First Aid Training For Frontier’s Remote Environments

by Paul Kirtley

Paul Kirtley doing CPR on a Resusci Anne

However much first aid training you have done, it's always good to refresh the basics. Photo: Martin Tomlinson

First aid and outdoor safety training forms part of the annual training cycle for Frontier Bushcraft team members.

Any regulated outdoor instructional or leadership discipline I can think of - for example mountain leadership or canoe leadership - requires a specified minimum amount of relevant first aid training before you are certified.

Moreover, to keep your "ticket" current, you need to keep your first aid training current, usually with a refresher every three years.

Now, while there is no national governing body award for bushcraft, I don't see any reason why those teaching bushcraft should not be held to the same standard. I certainly hold anyone who works for Frontier Bushcraft to this as the absolute minimum standard.

Indeed, I try to facilitate first aid training and refreshers more frequently. Unless you are dealing with medical emergencies on a regular basis three years is a long time to go without making sure the relevant knowledge and protocols are clearly and fully remembered when required.

However much first aid training you've received before (I've done a lot) and however good your memory is (mine is relatively reliable), everyone still benefits from regular training or scenarios where relevant skills and knowledge are brought front of mind.

The best way to refresh even the basic protocols are to do them and do them repeatedly. Photo: Paul Kirtley

Moreover, rather than drilling the basics in a classroom, it's much better to do them in the environment we work. Photo: Paul Kirtley

Adam Gent of Real First Aid, who we employ as our first aid trainer, has provided first aid training of various forms at Frontier Bushcraft's pre-season staff training five years out of the last six, in 2012, 2013, 2014, 2015 and 2017.

Adam remarked recently that some of the Frontier Bushcraft team have had more first aid training than some outdoor professionals receive in their careers.

I have attended every one of these trainings and even though I'd had a good amount of good quality outdoor first aid training previously, I never fail to find these sessions valuable.

Adam Gent teaching outdoors

Adam Gent teaching first aid under Frontier Bushcraft's parachute. Photo: Paul Kirtley

Frontier Bushcraft team taking first aid lesson under parachute

The Frontier team become the students. Photo: Paul Kirtley

Remote Begins Not Far From The Beaten Track

While I did do my first aid badge in Scouts and did an HSE First Aid At Work certification not long after I graduated University, it was a bit later that I undertook further first aid training specifically aimed at dealing with incidents in the great outdoors.

As you move away from being any place an ambulance can drive, incidents where first aid is required increase in complexity.

You don't have to be in a rarely-visited wilderness for your location to cause complications.

Being taken ill or injured in the middle of an area of woodland, 500 metres down a muddy track with a locked gate at the end of it, is harder for the first aider to deal with than the same incident in an office or on the high street of a town. Plus it'll likely take paramedics longer to get to you. That is of course, once you have let the emergency services know where you are. What's the postcode of that oak tree?...Good navigation skills go hand-in-hand with outdoor first aid.

The area of Sussex where we run many of our courses is not far from the local hospital (about 10 miles) but the estate we work on is large and has various private single-track roads which lead into the land. From these, to get to where we run our programmes, the nearest tracks are the realm of 4x4s.

People doing first aid training in the woods

Down a muddy track in the middle of the woods, is a different level of complexity to the high street. Photo: Paul Kirtley

Casualty simulation at night

Tending to a casualty in the middle of the woods, in the dark, late at night. Photo: Paul Kirtley

It is an exercise in logistics getting a casualty to a road or paramedics from a road to a casualty. Every team-member has laminated emergency procedures on their person. On one side is a map of the area with the names, post-codes and grid references of places we could direct people to rendez-vous with us. Even so, this is something we practise.

We undertake our first aid training in the environment in which we do much of our regular work, and we train through the use of scenarios. As the scenarios become more complex than an individual first aider applying basic life support protocols then putting an unconscious casualty in the recovery position, we iron out wrinkles, remove dangerous assumptions, improve communications and debrief decisions. The team visibly improve their sharpness in being able to deal with incidents over the course of the training, even from a relatively high baseline. This sharpening is one of the values of regular, relevant training in the environment in which the team works.

On a more general note, training where the team have to be collaborative, communicative yet decisive is beneficially in their general development as outdoor professionals. I also find putting this training not long before our main course season is a good team-bonding exercise after the quieter winter months, when they may not have been working together.

Exploring techniques for moving casualties. Photo: Paul Kirtley

Remote Extends A Long Way Out

As well as our training area in the south of the England, we run various programmes and trips around the UK, some in more remote or less accessibly places than our base in Sussex. We also lead trips outside the UK, most of which do involve travel in truly remote areas. Further, a good number of our team undertake remote trips on their own time and it is good for them to be as trained as possible in order to look after each other as well as non-Frontier Bushcraft companions.

These situations, in less familiar locations, require a more dynamic range of thinking, perhaps, than dealing with an incident on familiar ground. Hence, we add scenarios which put our team into less familiar situations. This doesn't detract from the fact that the basics always need to be done well. It may, however, add on a layer or two of additional complexity which needs to be thought through.

For example, the backdrop to one scenario we gave some of the team was that they were undertaking a canoe trip on the Bloodvein river in Canada. They were undertaking a 300 metre portage, and all but one of the team were at the end of the portage with their gear and boats. They had had to make two trips to get everything there and had walked back and forth at their own pace. One of the team had not returned with their final load even though he had been not far behind. The team went back along the trail which was acting as their portage trail and found the final team member, who had fallen and broken their collar bone.

A broken collar bone is painful but causes extra complications one week into a two-week wilderness canoe trip. The team were provided with a real map of a section of the river and surrounding land. There are no roads, trails or buildings anywhere on the 1:50,000 sheet. I marked a point on their map as their location. They were also supplied with a working satellite phone, which I take on remote trips with me, along with a phone number which we told them was the phone number of the outfitter and supplier of float plane transfers. Their task was to deal with the situation as if it were real, thinking through the ramifications of the injury and liaising with the outfitter as to where they could be met with a float plane (it wasn't where they were).

A broken collar bone on a remote trip. Photo: Paul Kirtley

Working out their exact position. Photo: Paul Kirtley

Learning about the use of satellite phones. Photo: Paul Kirtley

Communicating with outside assistance via satellite phone. Photo: Paul Kirtley

These training scenarios, along with debrief sessions, are invaluable in creating the right thought processes for in case eventualities such as these do occur. They also focus the mind on thinking about risk in remote settings. Breaking your collar bone by falling off your bike near home or slipping on ice near to the shops is undesirable but the logistics of dealing with it are relatively straightforward. The same injury on a wilderness journey is more problematic.

Equally, other common non-life threatening conditions can become problems on remote trips. One potentially painful area of concern is teeth, either damage incurred during a trip or even something as simple as a previous filling coming loose. Some of us who are involved in overseas trips have previously undertaken extended care training, including temporary fillings. We included this as an evening session of extra training for the team.

Adam Gent talking through and demonstrating dental techniques. Photo: Paul Kirtley

Iain preparing to add a temporary filling. Photo: Paul Kirtley

A row of budding dentists! Photo: Paul Kirtley

At the core of our first aid training are the basics... Danger, Response, Airway, Breathing, Circulation, etc., taught with pragmatic realism, applied to our work environments and practised through scenarios. The basics are augmented with a range of skills which make our team even more capable of dealing with emergencies in the far-flung places as well as the nearby remote places.

Adam demonstrates his bedside manner. Photo: Martin Tomlinson.

Smiles all round. Photo: Paul Kirtley

Team coordination required... Photo: Paul Kirtley

Practical training for the outdoors. Photo: Paul Kirtley

Keeping the casualty warm. Photo: Paul Kirtley

Monitoring changes in temperature. Photo: Paul Kirtley

After dark lessons in the parachute. Photo: Paul Kirtley

Adam revising methods of wound closure. Photo: Paul Kirtley

The team practising methods of would closure. Photo: Paul Kirtley

Wound irrigation. Photo: Paul Kirtley

Simple yet effective techniques, using what you might realistically have with you. Photo: Paul Kirtley

Multiple days of continuous outdoor learning and revision. Photo: Paul Kirtley

Catastrophic bleeding... not a fun subject but one Adam covered with his usual pragmatic, practical approach. Photo: Paul Kirtley

Ben says it's a wrap... Photo: Martin Tomlinson.

Let us know in the comments below what the caption for this photo should be.... the funnier the better.... Photo: Paul Kirtley

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Paul Kirtley is owner and Chief Instructor of Frontier Bushcraft. He has had a lifelong passion for the great outdoors and gains great satisfaction from helping others enjoy it too. Paul writes the UK's leading bushcraft blog as well as for various publications including Bushcraft and Survival Skills Magazine.

 

{ 6 comments… read them below or add one }

Craig Taylor

When Paul says “Don’t touch my whisky” he *means* “don’t touch my whisky”!

Reply

jamie dakota

“he was so happy to learn he was about to become a mummy”
Great article, and an inspiring professional ethos.

Reply

Robin

A great article, thank you for posting it!

In England and Wales the ambulance services have specialist teams called “HART”, Hazardous Area Response Team. These teams are trained in a number of specialist areas, including lowland search and rescue. They have access to 4 wheel drive vehicles. It can easily take them over an hour to get to a casualty. Helicopters can be faster but may not have access!

How do these teams train? Scenarios! They run scenarios till they are second nature. All of them are paramedics but the environment requires the specialist training and more scenario work! You practice the skills, you practice with the kit and you run more scenarios.

To be honest the scenarios get boring but if you are not bored of them you haven’t done enough.

First Aid is just that, the first aid that is given. It can easily be the difference between life and death, even if the ambulance is just 8 minuets away. Try holding your breath for 8 minuets!

It’s great to see that your staff do this type of scenario work. It has been proven to save lives, many times over!

Regards

Robin

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Ian

Caption : “So that’s where I left my Sam Splint!”
Are you likely to offer wilderness first aid courses at Frontier Bushcraft? The one I was due to attend shortly folded due to lack of uptake. Great blog, many thanks, Ian

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tony

If interested in First aid, volunteer as works first aider. The firm will send you on a course which is usually run by the St John’s ambulance, I did 10 years with refresher top ups. Served me well a few times and you meet all sorts

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Jim Thompson

This is excellent Paul. I did a 2 day ‘wilderness first aid course’ last autumn as a pel to the Elementary course I did with you in April, motivated by the elementary but bolstered by the fact I realised my last first aid course was 15 years ago.
The course I did included scenarios, but even now I find myself reaching for the notes every so often and realising what I can’t immediately remember, it tends to be things like hyper/hypoglycaemia and as I found in the late night talk, cold (and I took the course notes out of my FAK for that one to compare), than the physical injuries.
Glad to see we’re in good hands.

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