Mounted search and rescue

["IRVIN LICHTENSTEIN" <ilichten1@verizon.net>]

It works with upper extremities because the patient can assist with the
lift.  In any case the patient has to get to saddle height if they are going
to sit in the saddle.  If the legs are intact and usable a leg up works
fine. We have even doubled with small enough victims but legs are a real
problem. Even a small horse puts its back 60 inches or so (15 hands) off the
ground.  Assuming you find a hole for the horse and a hill for the patient
you still have a lift for a patient that cannot bear weight on the leg. It
does get easier with practice but the overall medical risk is still high.

It is relatively easy to break a tibula or fibula, ankles don't really get
repaired so it may not matter, but it takes a reasonable amount of force to
break a femur or an upper arm/shoulder and often these are relatively high
velocity/energy impacts which can result in other damage which you cannot
see without imaging. Maybe I am too risk averse but I don't want some
malpractice lawyer coming after me or my team because our transport method
aggravated his client's injuries or perhaps killed him, and was not best
practice or even an accepted practice in the EMS community. 

Our trauma center demographics are little old ladies and men who break bones
easily and are usually on heart related medications at one end and vehicle
accidents on the other, although gunshots and other penetrating trauma is
gaining. 

The physically sound when they disappear tend to be not totally competent
but well developed physically, usually distraught because they are lost and
think they will be in trouble.  These are serious medical risks before we
find them, and aggravating their injuries or chronic conditions is not an
option.  Our basic questionnaire now specifically asks about Plavix and
other anti-coagulants, and heart related conditions.  If a fall or chest
impact is suspected damage to the aorta or other cardiac vessels is often
associated with this type of injury and bouncing around is not good. 

Our population is not a good candidate for in saddle evac when they are
healthy, and if they need a ride they aren't.  By the way, the last evac
from the state park I was involved with was a pleasure ride encounter with a
mother and her kid in a stroller and another on a bike.  The biker had a
scrapped knee and mommy was over 8 months gone with number three... so a
ranger did the job with a 4x4, a bike rack, and a slow drive to the parking
lot.  I started carrying an OB lit in my saddle bags and haven't had another
maternity incident since.

The decision to transport now, stabilize first, or treat on location is a
medical one and should be performed by qualified medical personnel.

Irv Lichtenstein 
     

-----Original Message-----
From: msar-riders-bounces@lists.ibiblio.org
[mailto:msar-riders-bounces@lists.ibiblio.org] On Behalf Of Jorene Downs
Sent: Sunday, July 19, 2009 8:00 PM
To: 'Mounted search and rescue'
Subject: Re: [MSAR] Transport via horse

Una is correct that there are numerous factors to consider, which is part of
the training. 

        -Jorene

-----Original Message-----
From: Una Smith

Jorene Downs wrote:
>The person with minor injury who doesn't need a helicopter or
>litter but shouldn't (or couldn't) hike any real distance is a
>good candidate for the saddle transport.

This assumes a whole lot about the situation and the subject. [...]

_______________________________________________
MSAR-Riders mailing list
MSAR-Riders@lists.ibiblio.org
http://lists.ibiblio.org/mailman/listinfo/msar-riders