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10/5/2012 9:25 PM
 

I attended the TCCC class presented by Joe, and organized by the Hills. 

As some of you know, I'm part cowboy/buckaroo.  I just returned from a week of gathering cattle in the timbered mountains south of Pendleton, OR.  While I was there one of the guys I was riding with had a bad wreck, ending up with his horse on top of him, horse's legs tangled in barbed wire fence, resulting in at least 10 breaks in his (the cowboy's) femur. I was right there when it went down and slicked off my horse to hold his horse down until we got things sorted out, thereby preventing further injury to man and horse.  We got him out of danger, and then my Leatherman was used to cut the barbed wire to free the horse (BTN and "Be Prepared").

Then I took charge of the first aid, especially treating for shock, etc until EMT's arrived about 2 and half hours later.  While I may not have done everything perfectly the knowledge I picked up in the class was very useful, and contributed greatly to being able to hand him off to the EMT's in pretty good shape, all things considered.

A big THANK YOU, guys!

 

 

 
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10/6/2012 12:19 PM
 

 Thanks for sharing Buck. Glad everything turned out OK. I am also really grateful for taking that class, and I hope the oppourtunity comes around again sometime.

 
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10/8/2012 5:51 AM
 

Buck,

Right on.  I'm super happy cool heads prevailed.  10 breaks?  Wow, he still have the leg?

 
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10/8/2012 10:40 AM
 

Buck I am glad it wasn't you and hope the man is OK! Always good to be of help ina situation like that and I am sure you put your knowledge to good use.

 
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10/8/2012 10:52 AM
 

Yes, he was told the leg should heal.  He was in surgery for 5 hours, and I was told they stopped counting breaks at 10.  The guy is about 50, and had told me earlier that he had very little cartilage left in between discs in his spine.  That makes me wonder if he might not have had osteopenia or osteoporosis.

Once we got him away from his horse's front feet (and the danger of having his head or chest rearranged) we did not move him.  The main question I had was whether to apply traction to the leg or not.  There was no external bleeding, and based on minimal swelling I was relatively confident there was very little internal bleeding.  Pain and cramping in his injured thigh was not getting much worse, although it was considerable (tough guy).  He maintained feeling and circulation in the foot (his boot was off).  About the only materials I had for splints were branches and saddle pads.  My biggest concern was that I might not be able to maintain constant traction until he got to an ER.  So I left the leg alone.

Fortunately, there were people around when it happened, we were near a road, and also, even more fortunately, near a meadow for the LifeFlight chopper to land.  It was actually far more likely to have happened while he was on his own in the timber, and we might still be looking for him. 

 

 
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10/8/2012 10:53 AM
 

Thanks for the good wishes.

 
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10/9/2012 11:46 AM
 

Buck W wrote
My biggest concern was that I might not be able to maintain constant traction until he got to an ER.  So I left the leg alone.


He maintained feeling and circulation in the foot (his boot was off).

Circulation checks!!!!   Right on!

 
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10/9/2012 11:59 AM
 

Buck W wrote

I...slicked off my horse to hold his horse down until we got things sorted out, thereby preventing further injury to man and horse.

Then I took charge of the first aid, especially treating for shock, etc until EMT's arrived about 2 and half hours later. 

Sounds pretty similar to what other people your age are doing....  Just another reminder of what a stud my dad is.  Circulation checks and all!!  :)  Great job Dad!

Joe - in my EMT class, they said outright that in a backcountry situation, you should never traction a femur fracture (mid-shaft or not) since it is so difficult to maintain (unless you have a dedicated traction device of course).  The thought being that if the femoral artery hasn't already been nicked, that the risk of applying traction and subsequently losing that traction increases the risk to the artery when it re-contracts.  Do you concur?

Also, one more question - when treating for shock, have you seen much (if any) benefit to putting people in the trendelenburg position in addition to body temperature managment and Oxygen (if available)?

Mark

 
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10/9/2012 12:55 PM
 

Right on Joe! It must feel good to see your teaching be put to good use.


We are fortunate in this matter that your conduct will be your marker and, thus, your reputation. The conduct of others on this forum has been, and will continue to be, their marker, and thus, their reputation. In the west, a person invests in one's reputation carefully. - 112Papa
 
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10/10/2012 11:13 AM
 

Mark,

As far as traction in the BC, I agree with your instructors.  It's time and resource consuming.  The resource being you.  The quads and hamstrings are strong too.  You may be pulling against the body's compensatory mechanism of 'splinting' via large muscle contration.

Trendelenburg, at least according to what I have read and been taught, is largely a waste of time.  Remember, the body will shunt blood during shock, so the blood return to the core you are hoping to accomplish via raised legs, is already happening really.  O2 is not going to be available to you in the woods.  Now hypothermia prevention, as the class attendees know, is near and dear to me.  Any significant trauma at least warrants it's consideration.

Evan,

It does.

 
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