia's size and emptiness, it’s pretty obvious that remote area first aid would be a good skill to have. Follow this guide and be prepared.

Introduction

Given Australia’s size and emptiness, it’s pretty obvious that remote area first aid would be a good skill to have. If you don’t know how barren Australia is just have a look at Australia on Google Maps. Use the satellite view and a nighttime view as well. There’s a couple here – Night Time Australia.

Australia is empty.

A remote area is generally defined as an area where access to medical assistance is delayed by time and distance, which is most of inland Australia.

However, remote for First Aid purposes could be anything over an hour, or 50 km, from a city or a country town.

If you are in a remote area and have the ability to manage injuries with skill and confidence you may be able to prevent complications. Complications which would hinder a speedy recovery.

Because you can’t call an ambulance and expect one to arrive within a reasonable time, remote area first aid has its own unique set of considerations.

Remote Area First Aid in Australia. A remote area is generally defined as an area where access to medical assistance is delayed by time and distance. Which is most of inland Australia.

Remote area First Aid considerations

Distance – The further you are from medical/ambulance assistance generally means it will take longer for that assistance to reach you.

Time – As for distance, the further away the more time it will take. However, in some cases, you may only be a couple of miles away from aid BUT it may take days to reach you. Mountainous areas for example.

Number of people in the affected party – This will determine what can be done if someone becomes injured. The more people in the group, the more options you may have. One or two people could stay with the casualty, others could go for help. There may even be enough people to carry the injured person out.

Weather Conditions – Storms may prevent aircraft, as well as land transport, from reaching the casualty. High temperatures may inhibit a quick on-foot rescue. Deep snow the same.

Fire and Flood – (What? In Australia? – surely not!) There’s no denying that these are fairly commonplace within Australia. These natural disasters will have an impact on medical response time if they are happening in your area.

Lack of communication – No mobile network. No road access. Lack of communication will, of course, delay any medical response. Lack of communication may also deprive you of contact with a doctor and the provision of medical advice.

Medical supplies – When travelling in remote areas the level of first aid you may be required to perform may be higher than the level of first aid closer to home. This will have an impact on the contents of your first aid kit.

The severity of the injury – This will determine your actions and response.

After reading the list above you can see how isolated you might feel if you are out in the great outdoors with a couple of friends and something injurious happens.

Let’s make it worse… You’re by yourself.

Distance & Time: Further means longer help arrival. Number of People: More options with a larger group. Weather Challenges: Storms, heat, snow affect rescue. Fire & Flood Risks: Impact on medical response. Lack of Communication: No network delays help. Medical Supplies: Remote areas demand advanced first aid. Injury Severity: Guides actions and response.

Management Strategies for remote area First Aid

While there are some extra things you need to consider for remote area first aid, it is important to remember that the basic principles of first aid remain the same.

The initial action plan of DRSABCD is just as valid in a remote area as it is in the suburbs. What does make a difference is a sound knowledge of survival techniques and correct preparation before remote area travel is undertaken.

The Basics

First and foremost, tell someone where you are going and when you expect to be back. You might even organise before you leave what to do if you do not return at, or close to, the expected time.

Avoid travelling alone. The recommended number is 4. That way one can stay with the injured person and two can go for help.

Leave a map with your travel details on it and organise a schedule of times when you will contact a nominated person. Keep to the schedule.

Remember there are four vital requirements to support life. Water, shelter, warmth, and food. Make sure you set out with an adequate supply of these vital requirements to sustain you should you become stranded. Even if you are planning to go to a remote area for only a short period.

Take appropriate communications and location equipment for the area you are going to. Know how to use them. These may include a long-range radio or mobile satellite phone, global positioning system, emergency position indicating radio beacon and maps. Use a torch, whistle or mirror to signal for help.

Check weather forecasts before you depart and while you are away. Be ready to change your plans or delay the trip if necessary.

Ensure all members of your group are fit for travel. Carry extra prescription medications for the journey.

Wear and pack appropriate clothing for the weather conditions and terrain.

So, planning and preparation beforehand is the key. However, even the best preparation and planning cannot prevent an emergency.

Inform someone. Travel in groups. Have a communication plan. Always carry water, shelter, warmth, and food. Bring communication tools (radio, phone, GPS) and signaling devices (torch, whistle, mirror). Check forecasts, be flexible, and adapt plans accordingly. Ensure group fitness and carry extra prescription medications. Dress and pack according to weather and terrain conditions

Remote Area First Aid emergency

If well planned, your trip should go smoothly and safely, but if you get into difficulty, here are a couple of key things to remember:

if your car breaks down or you become lost on the way, never leave your vehicle. You can use it for shade and shelter. Also, it is easier to locate a missing vehicle than a missing person in the vast Australian Outback.

if you become lost while hiking, stop, try to relax, and study your maps. See if you can determine where you came from and slowly make your way back. If you can’t find your way back, move to higher ground for a better view.

If you become injured, deal with the injury and try to make yourself as comfortable as possible.

Ration your food and water supplies.

If you hear signs of rescue, signal with three torch flashes and with your whistle.

Light a small smoky fire with green leaves during the day and a small bright fire with dry materials at night.

Be patient and prepared to wait.

If your car breaks down or you become lost on the way, never leave your vehicle. If you become lost while hiking, stop, try to relax, and study your maps. If you become injured, deal with the injury and try to make yourself as comfortable as possible. Ration your food and water supplies. If you hear signs of rescue, signal with three torch flashes and with your whistle. Light a small smoky fire with green leaves during the day and a small bright fire with dry materials at night. Be patient and be prepared to wait.

Other outback emergency considerations especially if you are in a group.

Continue or stop. Somebody will have to decide whether the casualty is able to continue the journey, or it should be abandoned to care for the injured person. Or maybe take them out to medical aid. Whoever makes that decision should consider the welfare of the whole group.

Medical assistance. If you are able to call for assistance you will now have to decide whether you go to the assistance or wait for the assistance to come to you. The severity of the injury, time factor – travel out vs travel in. Can the casualty even be moved? Will determine your decision.

Time Frame. Because of the distance and extended time frame for assistance, the casualty may become more stressed. The decision maker/first aider will need to remain calm and reassure the casualty. Regularly monitoring the casualty’s condition will help reduce anxiety levels. Make sure they are as comfortable as possible.
Observations. Keep notes on the casualty’s condition. Record things like changes in signs and symptoms, vital signs, and first aid provided. Monitor and record fluid intake and output. Be aware that the casualty may go into shock.
Shelter and survival. Try your best to shelter the casualty from the elements. Keep them as comfortable as possible. Keep cool if hot and warm if cold.

Ok. Now all of the above may have felt like death by dot point. But when you stop and think about it, moving around this great empty country of ours does require planning and preparation.

There are about 40 deaths per year in the Australian outback. Most are due to motor vehicle accidents. However, people do perish directly as a result of poor preparation.

Check this out: How a desert claimed two ill-prepared travellers.

Conclusion

If you want to hike around in remote parts of Australia then I suggest you do your research, complete a Provide First Aid in a remote or isolated site course, plan your trip – using the above articles as a guide and try not to travel alone.

I have deliberately not given details of how to deal with First Aid emergencies, contents of first aid kits, communications equipment etc.

I will cover those in Part 2 of Remote Area First Aid.

Well, that’s that. Until next time…Stay safe

Introduction

I want to talk about the CPR discrepancy and closing the gap, one rescue at a time.

Do you know that females in cardiac arrest are less likely to receive out-of-hospital cardiopulmonary compressions (CPR) than males? That is simply because the provision of bystander CPR is less likely to be performed on a female by a member of the public. This is the CPR discrepancy.

Cardiac arrest:

A cardiac arrest is a life-threatening emergency situation where these casualties require immediate chest compressions to imitate the pumping of the heart, which promotes blood and oxygen delivery to the brain and other vital organs.

Despite the severity and complexity surrounding a cardiac arrest, the initial life-saving treatment simply involves using two hands to administer chest compressions in the centre of the chest, hard and fast.

However, despite the simplicity of performing CPR, recent literature states that only 39% of women received CPR from bystanders in public compared to 45% of males. (American Heart Association)

CPR on Women:

So, let’s unpack why the provision of CPR is less likely for Women and why the CPR discrepancy exists:

Gaining an insight into understanding the public perceptions of why the provision of CPR is less likely in women is an essential measure towards promoting the equitable implementation of CPR.

Bystanders are less likely to perform CPR on women due to concerns about inappropriate touching, potential accusations of sexual assault, or fear of causing injury.

Although these concerns for privacy and cultural sensitivity are valid, exposing the casualties’ chest must be done to initiate life-saving medical treatment. Using an Automatic External Defibrillator (AED) for example.

Exposing their chest includes removing all upper body clothing, which also includes removing or cutting their bras. This is optimal as it will allow for correct hand placement for compressions and for the AED electrode pads to be properly placed in the correct position. Further, as many bras include metal components, removing them reduces the risk of burns or electrical arcing during defibrillation.

Remember, exposing the female’s chest is necessary for optimal medical care. In the case of a woman with larger breasts, it might be required to lift the left breast with the back of your hand for accurate positioning of the AED pad. When a bra is removed and a female is lying on their back, it’s likely the breasts will fall to the side and thus allow for correct hand placement in the centre of their chest without the requirement to touch them. This is the correct location to effectively deliver compressions.

Preserving privacy:

Preserving the privacy of female patients can be achieved by continuing to treat them with dignity and respect at all times. It is important to ensure only those assisting with resuscitation are within sight of their exposed chest and for all other bystanders to maintain at a distance. In addition, capturing photos or videos of the casualty is inappropriate and unnecessary. Additionally, if there is a cloth or towel available, it can be used to cover the chest and preserve modesty, whilst compressions are provided.

CPR on pregnant women:

It is often misperceived that pregnant women who experience a cardiac arrest should not receive resuscitation with CPR and defibrillation. However, the standard protocol for resuscitation remains unchanged and it’s expected that they receive the same quality CPR and AED shocks as anyone else. Therefore, observing the same three life-saving procedures; calling 000, starting CPR, and utilising an AED as soon as possible is vital to attempt resuscitation.

Both compressions and defibrillation should not pose any significant risk to the mother or baby. However, there are some alterations we can practice to further mitigate any risks.

Whilst they are lying flat, place a padding such as a cushion or towel under their right hip to tilt their left side about 15°-30° while leaving their shoulders flat to the ground. This will facilitate blood flow for the pregnant woman and baby.

Finally, as for all patients, if CPR is successful, placing them in the recovery position whilst you wait for the ambulance to arrive is ideal. However, the left side is preferred as it prevents the baby from compressing one of the major blood vessels in the abdomen.

Conclusion:

Remember, if you attempt to resuscitate and save the life of a female casualty with genuine and well-intentioned efforts, you will always be protected under the Good Samaritan Legislation.

I hope this blog encourages strong public education and eliminates the biases surrounding bystander CPR on female casualties so we can make a difference together and save lives, regardless of gender, one rescue at a time.

Thanks for tuning in, see you in the next blog! – Dounia

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