Student Stories

From Holly - LWAFA grad March 2006

Remember when you said you wanted some ´gory stories´....... well!

Having finished the WMI course just over 2 weeks ago, I have one..... Ive decided I don't really like seeing people hurt (funnily enough!). I flew to Guatemala on Wednesday 22.3.2006 and took my first two Spanish classes Thursday and Friday, beginning the tough 3 weeks today (Monday 27-3). Unfortunately this was not soon enough to use my training to its full capacity!

And the story begins...

I took a private shuttle (mini bus) with 11 tourists, on Sunday to Chichicastenango (Provence 2 hours out of Antigua, Guatemala). After discovering this bus had seat belts I gladly used one on the trip there; however, people thought it was a little unnecessary (not many buses actually have seat belts here!) So the day was great, spent time learning about the Myan people, their Gods and their customs. It was on the return journey where the trouble... On the trip there, one fold-out seat in the bus was faulty, so for the return trip, I offered to sit there. To fix the seat, they jammed the belt under the fixture!!! So no belt for me...

About 1 hour out of Chichicanstenango, on the return trip, we were on a three lane freeway and a car was passing us (two lanes our way, one going to Chichi). As we neared a bend, on top of a hill, a car on the wrong side of the road coming towards us hit the car passing us head on, which then swerved into a car in front of our mini bus. ´Grande Accidente´!!! Luckily someone in our bus said ´we're going to hit´so I braced myself momentarily in the stairwell of the bus!

After the crash, I checked the people in our bus (luckily no one hit us again from behind) and we were all relatively OK. The three other cars however, not so good! We emptied the bus because the smell of petrol was everywhere and told the occupants to get clear of the crash (there were other cars everywhere screeching to a halt!).

An American fella from my bus made it to the other car and somewhere in there I grabbed the resus mask WMI sold me, ready and in my pocket (thanks heaps!) - OOPS no gloves though! The American pulled the door off the passenger's side and the driver was already out. In looking in the other cars, I saw no driver and a guy with a small gash on his head, walking to the first car.

With the smell of petrol so strong and 100´s of local people coming from everywhere to watch, the American guy checked the passengers mouth and breathing. Seeing that his leg was broken but worried about the petrol, with the help of some locals, they lifted him out of the car and off to the side of the road. When i got there, I took control! The American did not know what to do now... and I was the most experienced person stepping forward, there... but without much knowledge of Spanish, it was really difficult. The guy was going into shock (pale and cool) but not making a sound. I took control of his head and checked his ABC´s. I told the American to hold the head and did a blood sweep.

His leg appeared snapped in at least 2 places and I was about to survey the scene and perhaps attempt to cut his jeans off the leg when I heard sirens in the distance (I couldn't ask if an ambulance service even existed, let alone, had been called!). By that time the ambulance arrived (very rapid arrival, about 6 minutes from the time of the crash, I don't know how), the driver of the other car (I am told) was unconscious and they took him immediately, giving him Oxygen. There were 100´s of people (locals) standing around, in the petrol, blocking the view of the scene, watching but not helping at all. One guy was taking video of the leg!

The ambulance made it to us and put a really bad splint on the guys leg, just moving the leg and splint as they needed to, putting it on wrong the first time! They then brought out a backboard and with the help of some locals, pulled the guy onto the board not worried about his spine at all. When moved the guy onto the stretcher, we had to let go of the guys head but the ambulance officers didn't seem concerned at all with his spine. He left in the ambulance with a bad splint and not strapped down at all, moving his head and looking around in the back of the ambulance!!!!

The driver with the gash in his head did not want to go to hospital and without being able to effectively communicate, I insisted to my American counterpart that we check his breathing, chest and back. We gave him a check but he seemed more concerned with his car than anything else (his side, drivers side, had an airbag). He had pressure on his head with a spare t'shirt. There were so many people, so when the police arrived, they were not concerned with what happened, only getting the cars off the freeway so... the locals picked them up and moved them!

We continued to check others involved in the crash after the ambulance had left (our driver) but all seemed OK. We were on the side of the road for about 3 hours before 3 other vehicles could fit in the 11 of us (our bus engine was totaled). After leaving Chichi at 2pm, I made it back to Antigua by 6pm for a 2 hour trip!!!! What a great forth day of my trip!

So, I hope you enjoyed the story. Just to let you know, I felt calm in the situation (to my surprise) up to the point of the language barrier. I keep replaying my reactions and decisions in my head, knowing I will kick myself for ever (but learn from) having not found the second driver unconscious earlier. With the 100´s people everywhere, standing so close in our way, and not being able to ask is any one else hurt, it was really difficult...

So I would like to say a HUGE thank you to WMI, yourself and Tyson for the fabulous training. It was fantastic to see that the injuries didn't phase me, and i remembered what to do. I will defiantly learn from this experience and take that with me into Costa Rica in three weeks time. I just wish the ambulance officers in Guatemala could have WMI training, they need something desperately to understand the importance of moving a patient correctly and obviously splinting.



From Jacky - WFR grad Aug 2004

Arriving in Vanuatu was a great start to an awesome 1 ½ year experience.. ….. I worked as a team leader on the Youth Challenge International Vanuatu (YCI) program. The groups consisted of ten to twelve volunteers coming from local Ni Vanuatu, Australia and Canada. The aim of the program is youth development through community development. This also includes a local Ni Vanuatu Skills Development program that enables further employment opportunities for local youth in Vanuatu where there is a high rate of unemployment. The projects are based on the outer islands of Vanuatu. It involves working in groups on community projects, and the cross-cultural exchange is always a highlight. The international team leaders work with a Ni Vanuatu counterpart. In addition the volunteers work closely with local youth counterparts in the villages.

Only a few months ago I was sitting in a remote island village with a group of YCI volunteers. It was our second last night before finishing the 1 ½ month project. The volunteers and their local village counterparts had just completed running a Youth Skills Summit with the youth in the community. We had some research notes to finish writing up on that last night so it was late.

All of a sudden we heard a loud bang near the door. In a state of shock the volunteers urged me to turn around. I turned to see one of the local Ni Vanuatu volunteers convulsing. He was hitting the door frame and side of the house with his body. Blood ran from Hungai’s head as one of the local village counterparts tried to keep him stable. I immediately grabbed a tarp and asked one of the other volunteers to grab a first aid kit. I sent a distressed group member to go and get Matthew my local counterpart team leader Outside I put the tarp down spoke calmly to John. I told him to breathe in and out and relax. I asked Sophie a third volunteer on the scene to put her hand on his head and sit down behind his back to ensure back support As the convulsing reduced, I put a pad to his head to stop the bleed. Sasha another volunteer helped out too getting dressings and saline solution.

Whilst we held diffuse pressure to the wound, Sasha checked for other injuries. I asked John if he remembered what had happened… Hungai said he had drunk 13 shells of kava, sitting outside with a few friends chatting. Standing up too quickly, he lost control of his body, and fell down hitting his head on a rock. When I looked at the wound it was obvious he needed stitches. There was a deep split above his eyebrow, I cleaned it with clean water through a syringe, and covered the wound. The process continued and two community members rushed down to where he was. They whacked leaves on his back; this was apparently the traditional way of reducing the effects of kava. I could speak Bislama, the national Vanuatu language, fluently so I asked them to stop doing this as it was making the situation worse as Hungai was scared of what was going on.

Once John was stable, another group member came out of the house, Georgia. She told me she wasn’t feeling well, and suddenly fainted unconscious behind John. I then had to ask another local Ni Vanuatu volunteer, (who had 2 days training with WMI in Vanuatu) to speak with Georgia and reassure her, put her in the recovery position, check for breathing and pulse and ask her questions. All was ok after 45 seconds she regained consciousness and vomited. At the same time after asking John many questions, I cleared him of having any back injuries with procedures taught by WMI, and Sophie took her hand off his head.

The group looked after each other well and Matthew finally arrived at the house. I explained to Matthew, the local team leader, that Sasha and I were in a rush to find the local nurse. Matthew stayed with John and made sure he was ok. In pouring rain, through ankle deep mud, up the mountain, Sasha and I rushed along disorientated with all the paths. Together in the dark with our little head torches guiding the way we arrived at the next village where the aid post was. There we finally found the nurse. After knocking very loudly on his front door we found that he had drank some Kava too, not what we wanted to hear. We knew that there wasn’t another option, and Greg the nurse seemed perfectly stable. We told him the ordeal of the night. He went to get the medical supplies and tools from the aid post that was a little further up the hill. We heard a big crash inside the aid post and looked at each other stunned and worried. Greg came out smiling with the medical supplies.

The three of us arrived safely at the volunteer house after sliding down the hill in mud and looking out for each other. We lay John flat out on a thermarest on a coral floor. I assisted the nurse while he put the stitches in his eyebrow without much anesthetic. It was a painful process to watch. I realised just how lucky we were to have access to a nurse on such a remote island. After the treatment was completed, John rested. The sun was close to rising and we all sat around to have a few coffees. We all reflected while the rest of the group was still asleep, and had a good laugh about the intensity of everything happening all at once.
The 10day WMI course allowed me to deal with the situation, at ease, with confidence together with a good knowledge base.



From Mike - WFA4 Graduate May 05

Dear WMI Crew -

I attended a school trip to Central Australia (12 days). We (I) had a raft of first aid situations contend with. Many students fell victim to dehydration – leading to headaches and the usual complaints. By the end of the trip (as it was winter) many kids were feeling the affects of the cold nights, and had begun showing signs of dizziness, headaches, high temps, sore eyes etc. Many ended up with common colds as a result of not preparing and bringing suitable clothing etc.

On one occasion, as a boy who refused treatment, proper food, water and Paracetamol – he collapsed and fainted on me; resulting in hospitalization and a very strong course of antibiotics (he had a throat infection of sorts). Followed by a good kick in the bum...from me.

I also dealt with a diabetic who ‘hypoed’. As well as strapping more ankles than l care to remember after we had climbed Uluru, and dealing with the usual bites and stings you get in a wilderness setting.

One thing that surprised me was that when the diabetic kid went down, as well as the boy who fainted, I didn’t panic, but rather went into the ‘systems’ we had been taught. Checking airways, breathing, etc etc. Despite other teachers and staff screaming and panicking around me. I put this down to the scenarios and the quality of the instruction received whilst on your course. I was surprised how well l remembered what to do and how calm I remained.



From Holly, WFR graduate 2004

I was enjoying a day off down at the beach with mates, went swimming in the way-too-cold water so went to the cafe across the road to warm up. Ordered coffee, saw some commotion in the corner, noticed an old lady lying on the floor and a bunch of people standing around looking helpless.

Went over to offer help though there were people there who seemed like they knew what they were doing, so we backed off. After they fussed around for a minute or two, they looked around the cafe and asked if anyone knew CPR!

So 4 of us (more of your ex-students!) rotated around doing compressions for about the next 1/2 hour. The people used our mobile phone to call an ambulance. Soon after, the ambulance turned up (one with a defibrillator I guessed) they put 5 doses of adrenaline and 2 of Atropine(?) into her arm. Eventually her son turned up and said it was OK to stop.

Anyway, it was just like you taught us - I felt ribs break. The Ambo's were glad for our assistance, I noticed some weird things like feeling the air from the bag valve mask going into her lungs under my hands, and right at the start her hands were purple/blue.

Anyways, turns out she was 86, and had a pre-existing condition (pulmonary edema). It was a good experience, glad I was there & glad I now know what its like for real!

Thanks again for running such an awesome course!

Holly




From anon, WFR grad 2002 leading a group in India:

On the second day of class, I was woken up by the camp manager and asked to check on a student. The student, Karen, was sitting outside of my room. Karen seemed to be very confused and blood was coming out of her mouth. Dirt was caked on her back and head, there we scrapes on her elbows. Karen was verbally responsive with a dazed look on her face. Through a quick physical assessment she did not seem to have any obvious serious injuries or any serious bleeding. The three other students / peers that were present denied any knowledge of Karen''s accident nor did they know about her medical history. During the next 10 minutes Karen became alert and oriented to "person" and "place". She admitted to having a history of "fits" and that she forgot to take her medication in the morning. During the next 10 minutes she described her history of fits (seizures). According to Karen, she has had seizures for the past 2 years and her doctor told her it was due to her difficulty sleeping. Karen said that she was tired and requested that she be allowed to rest. We attended to her scrapes and then allowed her to get some rest.

I checked on Karen around lunch time. She had rested, showered and appeared to be very clear about her situation. We spoke again about her seizure. She assured me that she wanted to stay at the camp and that she would not have another seizure if she took her medication. Given her clear mental state, understanding of her condition and the cultural situation, I felt that it was reasonable for her to stay in the course. She did describe being sore and that her tongue was badly chewed and wanted to continue resting. Karen asked if she could rest in the afternoon and attend class in the morning. I agreed. Back at class I asked her friends to check on her and let me know if her condition changed.

That night, we were woken up by a student who asked us to "come quick". They said that Karen had collapsed in the next room and they wanted us to attend to her condition. We were both thinking that it was probably another seizure incident. Within 10 seconds we found Karen face up on the tile floor of the bed room. Students reported that she was standing up and all of a sudden she collapsed. They said that they lowered her to the floor and that she did not hit any objects on his way down.

Karen was positioned with her chin to her chest. We assessed her airway and determined that she was not breathing. We rolled Karen on her side to allow fluid to come from her mouth and to give better access to her airway...........Karen was still not breathing. We also assessed her pulse, Karen did not have a pulse. Thinking we were not properly assessing his pulse, we searched for around 15 to 20 seconds when spontaneously she gasped for a breath, her pulse resumed at the same time. Expecting Karen to be post-ictal for a few minutes we monitored her airway and pulse and reassured her that we were there to help. Instead of quietly coming up the AVPU scale, as she had done before, Karen was breathing violently, gasping for a breath while completely unresponsive. After a couple minutes with no change, we decided that an ambulance was necessary (these are very rare in India). We asked one of the lead students to call for an ambulance. At this point we monitored and recorded Karen''s vitals, we kept her airway clear. Our first set of vitals started at 9:25......we believe that her seizure started at 9:20pm.

Time 9:25
LOC Unresponsive
RR 22 gasping and labored
HR 110 Strong / Reg
SCTM P/W/D
Pupils PERRL
BP 170/P

At 9:32pm, while Karen was still unresponsive, she began to have another seizure. Karen's posture was stiff and violent. She was still in recovery position and unresponsive but her body had gone completely stiff with jagged / rigid movements. She was still gasping for a breath. We were convinced that getting Karen to the hospital as soon as possible would be our best option. There were no options for supplemental oxygen at the camp. Karen continued her rigid and violent posture for almost 45 minutes......during this time we took multiple sets of vitals, and began the transport in the back of a taxi as the ambulance was a no-show. It's unclear what happened to the ambulance, some reports are that an ambulance was not available and other reports are that at taxi was called instead. Given that the taxi was our best option we decided to transport 5 of us in the small taxi. We put the rigid patient across the back seat, one of us straddled her while the other got in the front seat and faced backwards...the driver and Karen's boss were also in the front seat. Karen was fighting us, while we were struggling to restrain her and keep her airway clear...it was a very difficult taxi ride. At one point we did not feel comfortable about the high speed driving that the driver was doing, we asked the driver to slow down. This is a land where dogs, cows, motorcycles, and people all use the same narrow road to conduct their business. While attending to Karen''s condition we had little knowledge of what was going on outside of the vehicle.

During our multiple sets of vitals the most noticeable change was her respirations, pupils and skin...

Multiple sets over 45 minutes
LOC unresponsive,
Pulse 110 W/R
RR 38 and labored and gasping
BP 170/P
Pupils unresponsive to bright light and fixed
Skin-pale (cyanotic around lips)/cold/wet

During transport Karen came up to verbally responsive for about 5 minutes. She could squeeze my fingers after considerable prodding. This was the most response we saw from her throughout the night. We arrived at the first hospital and were denied access (not exactly sure why). After 10 more minutes down the road we were at another hospital. Karen stood to get out of the car, dazed and confused, and had to be forcibly pushed into the waiting wheelchair. She was still only verbally responsive. her stiff and rigid posture did not fit well in the wheelchair. Karen was in a daze and soon lapsed into another seizure after entering the hospital. Her muscle tone was again rigid, and any movements were powerful and jagged. At this point Karen was assessed by the "triage nurse" and given an injection of Dilantin. Soon thereafter a team of doctors came to get a history from us, then telephoned both witnesses of her first seizure that night, and her partner for a thorough history. All this time we aided the doctors and nurses in keeping Karen restrained so as to not disturb the IV access that had been established. We communicated our concern as to Karen's apparent hypoxic state for such an extended time leading to some brain tissue death, a concern that was echoed by the doctors attending. Upon our leaving the hospital at 1:45 am, a CT scan was scheduled for Karen. It is unbelievable how well your course prepared me for this situation, complicated by being in a foreign country with different emergency response. Many thanks....



Graduates email your first-aid stories to wmi@wmi.net.au