Monday, October 28, 2013

October medical skills training

BAMRU held its annual medical skills training in Huddart Park on October 26-27. Lucas Marciniak, a BAMRU technical member and registered nurse, organized a day of lectures and breakout sessions, followed by a day of awesome scenarios we called the “Medical Olympics”. Twenty-three active BAMRU members showed up, along with five guests and a handful of BAMRU's friends.

Day 1 started out with a fascinating lecture by Dr. Zina Semenovskaya, on wilderness medicine. The group discussed the unique risks associated with environmental exposure, and spent a lot of time deliberating sticky questions about acute mountain sickness (AMS): How do you recognize it in the field? When do you make a decision for search teams to descend? What are early warning signs for the life-threatening forms of AMS?
Learning wilderness medicine!
Dr. Semenovskaya Lectures on Wilderness Medicine
The team then split up into groups by certification level (EMT, WFR, WFA/First Aid), and began rotating through stations manned by knowledgeable BAMRU members. RN Abi Fitzgerald educated first responders and EMTs alike on the value of taking good baseline vital signs and an accurate medical history. Kyle Barbour walked each group through the contents of BAMRU’s jump bags - no one wants to be searching for the right piece of equipment in an emergency! Former BAMRU member and practicing anesthesiologist Dr. Victor Tubbesing mediated a discussion on patient medical scenarios and airway management, and Lucas Marciniak drilled the teams in how to properly package patients with cervical spine immobilization.

PPV is your friend
Dr. Victor Tubbesing Teaching the Airway Station

Lucas Marciniac, RN Teaches the Packaging Station
Lucas Marciniac, RN, Teaches Litter Packaging and Spinal Stabalization

At the close of the day’s training, some of the group headed home while others camped at Huddart Park (and, after contemplating a dinner of dehydrated food, made a late-night taqueria run instead).

Day 2, the Medical Olympics, began with the creation of mixed certification level teams. Friends of BAMRU as well as some generous paramedic students from Foothill College volunteered to act as patients for the Med Olympics scenarios.

Each team had a full day of patient care! The training scenarios included a hiker with a broken ankle who was having an anaphylactic reaction to a bee sting; a teenager, alone in the park, experiencing food poisoning; a woman having tonic-clonic seizures following head trauma; a diabetic backpacker in DKA who'd left his insulin at home; and a lightning strike on a member of the BAMRU rescue team.

A Foothill College Student Acts as a Diabetic Patient in DKA with a Damaged Ankle and is Rescued By BAMRU Students
Evacuating a Diabetic Patient in the Medical Olympics 
In addition to each BAMRU member getting invaluable practice with patient care, patient packaging, and equipment handling, each group vastly improved in communication and teamwork over the day. The scenarios also prompted discussions on managing bystanders, interacting with minors, approaching potentially dangerous patients, and handling the incapacitation of a team member.

Overall, the BAMRU members present at the training had the chance to refresh their EMS skills, gain familiarity with BAMRU’s equipment, and experience how rescue teams might conduct patient care in the field. It’s safe to say that no matter the certification level, we all learned a ton!

BAMRU Team: Abi Rankin Fitzgerald, Alexa Fredston-Hermann, Alex Grishaver, Brian Ducay, Charles Dimmler, Chris Seffens, Christiaan Adams, Christopher Nielsen, Dominique Freckmann, Eric Mcdonnell, John Chang, John Zirinsky, Kimberley Craig, Kyle Barbour, Kyle Smith, Lindsay Chromik, Lucas Marciniak, Mike Dacre, Patti Viri, Rachel Allen, Sarah J Roth, Thom Dedecko, Tom Grossman

Sunday, October 13, 2013

Spruce Grove Search

On September 25, BAMRU of San Mateo County Sheriff's Office received word of an ongoing search for 72 year old missing hunter in the Mendocino national forest area in rugged terrain above 5,500’. Gene Penaflor had disappeared during a hunting trip the day before. He and his partner agreed to meet for lunch and the had split up to walk down two different ridges. Unfortunately, Gene never met his partner, and was reported missing later that day. Seven members of BAMRU/SMCSO responded to the call out, and met with Mendocino county search and rescue at 8:30am on Thursday the 26th. The search continued until Saturday, with 13 BAMRU/SMCSO members attending on Friday, and a total of 14 on Saturday.
The Searchers Prepare
Accessing the site was quite challenging: it required a multi-hour drive on dirt roads from Ukiah following the drive up from the bay area. Thankfully our hosts were incredibly helpful, which made the process substantially easier.

Making Maps
Once on scene BAMRU/SMCSO was honored to be able to help coordinate a significant part of the effort to locate Mr. Penaflor, including analyzing the map of the area and using information from Mr. Penaflor's hunting partner to plan the search assignments for the weekend. The terrain was very rugged but the search teams all worked together seamlessly to cover a very large area over the course of the four day search, we were very grateful for the incredible professionalism and hard work of all of the teams involved. With great sadness we were all forced to leave on Saturday night by an incoming bad weather front and a total absence of clues. We always hate leaving searches without any result, and so an early end to the search was very hard on all of the teams involved.

Thankfully, two weeks later on Saturday October 12th, a full 18 days after Gene Penaflor went missing, BAMRU/SMCSO was invited back to Mendocino to assist with a follow up search. Eight BAMRU/SMCSO members were able to attend, although none of us expected the result that followed. At 08:30am Gene Penaflor, still alive and sheltering near a creek not far from where he fell, was able to get the attention of a group of hunters passing near by. When the hunters found him, he reported that he had not been able to eat for three days and was incredibly weak. They were able to use their sweaters to make a stretcher and carry him to a nearby clearing. They also called 911, and we were able to use their GPS coordinates to locate them, and find Gene.

The members of BAMRU/SMCSO were privileged to be able to assist with the care and extrication of Mr. Penaflor. We are very grateful to the hunters who found him for their assistance in the hauling of the stretcher to the helicopter landing zone, where Mr. Penaflor could be air-lifted to Ukiah Valley Medical Center. We are also incredibly grateful to all of the other search teams involved, their professionalism and expertise was instrumental to the success of this recovery. Mr. Penaflor was treated for minor injuries and released to his family the next day.

Ready For the Rescue
It is truly amazing that Gene Penaflor was able to survive for so long alone in the wilderness. He reported that he was able to shoot squirrels and other small game, and that he cooked algae from the nearby stream to stay alive. To stay warm he insulated himself with packed leaves and grasses and made a small fire. When it rained or snowed he crawled under a large log to keep dry.

On Our Way!

Carrying Gene Penaflor to the Helicopter Landing Zone

Off to the Hospital
An important element of this story is that during the initial four day search Mr. Penaflor used his camp fire to burn wet leaves and produce smoke in an effort to signal the CHP helicopter that was flying overhead assisting with the search. He did this during two full days of the search, but the helicopter was unable to see him. Members of the public are often unaware of how incredibly difficult it is to see small objects - such as people or campfires - from a helicopter flying over an expansive and thickly forested landscape. In this case, the wind was strong enough to blow away most of the smoke, and the crew of the helicopter could see nothing.

We are incredibly pleased with the outcome of this search, and very happy that Mr. Penaflor is out of the hospital and doing well now. The members of BAMRU/SMCSO were truly privileged to be able to assist with the care and extrication of Mr. Penaflor, and we hope that other searches can all have such a happy outcome, although preferably with much less time in between the disappearance and the recovery.