Wilderness Advanced First Aid Course

It's been nearly two weeks since I've last posted, mainly because it's been pretty hectic here. I'm going to split the time since my last post, the first talking about my time in Pucón and the second about the rest of the time. So here goes.

Pucón, with the volcano smoking away in the background.

From Tuesday 25th to Saturday 29th I was based in Pucón in the south of Chile, I decided to take an Advanced Wilderness First Aid course to better prepare me for various kayaking trips I'm planning here and to be able to work in Pucón over the summer. The course, WAFA for short, is a 40hr course designed for outdoor instructors to give them an advanced level of first aid training to be able to operate in remote areas safely. The main difference between wilderness and urban first aid is that in urban first aid you are likely to be supported by paramedics or clinical practitioners within an hour or two, whereas in the wilderness environment first-aiders may have to wait anywhere from hours to days till they get help and may have to evacuate patients themselves. For this reason, the course is designed to give participants more training in detailed patient assessment, prolonged patient care and evacuation. The reality in Chile is that in some places, help is quite far away and calling mountain rescue or a helicopter isn't free, in fact the minimum amount a patient will pay for helicopter support is over £1,500 so the guides out here often have to evacuate casualties themselves.

The idea is to use what you have and improvise

I travelled down to Pucón on Tuesday evening and we started at 9am on Wednesday, I was pleased to find out that all 18 of the participants were raft guides because this meant the course would be very specific to the whitewater environment. The majority of the first two days was spent in the classroom studying the theoretical side of physiology and medical emergencies as well as looking at in-depth primary and secondary surveys. We spent 9am-9pm on day 1 and 9am-5pm on day 2 on this stuff, and although boring, it's pretty vital stuff. Luckily I'd done first aid courses before and was familiar with most of the content so it wasn't too hard. At around 5pm on day 2 we started to look at some practical components of the course. We looked at immobilising spinal injuries, fractures and reducing dislocations. Something that I found very useful about the instructor's approach to the course was that all the material we used to immobilise these injuries was equipment we carry on the river. There's no point me learning to use a complicated leg splint when it won't fit in the back of my kayak, instead we used paddles, slings, rope and rollmats to complete the tasks. We also learnt how to build improvised stretchers which is something that would come in handy for practical scenarios across the next few days.

On day 3 we spent the morning looking at altitude sickness, shock and evacuation plans in the classroom, followed by a practical session on CPR and the use of airway adjuncts and defibrillators, safe to say that the CPR mannequins were the most stylish I've seen. After lunch we worked for a few hours on spinal cases. This was a complex topic because we had to learn how to immobilise patients, safely roll and lift patients, secure them to improvised backboards and evaluating the spinal column to rule out spinal injuries before evacuation. We then spent until 8pm practising with various scenarios, basically one of the participants being given a role and a medical history and the rest of us turning up to deal with what we found, we were confronted with around 20 different cases of medical cases, trauma and environmental cases. I really enjoyed the hands on stuff and found it kind of like problem-solving to figure out what was wrong with the patient in some cases, treat the issue and form an evacuation plan. Some of these scenarios also involved building the stretchers to evacuate the patient and moving the patients through tricky terrain.

Teamwork was imperative

Not sure how many babies I'll take kayaking, but good practice all the same

Using defibs and airway adjuncts

The coolest mannequins in Chile

Night rescue was challenging

At 8pm we were told to go and grab dinner and meet back at the centre at 9pm, mysterious... At 9pm we were told that the 18 of us were going to take part in a scenario, myself leading one team of 9 and another guy leading the other half. We spent half an hour gathering and organising our equipment and suddenly received a call on the emergency phone from a distressed and incoherent guy telling us he and a friend needed help on the beach, we couldn't get any more information from him. We headed off the beach and split up, my team went right and the other team left. The unfortunate thing was that the beach is very long, being pitch black we had to thoroughly search the beach and the forest that lined it. After 30mins of searching my team found the two casualties, a kilometre from the entry point. Both casualties we on the waters edge and soaked through, supposedly kayakers that had entered into difficulties. As team leader I quickly called for the other team's support and we evaluated the patients. One patient had an open head wound, penetration wound to the chest, no feeling in his legs (suggesting spinal injuries) and severe hypothermia, the other was also very cold and wet, had an open fracture to the leg and was in shock. The instructors were the scenario 'gods' and provided the information on things like pulse, temperature etc when we asked for it, I must say the situation was very realistic and since it was dark it was made even more realistic. We stabilised both patients with our improvised kayaking/rafting equipment and began the evacuation. Unfortunately for us it wasn't going to be that easy, both patients vomited multiple times (tricky to deal with when they're strapped on their backs to spine boards) and stopped breathing more times than I can count. In total, both teams did around 35mins of CPR in the freezing cold. We finally managed to reach the evacuation point and do a patient handover and debrief, at 12pm over 3hrs later... It was great to be able to practise a serious situation and we were told that the next day would hold even more scenarios, this time for our evaluations.

The final day was almost all practical based, it was also evaluation day and we had to do our practical and written exams. My practical scenario was hard to believe when I reached the scene. The instructors had put a victim underneath a bus, face down and screaming in pain. There was almost no space under the bus and rolling the victim over and extracting here, all whilst trying to keep her spine immobilised was a difficult task. I then had to make an immediate treatment plan for her multiple fractures and bleeding, and then give my plan for a three-hour evacuation, all within 10mins (luckily we didn't have to carry out the 3hr evac!). We also went to the lake, where I was asked to teach a lifeguarding lesson to the course, sharing various towing strategies in the water and we did our CPR and defib evaluation on the beach. Note to self: If you try to do 10mins of CPR in shorts, on a beach full of vicious volcanic rocks, your knees will start to bleed... The final thing we learnt that day was how to inject drugs subcutaneously, which mean we all had to inject somebody else as well as ourselves. The needles were only small but I have to admit that it was a weird sensation sticking a needle into yourself, you'll all be glad to hear that it's not something I'll be making a habit of.

We finished the day by doing the final written exam which everyone was a bit nervous about. The main thing that worried me was that the exam, as well as the whole course, was in Spanish, so with some technical medical vocab I was just praying I'd understand it all. Thankfully I did and I passed with the highest practical and theoretical marks of the course! I now feel much more prepared to work in remote areas and be able to provide an appropriate level of first aid cover for the friends and/or clients that I paddle with. I was going to say that I look forward to putting the skills I learnt into practise, but in this case it's probably not appropriate!

Perhaps slightly oversized...

An Outdoorsy Week

I was lucky enough to spend the majority of this week in my favourite place to be, outdoors. Tuesday is my day off work and I was invited to the nearby town of Hualqui to offer some training. A few people from Hualqui that I know are trying to set up a rescue organisation to respond to emergencies in the mountains and rivers that are found in this region. A few of them are adventure tourism teachers here in Concepción so already have a very high level of knowledge of mountain rescue, advanced wilderness first aid and search and rescue operations, however the area that they want to improve is their in water rescue skills. They invited me to Hualqui to share some flatwater and whitewater rescue techniques. This was really good fun since I was able to combine my work as a swimming teacher and WW kayaking coach to give them the skills that they wanted to learn. In fact, it turns out that the river they took me to, a bit of a trek into the nearby jungle, was absolutely perfect to practise those kind of skills in a fairly remote environment and I'll definitely be going back to run more workshops and training. That river also has some waterfalls and canyons that would be perfecto to do some canyoneering or perhaps with a hell of a lot more water, to do some first descent park-and-huck kayaking runs.

Great session in Hualqui!

Wednesday I was in the local park once again teaching a ropework workshop to a group of 14 raft guides, kaakers, mountaineers and climbers to share and practise some of the techniques we use on rivers. It was good to be able to collaborate with the tourism teachers from DuoC (a local uni) this time because watching them teach sections of the workshop really helped me improve my Spanish teaching style. It's pretty difficult teaching such a niche area in Spanish since almost all of the vocabulary is new to me and a lot of it is vocabulary that doesn't translate so well!

Thursday I also spent some time outdoors, but not in such a conventional way. Me and a friend went out at about 10pm to drop off another friend at the bus stop. It turns out there was a protest scheduled which we hadn't realised and we managed to end up right in the middle of it when the riot police arrived... The unfortunate thing about the situation was that they arrived with the water-cannon truck and proceeded to try and soak everyone. After spending a while trying to find a dry way through the blocked off streets to the bus stop we managed to drop off our friend and returned to find that there were more fires and protests at the end of our street. This is now a pretty normal event to me since it happens quite a lot, and my general philosophy out here is that if it doesn't worry the locals, there isn't generally that much cause for concern.

Robbie and I with our 'neighbours'...

If you ever see this water-truck in Chile, get out of its way!

Saturday I took two buses to reach the town of Coliumo, which is known for having some great sea cliff climbing. I went with two friends, one of who is a really great climber from France, and we had a really entertaining day doing lots of top-rope and traditional climbing in a really beautiful place. Definitely have to get back there to make better use of my climbing equipment and improve my technique!

Tonight I ended my week by cooking pancakes with friends. Lemon and sugar would be my go-to filling back home, which I've already learnt is laughed at here. The Chileans don't seem to think that it constitutes a 'filling', strange creatures. Today we filled our pancakes with 'manjar' (also known as 'dulce de leche'), a creamy caramel made by heating condensed milk (think of the toffee part of a banoffee pie). I'm not sure if it's available in the UK, but if it's not it definitely should do. We ate the pancakes whilst watching the film "Gladiator", I still haven't quite got used to watching films dubbed in Spanish! A great end to the week. Next week I'll be attending an advanced wilderness first aid course in Pucón, where I'll be learning how to do all sorts of interesting things like deal with spinal injuries, relocate dislocations and give oxygen to patients all in a remote setting in the mountains and on the rivers. I'll be updating you all soon with how it went and hopefully some interesting photos!

P.S: For those of you wondering about the photos, yes I do now have a "moustache", and no it's not going anywhere for a while... (I wrote moustache in quotation marks because I'm still not convinced it constitutes a moustache, still kind of lip fluff if you ask me)

Mexican look here we come

My First River Festival

This past week has been a very very wet week. It hasn't stopped raining in absolutely ages! As I mentioned last week I was invited to participate in the first river festival in a place called Curanilahue called "Nahuelbuta libre". River festivals are a big thing in Chile and are generally sparked by some campaign to dam a particular river, hence the local community organises a festival in defense of the river, gathering people from all works of life who have a mutual interest in protecting the rivers of Chile. There are now about 12 river festivals throughout the year in various parts of Chile and I've been told they all have different vibes, some have a more party-style vibe, others hippy and others more artisan crafts and things. I was invited to give a river rescue workshop at the first year of "Nahuelbuta libre", about 2hrs from where I live. The idea was to give it at 6pm on Saturday to 8 participants and all the equipment would be provided. When we arrived the place was an absolute mudbath, the rain having turned the whole place into a swamp. Loads of people turned up anyway (over 200 in total!) and the festival had a really good vibe, with decent music, environmental talks, food, rafting and drinks. Everything was behind schedule, as expected being the first year and given the rain, so I ended up just paddling with some friends on the lower section of the river which happened to be quite good fun.

It's a good thing I teach a watersport!!!

The next morning I was told I'd be giving the workshop at 10am, my first question (as with most events in Chile) was: Chilean time or English time? Punctuality is not a thing here. When the answer was Chilean time I knew I had at least 2hrs to wait, turns out we started at 1pm... Anyway, considering I banked on having 8 people and all the equipment provided, it was a bit of a shock when they gave me 19 people and no equipment. Resourcefulness was the order of the day, and I made it work more or less. We spent a good hour messing around with ropes and rescues and the feedback was all very positive. I followed it up by a quick blast down the river and a few hours chatting with the festival-goers and exactly 10 minutes after I got in the car to return home, the rain stopped. Typical.

Throwbagging practice

Made it work in the end!

Overall my first festival was a great experience, definitely going to try and get some more and have been invited to a few to compete in the races and teach more workshops and courses. This week is set to be a busy one, doing another two rescue workshops (they're getting popular now) and trying to finish an article I'm working it. Update to follow!

Long weekend in Pucón

There are two good things about long weekends in Chile. The first is specific to me. I don't work on Tuesdays (I know, it's a weird day to have off), on Fridays I work the morning and Wednesdays in the afternoon , so if we have the Monday off then I get a really long weekend starting Friday afternoon and ending Wednesday morning! The second is that holidays in Chile include 'sandwich days', this means if a public holiday falls on a Tuesday, we get the Monday off too.

This weekend the stars aligned and I got the elusive super long weekend. I spent the Friday afternoon coaching some freestyle at the local lake, Saturday morning I working on my Year Abroad Project and the afternoon I planned a last minute trip to Pucón. For those of you that don't know, Pucón is known around the world amongst kayakers for being a kayaking mecca. I've been dying to get down there to paddle and was lucky enough to be invited down by the owner of a big rafting company there. He was teaching a month long raft guide course and asked me if I'd like to accompany them on the Monday and Tuesday. Everything didn't go quite to plan, a lot of the students were ill on Monday so he postponed the classes. Instead he dropped me off at a local rafting company and I spent the down paddling on the Lower Trancura helping out with the photography and safety boating. Considering that sections is only a grade 3 section, it was really really entertaining. There were plenty of big waves to play on and lots of interesting lines to experiment with. Any river that starts with an amazing view of a snow-capped volcano is a win in my book.

Group of Argentinian clients enjoying the ride

What an entertaining section

Villarica volcano looking over the river

I felt like I was back at home on the Tuesday when it started to hammer it down with rain... Rather than accompany the course I decided to spend the day walking around the town in the rain trying to make contact with local companies and paddlers to try and sort out some kind of opportunity to paddle as much as I can in December-February. I went to all the largest companies, shops and hostels and made lots of new contacts who all invited me back to paddle. The return journey took around 9hrs, I have no idea why what should be a 6hr journey took so long but that's life. I returned to classes today absolutely shattered but pleased with how productive and fun my weekend had been. I'm planning to go back as soon as possible to tick off some more rivers!!!

Non-stop!

It's been a while since I wrote my last blog post. The last couple of weeks I've been incredibly busy, what with starting the work for my year abroad project, trying to organise holiday work, planning and preparing classes and some more travelling. My weekend once again was spent working as a safety kayaker and photographer on the mighty Bio-Bio River with a rafting company. This Saturday the day was incredible because there were a lot of very low-hanging clouds which make the mountains look really impressive.

These clouds make all the mountains look pretty amazing

Always time to mess around whilst the clients are faffing!

Sunday I was invited to help out at a watersports event in Hualqui, a small town about half and hour away from Concepción. The idea was to help out with safety for a massive flotilla of kayaks, SUP's and rafts which were going to do a 3hr descent of the flat section of the Bio-Bio River. It was great to see such a large group of people out on the river, 47 to be precise, especially in such a wide range of crafts! The start of the day was very foggy and overcast, which made for some great photos, but it soon cleared up and the sun came out so we could enjoy the heat of the day. I was especially thankful for the sun since I managed to get my hands on a playboat for the first time since being out here. It was great to get back into freestyle after so long, I've really missed it! Although the boat was far too large for me which made throwing some tricks pretty challenging... I even got the chance to do a bit of guiding the raft (which I've also been practising on the bigger rapids on the Bio-Bio) which I've been finding good fun.

Atmospheric start to the day

Not a bad day at the office

Yesterday was probably my most productive day recently. I got a lot of odd tasks done. My kayak, which I managed to break the first time I used (just the thigh braces, nothing major) needed repairing, so is currently at my flat whilst I repair it. I also booked flights to Torres del Paine with one of my housemates for February. Torres del Paine is supposedly one of the most beautiful places in Chile (check out some pictures if you've never seen it before!) and we're going to spend 10 days there trekking together which I'm really looking forward to. In stranger news, I also turned my hand to face-painting this week, helping one of my housemates prepare for a dance he has to do. It was supposed to be a traditional Rapa Nui design, the Rapa Nui are the indigenous people from Easter Island, which belongs to Chile. I think it turned out ok...

Boat successfully repaired with the help of my trusty assistant.

Going to Torres del Paine with this one... Also must be a nutcase since he let me paint his face!