| Medical Crises Planning 101
STAT! Before serious injuries occur, take our resident Dr. Quinn's advice on building a homestead ER.
Running chainsaws, driving tractors, tending large animals and the hard physical labor and myriad chores of homesteading are inherently somewhat risky. Minor cuts, abrasions, bumps and bruises are commonplace and, fortunately, easy to manage. But much more serious injuries can and do occur on the farm.
Most of us, though, are willing to accept the risk as an unavoidable downside of self-sufficient living in order to do what needs to be done. Nonetheless, especially since our homesteads are often remote from the nearest hospital, we need to know what to do when or if someone is seriously hurt. Taking a first-aid and CPR class or, for the more ambitious, EMT training, would be a good start in that direction.
Managing medical emergencies on the homestead or in remote areas begins with a discussion on the general approach to emergency situations and what should be included in an advanced layperson’s first-aid kit. Whenever I talk about emergency care for the layperson, everyone wants to get right down to the gory details. But understanding how to plan for and think about an emergency is the best information you can have if and when one actually occurs.
YOUR 911 APPROACH
Before medical students head out for their first day in the Emergency Department, their attending (the senior doctor) gives them this advice, “The first pulse you take should be your own.” In other words, keep your head on your shoulders, your feet on the ground and calm down. The second: someone needs to be in charge and it is better to make the wrong decision than no decision at all. These two pieces of advice and some common sense will get you through almost any medical emergency. Come to think of it, they’ll also get you through life.
To handle emergencies well, have a plan. Before the disaster, you want to know who does what, when do they do it and where do you go, etc. Every family will have its own unique needs, so each family will need to develop its own unique strategy. However, there are a few things that should be common to all.
DESIGNATE A LEADER
The most important thing a crisis needs is a leader, so the first item when making a plan is to designate one (and only one). For the leader to lead, everyone must trust and follow that leader without question when the time arrives. The middle of a crisis is no place for democracy or dissent. This responsibility may be rotated, but each event should have just one leader. If there are only two adults in your family (particularly if one of them is the victim), the issue is moot.
The event leader, obviously, needs to be a person with medical knowledge, but also should have a calm demeanor and plenty of self-confidence. It takes a bit of arrogance to take charge in a crisis, but not so much that other people’s good ideas get lost in ego. If the situation is dire and there are enough people, the team leader should focus on the big picture and so should have as little else to do as possible. Think of the event leader as the maestro and everyone else as the musicians. However, most of the time, they will have to multi-task.
At a time of emergency, everyone present should have a job to do. This is the second most important consideration. Idle hands just get in the way, at best. If everyone is busy, everything will run more smoothly. Usually, though, the problem is too few people, not too many. Even so, anyone who is not needed should be sent away. For a small group, some or all members may need to take on multiple jobs.
An important task that is frequently overlooked is childcare. In a crisis, it is easy to forget that children need someone to comfort them, answer their questions, get them a drink and take them to the bathroom. Parents will be reassured to know that their confused and scared kids are not just floating around out there by themselves.
The third item is to have all your supplies and equipment organized and stored in a safe convenient place. Every family should have a first-aid kit and keep it stocked and up to date. One family member can be given this task. Again, the job can be rotated, but who is in charge at any given time should be clear.
Any items that have been used need to get replaced right away. A crisis today does not guarantee that another one won’t happen tomorrow. Have a can of gas put aside in case all your vehicles are out, but keep at least one vehicle gassed up at all times. Time is often of the essence during any emergency.
The decision of whether to wait for the ambulance or drive to the hospital yourself can be difficult when you are in a remote area. Don’t just consider the time alone, remember an ambulance comes with a lot of equipment and highly trained personnel. Furthermore, if 911 is activated as soon as possible the ambulance may arrive before you can get the injured person and your vehicle ready to go.
USE COMMON SENSE: This is the approach ER doctors and other first responders take when handling emergency events. Do the same and you will maximize your chances for a good outcome. Ignore this advice and you will likely muddle thru, but you may also have a circus act on your hands.