PMS Is Your Friend and Other Things I Learned Taking a Wilderness First Aid Class: Info for Writers

(Photo credit: Wikipedia)

First of all - HOLY MOLY the list of horrible things that can go wrong far from help is long and daunting. What awesome plotting fodder. Things should never go easily for our heroes and heroines.

When faced with an emergency where professional help is anywhere from far away to non-existent, things just aren't looking good for your character. You can apply this information to a wilderness setting in your writing or to a natural disaster or terror activity in an urban center where resources have been stretched thin or destroyed. 

I'm using my crack acting skills. Can you feel my pain?

PMS is your friend -- no, honestly.

PMS stands for:

• Pulse
• Motor (ability to move)
• Sensory (Can you feel this?)

Your character needs to check these at the beginning and the end of the first aid application to make sure they didn't do something that would make the situation worse. What? Your character made it worse? Hmm. Interesting plot twist.

For other cool acronyms that your character would know if they have advanced (more than band-aids and "Stay calm, I've called 911") first-aid capabilities go HERE.

Do NOT use paracord to tourniquet a limb unless the pressure is dispersed by a wider fabric. Your character can do a lot of harm. Use something that is wider, at least a few inches wide. (more about paracord and survival HERE) 

Do NOT - put sticking-out bones back in the skin. Same with sticking-out organs, for that matter. Cover them with sterile water-soaked fabric. Remember this phrase -- Sticking out? Leave it out.

Do NOT - pull sticking-out objects that impaled the victim out of the victim. Your character should brace the object and keep it in place until the victim has medical support. Remember this phrase --If it's in - leave it in.

Being knotty is good. 

Knots are important and can be oh so helpful. (Go HERE for an article on knots) This class added to my knot repertoire, but I realize I need more. Did your character learn to tie knots as a Girl Scout? Guess what? They're easily forgotten. Your character needs to practice them to keep them handy. This can be written into the plot line with any little thing - even a perfectly tied up tomato plant in the garden that caught someone's attention could lead to a conversation about why they have this skill. 

• "I raced sailboats from the time I could walk." 
• "My family was big into camping, and I spent most of my youthful weekends around a campfire tying knots and listening to stories." 
• "I'm an Army Ranger, I dream knot sequences."

This is the new knot I learned -- a Prusik Knot:

Obsession Climbing

How cool is that?

• It can help someone climb out of a bad place. 
• It can keep someone who's going after and injured person from falling into a bad place. 
• It can tie up a tarp to protect the victim from heat stroke, or rain...
• It can be used to create a traction splint for a broken femur so the bone parts don't migrate out through the skin, sever the femoral artery and have your character bleed out. (yeah - gross.)

Below is a video of a traction splint. You're not going to have one of these in the wild. Your character will have to devise what she can from what she finds or happens to have carried in with her. Remember, the more trained your characters, the better they will equip themselves and the better they will function. You get Joe-everyday back in the woods for a first time hike or Suzy-running-for-her-life in the jungle, and you've got problems. (Yay!)

(Go HERE for an article about running away in the woods)

Matthew A

If your character is well trained, find information on how to properly apply first-aid with the right equipment, then figure out interesting new ways to make this happen. If you need some ideas look under the Saving Your Heroine tab to see this in action with tampons, condoms, cans of Coke, dental floss, and others.

Also, if your character knows what they're doing, they probably had plans in place for themselves and their children. In this HUG A TREE article, I included videos I made about helping a tracker to find you, giving notice to the rangers, and packing a basic hiking bag that even kids should carry. 

People are freaking heavy. 

Just sayin'                                                                                     In the movies when they throw the 200 pound man over the shoulder and are running and gunning their way out of a situation - well, that's theater; unless of course, your character is highly trained and in top physical condition.                                                                                                                                               Let's just say if you think that's how I'm getting you down the trail, it ain't gonna happen. If push comes to shove (and it may look like just that) PERHAPS I could devise a way to yank you by the foot down the trail. BUT doing something like that would put me at risk of injury. What? Now both of your characters are down for the count? tsk tsk tsk - what a plot twist!                                                                                                 

My point here was - people are heavy. At one stage of a rescue, my job was to shift -- NOT LIFT -- just shift a guy up the back board with the help of two other people. That was a hard earned two inches of movement. 

While we were encouraged to get the person to the rescue workers, if I'm alone, I'm going to try to get you safe and comfortable then I'll jog out and find help (marking my trail so we can find you). Seventy pounds is about my drag-your-butt-out-of-there limit. 

The Corporal's Corner

To actually move someone a short distance -- say up a hill and back down -- it takes eight.

• The victim is strapped in place and ties are put in such a way
  
  that the victim won't slide out the top or bottom - your rescuer forgot? WHOOPS!
• The head is protected with a blanket/jacket/whatever-is-handy if the victim had any spinal or head trauma.
• Three people stand on either side of the backboard/hastily-constructed carrier.
• Two more people stand at the head of the carrier system. 
• The top right person is lead (this rotates through each pass) They say, "Ready?" (waits for confirmation from two standing in front) "Pass."
• The carrier is moved up to the hands of the two in front. The two in the back run around the outside to now be front people. The leader is now the new person at the top on the victim's right hand side. Two people are in front and thus oh so very slowly is the victim passed fire-bucket-brigade-style up and down a hill. When on flat ground they can just grab hold and walk.
• Any extra people who are around can act as balancers,
  
  watchers of holes, and rotate in to give relief. 
• Everyone should be very quiet and focused so commands can be heard and heeded. What? Too much noise and they missed that there was a hole? The whole rescue team is now in a pile at the bottom of the hill? tsk tsk tsk. Now there's a plot twist (and an ankle twist. . .)

"Ready - Transfer" in action

I hope this was helpful as you plot your next great novel!

A HUGE thank you to CERT (for more information go HERE) and instructors Bill and Ray who were incredibly patient and knowledgeable. 

And as always, a big thank you ThrillWriters and readers for stopping by. Thank you, too, for your support. When you buy my books, you make it possible for me to continue to bring you helpful articles and keep ThrillWriting free and accessible to all.

What I Learned Playing a Victim at an Airplane Crash

That's me, the drowned rat, laying on the ground in a hangar at Richmond International Airport as a CERT member (more about that HERE), volunteering as a victim in a plane disaster.

That picture was taken three hours + into the exercise. I was wet to the bone and shaking uncontrollably. Hubby snapped the picture just before I laid down on my place in the triage black zone. 

I was dead. They ticked off the black box on my triage badge, and they gave me a time of death. 

Dead. 

But still incredibly cold.

Let me tell you how I got to that spot on the floor. 



The morning of the event was warm. I knew I'd be outside -- but outside and too warm is just as bad as outside and too cold, so I changed into some lighter pants and layers. As the rain started in earnest, and the temperatures dropped considerably, I grabbed hubby's coat from  the back of the van. Thank goodness. It was my saving grace. 

The clothes you put on your character/soon-to-be-victim are incredibly important to their outcome. 

FROM MY EXPERIENCE:

• Cotton absorbs and wicks fluids. That means even if your shoes have been water proofed, you will have puddles inside your shoes from your cotton socks.
• Wool is so much better - it wicks more slowly and even wet is warm
• Fleece - My coat was lined in fleece. My pants transferred water up my legs to my shirt and everything under my waterproof coat was thoroughly saturated/wringing wet (including my bras, ladies -- just sayin'). BUT Where I was covered with the fleece I was warm enough.
• While waterproof coats don't keep you dry underneath. What they do do is keep the wind off and help keep the fire foam at bay. 
• Leather absorbs water  but seemed (from talking to fellow victims) to be a warmer more comfortable choice than tennis shoes. The fire fighter said tennis shoes would probably have melted in the fire. Erp.
• Along those lines - according to USA Today travel tips - 

Stick to Natural Fabrics. Make sure your travel outfit is composed of natural fibers such as cotton, linen and wool. They are the some of the safest fabrics to have on in case of a fire. High heat melts synthetic fabrics such as nylon and polyester against your body, burning and blistering skin, while natural fibers turn to ash. Natural fabrics also keep you comfortable in normal flight situations, as these fabrics allow your skin to breathe, keeping you cool and comfortable in hot or humid conditions.

         Footwear -  Inappropriate footwear can pose major problems in the event of an evacuation. Open-toed or loose shoes such as flip-flops and other sandals can get caught on debris or wreckage or otherwise trip you up when you try to exit, and high heels can puncture escape slides. If you lose your shoes trying to escape the plane, you then are left with unprotected feet in an area that could be filled with sharp metal and other dangerous wreckage debris. Flat shoes or shoes with a low flat heel are ideal. Also make sure that the shoes you wear on the plane fit well, allowing you to be agile in an escape situation.

After our IDs were checked and we were bussed to the emergency site, we went through the procedures to find out our designated injury and stand in line to get moulaged (more about that HERE). 

This is what my assignment said:

Yup. My leg had been amputated in the accident. I went up for moulage to get in character. They held up the white face paint to make me "very pale" as per my designation and the makeup guy decided I was pale enough, he couldn't get me much paler. Nice.

They handed me my fake wound and sent me outside to the airplane.

Look at the picture just behind my head; there is a black square on the tarmac. That was a propane mat that they lit up as the fire crew raced to the scene. 

The fire fighters hosed the area down with water first. LOTS of water. LOTS and LOTS and LOTS of water. Then came the foam that burst from the ends of the hoses like a blizzard and suddenly the plane and everything around it looked like it was covered knee deep in snow.

A handful of us designated victims waded out to get on the plane. 

HOLY MOLY. 

The plane was extremely small inside - it was only used for practice; it was much narrower than you would think. It was burned out and smelled thickly of smoke. When they shut the door, it was very dark. Imagine if you will, the injured splayed out all over the place, moaning, screaming, begging. You couldn't see and all you could smell was fire.

Yeah, it was a little much. 

I like to think of myself as a brave(ish) woman  - but I just couldn't. This scene lit all of my "flee! run!" hormones up. I had to get out of there. Even though this was a training scenario, my adrenaline spiked, and I was sweating and panicked. It was hard to breathe that air. I can't imagine the horror of just the trapped feeling in a real emergency. 

I did what any smart heroine would do given the chance. I stood up, opened the back door and called for a ladder. The fire fighter chuckled and said, "Yeah, it can feel pretty intense in there." 

Yup. Pretty intense.

Out I went to the tarmac. I lay on the ground with my foot tucked up under my hip and my fake amputation stump Velcro-ed in place. It was raining pretty steadily, and there was already a lake on the tarmac from the water hoses and the foam. I was glad my tag said I was sitting up - others weren't so lucky.

Getting the very last victims processed - photo from CERT FB page

So here's what I learned. 

• There are a lot of people on a plane and so there are a lot of people who need help. You'll be laying there for a while - it's not going to go fast.
• It's chaotic 
• It's a carnival for the senses - the sights, sounds, smells, and sensations.
• People are odd ducks. And personalities seem to be amplified in these scenarios.
• It was 67 degrees - and it was FREEZING freaking cold. I can't imagine what it would be like in the winter in the rain/snow/and lower temperatures. The tarmac is exponentially the temperature of the day. (I did a bomb scenario at the hospital last summer, and we were out on the black surface with the temperatures in the high 80s. People weren't faring well - their skin was getting burned and blistering where they lay against the ground.)
• The foam that they sprayed was odd. Very odd. It didn't go away like soap bubbles in your kitchen sink. It floats on top of the water and sticks to you - but doesn't pop right away. I'm still not sure how to get it out of my hair. I found the picture below on Wikipedia so you could see what I'm talking about.

Firefighters sprayed foam on structures in the Mammoth Hot Springs complex on September 10, 1988. (Photo credit: Wikipedia)

• The backboards that they use to transfer you from one place to another are pretty narrow, and it feels like you're going to slide off. (I very much appreciated that the firefighters didn't grunt when they hefted me up.)The straps don't feel like they could stop you from falling - but that's a false sense. When I actually needed to sit up, my arms were secured down -- well, securely. Very securely.
• One of my tasks was to only speak French to the rescuers. That was pretty funny. 
• Each of the rescuers did the speaking louder and slower bit. But I stuck to it and only talked about "I can't find my husband; can you help me find my husband? I can't find my leg; can you help me find my leg?" and so forth. 
• One guy tried to mime "lay down", but it came off as one of those Italian gestures for "up yours." Maybe a few more miming classes for the new recruits. . .  
• One guy said in a very southern drawl, "Je ne parle pas francais, he he." (I don't speak French, he he) Then every few seconds, he'd look at me and ask, "Bien? (well?) he he." He was trying and obviously self-conscious - which was pretty sweet and much appreciated.
• They put ribbons on our arms (or ankles) and fill out your triage tag:
  

A system that has been used in mass casualty situations is an example of advanced triage implemented by nurses or other skilled personnel. This advanced triage system involves a color-coding scheme using red, yellow, green, white, and black tags:

• Red tags - (immediate) are used to label those who cannot survive without immediate treatment but who have a chance of survival.

• Yellow tags - (observation) for those who require observation (and possible later re-triage). Their condition is stable for the moment and, they are not in immediate danger of death. These victims will still need hospital care and would be treated immediately under normal circumstances.

• Green tags - (wait) are reserved for the "walking wounded" who will need medical care at some point, after more critical injuries have been treated.

• White tags - (dismiss) are given to those with minor injuries for whom a doctor's care is not required.

• Black tags - (expectant) are used for the deceased and for those whose injuries are so extensive that they will not be able to survive given the care that is available.

• resource
• As they got our colored tags on us, they got the ambulatory folks to walk inside. The rest of us were put on back boards or these carriers that looked like cots on very short legs. The fabric was a black mesh. They looked very comfortable and they kept those victims up out of the water stream. They moved us to stage for the ambulances. The red got the rescue squads first. So moving us was sort of like putting us in the taxi queue to wait our turn for the next rescue squad as they lined up to take their patient to the designated trauma hospitals.
• Blankets didn't show up until the end of the exercise when actors started having ill-effects from the cold and wet. One lady was hypothermic. I imagined that blankets would slow down assessments, but at the same time, shock can be lethal. I suppose how it is handled at an actual emergency would depend on the actual emergency.

• It was incredibly soothing on the scene to have an emergency worker talking to me. Calm friendly faces saying they are going to help really means something. At one point, a firefighter took off his coat and laid it over me to keep me warm. He had to grab it back all to soon when someone else was in worse shape than I was. But that he put himself in the wet weather for my comfort was meaningful to me, and I thanked him later.  That the rescuer attempted to speak French when he obviously couldn't was meaningful. The cop who figured out that I was miming and asking for my husband, and told me they would take good care of him, and we would be together soon, while he squeezed my thigh to keep me from bleeding out? Meaningful. Small gestures made by your heroes will make vivid memories (good or bad is up to you) for your character. And I would say from a psych POV make a big difference in the victim's recovery as well.

 A huge thank you to the professionals who keep us safe!

And as always, a big thank you ThrillWriters and readers for stopping by. Thank you, too, for your support. When you buy my books, you make it possible for me to continue to bring you helpful articles and keep ThrillWriting free and accessible to all.

What I learned by Playing a Victim in a Live Shooter Training - Info for Writers

Fake blood coagulates like real blood 

It's not how every girl likes to spend her Saturdays; but for me as a citizen and as a writer, it was awesome! I was a volunteer victim at an army base. The responders there were training trainers from other states in how to set up live shooter response courses.

How did I get involved?

I'm a member of CERT and a member of the Medical Reserve Corps (for mental health). To read more about these learning opportunities, read THIS ARTICLE. When a call goes out for volunteers, I do my best to show up. As a matter of fact, I'm scheduled to be in a plane crash in April. Stay tuned for more about that.

Why is it important to have live victims involved?

To be clear there were live victims and there were manikin victims. The manikin victims are created to allow tracheotomies and other invasive procedures. They are also severely wounded -  bi-amputations, perforations of the cavity with intestines dangling out. They have robotic aspects to mimic (via radio command) breathing, gurgling, screaming etc. But these are still plastic. 

It is important to remember that responders are human beings. When human beings are faced with a dangerous situation their bodies respond, like all bodies do, with an increase in adrenaline (among other hormones). Adrenaline messes with your body. In a situation like the one we presented, one would expect such things as:

• clumsiness and loss of fine motor capability
• tunnel vision
• distortions of time
• distortions of sound
• difficulty thinking and processing.

What researches have found is that newer experiences have a more profound impact and that an individual can handle the situation better if they've dealt with it before.

Hence,  we volunteers are moulaged (more about that in a second) to make it look like we've sustained a wound, and we act our part. We are in shock. We scream. We fight. We pass out. Basically, it's our job to present as if this were really happening so that it's not new to responders when they show up at a real-deal.

For this training, we were mimicking a live shooter event inside a dorm.

My assignment was to be stabbed (or shot) in the throat - the responder wouldn't know, and I couldn't tell them. 
LET ME BE CLEAR - I was not actually injured. I was never in any danger.

Getting into character - moulage.

Moulage is a word that means making fake wounds for responder training. There's an art to it. This is how they made my neck wound.

1. They came around and smeared spirit gum on the areas of our wounds (there were 18 of us 9 men and 9 women. The men were given the abdominal wounds. 8 of the women had arm and leg wounds. I had a neck wound.)
2. They next came around with liquid latex that they smeared on and let set.
3. The third pass was with a small spatula that crafted the latex into the wound with "raised flesh" around the periphery.
4. Below is a picture of stage 4 
   
   where they painted on theatrical makeup in red and blue to form the base of the wound.
5. The next step was to smear on an unctuous gel that gave the wound depth.
   
   it didn't look at all like a surface scratch but a deep wound.
6. They used a spatula to apply liquid blood that ran freaking everywhere and coagulated in my hair.
   

Getting the heck out of there. Here are some writing points that I picked up to share with you:

• They manipulated my limbs with my clothing. That is, they gathered and pulled my legs and feet with the cuffs of my pants. My arms were moved by the sleeves of my shirt. When they did this the cloth from my clothing supported my whole limb rather than say dangling from and ankle or a wrist.
• When they were moving my body into a straight line, they used the waist band of my pants to get a grip on my center. Again, this felt more stable as the cloth supported my hips rather than putting hands on either side and lifting. It meant that I would not slip out of their grip
• While being manipulated by my clothing, I wished my clothing choice had been a little tighter. My pants were scooching down my hips.
• They used a carrier that was basically a piece of cloth with handles. This allowed them to get me around corners with a great deal more ease than a flat solid board.
• To place me on the carrier, they rolled me in one direction - this was a two person deal, and they used my clothes to manipulate me. They then shoved the cloth under me and rolled me back. Lastly, they adjusted me onto the middle. 
• While they were rolling me, they were also searching my body for any other wounds. They were especially looking for an exit wound. Not finding an exit wound seemed to ramp their concern and upped my level of care. 
• There are 4 levels of triage (rudiments of the stages to give you a flavor). These are indicated by tying a piece of colored plastic ribbon on the wrist (if there is a wrist). I was red tagged.
• black = dead or beyond hope
• red = life threatening first to get response
• yellow = wounded but stable and needing assistance getting out.
• green = wounded but ambulatory
• I have hair that falls below my shoulders. When they placed me on the carrier my hair fell over the end, and it got stepped on. Who knew that could happen? In the grand scheme of things, it was so minor.
• It took 4 people to get me down the three flights of stairs: one at my head, one at my feet, and one on either side of me. They began with just 2 people one at the top and one at the bottom of the stretcher. Quickly, others joined in to get me out -- I was gurgling and needed a tracheotomy.
• On the stairs, the angle to get me down meant that I was sliding out the bottom. They had to both lift my weight and push the sides in to keep me from sliding down the fabric. The guy at the bottom had the biggest trouble. Well, now that I think of it, the guy at the top wasn't so easy either. The guy who lifted my head had to lift me high enough that I wasn't clunking my head down the stairs but not so much that my airway was cut off or that my body slid toward my feet. My head never clunked, during either of the two scenarios they ran.
• When we were not going down the stairs, they slid me down the hall rather than lift. This saved their strength for those three long flights.

Me and two of my CERT pals, catching our breath and regrouping before we went back in the dorm and let the heroes (both males and females) save us for a second time. Mel, on the right, had a sucking chest wound so he was red tagged too. He seemed to be handling the discomfort pretty well. (Big thank you to Mel for sharing his photos) And Anna had a severed artery so she was passed out the whole time.

And that was my adventure - bet it shows up somewhere in my next plot.

Find similar articles under the tab at the top of this page marked "TO THE RESCUE."

As always, a big thank you ThrillWriters and readers for stopping by. Thank you, too, for your support. When you buy my books, you make it possible for me to continue to bring you helpful articles and keep ThrillWriting free and accessible to all.