Risk

Risk Assessment and Management

Environmental factors: animals, gravity, substrate, weather, distance/ geography, poisonous plants, insects, H2O purity, nightfall/ time of day, sun intensity, heat, rivers, flash floods, rock slides, altitude, fires, waterfalls, depth of pools, temperature, wind, lightning

Human factors: other people/ group, fatigue, motivation, decision making, emotion, cultural background, level of experience, relative knowledge, leadership, ego, attitude, strength, health, diet, drugs, communication, sexual differences, sleep

Force Field analysis: more in alignment with goals of the program v.s. destructive divergence (“I’m going to go climb those rocks”)

-the overlap of the circles varies over the course of the day but never completely disappears, object is to minimize the risk envelope between environmental and human factors

-# of human errors per hour increases as temperature increases, errors go up before lunch and before quitting time, brain focuses on daydreams etc more frequently when under stress, assess patterns within your group as you approach lunch, after lunch, with altitude

Assessment of Human factors: start by taking care of yourself, for participants: how do they appear?, emotion, energy level, attitude/ interaction with the environment and people/ plus or minus?, eating well?, (not eating can ramify to other things), sleep/ rest?, perception of level of experience, motor skills/ observe their movements/ pronated? (Teach them how to walk on various substrates)

- cultural background/ bias: w/ verbal or physical abuse between students, call it, don’t let it go, if you let it happen you endorse: weight, gay, level of experience

- apply attention to individuals as well as group, check in w/ each student individually, tendency to treat group as group and forget to give individual attention

-group: honeymoon period, then things settle out, watch emotional and communication level

Assessment of Environmental factors: how can you know? through experience: pre-program visit- eyes, ears, smells, heighten awareness: explore, look around, spend time on the what if’s: cooking eating, water, shade, ticks, lightning, tents, min. impact. Evaluate resources: make a list.

-Know your limitations: have to take care of yourself so you can take care of the kids, don’t push envelope, don’t need to be a hero, super-supervisor syndrome.

Education:  talk to locals, geology, soil, books, history, gain as much as possible on your own, non-institutionally, puts you in the learning role

Prevention: our job!, have the power to set atmosphere around safety, on individuals and the group, imaginary safety net created around students, tone, modeling, behavior, when they catch you being inconsistent, chance to model how to deal with that, don’t lie

-group management: briefing, communication, focus on leadership within the group, delegating responsibility, roles within the group, safety King for the day

-how to get group to be safe? 1: have them live in close proximity, 2: set safety goals w/ group, (no one gets hurt, take care of one another, have then do it, have them own it), 3: have students do safety talks, 4: create symbols of safety, 5: element of competition, with other SCA groups for safest

-attitude: how to change and orient towards safety? conditions, consequences, modeling: conditions: muddy substrate, sharp rocks, human factor: not wearing sneaks, not paying attention, consequences: fall, cut feet

-give praise for safe actions and good work, best to be as encouraging as possible, remember how I feel to receive praise

-modeling is particularly important the first few days

-when people are aroused about their job/ living safety, they make less errors, more ownership o work, more arousal

-if there is a dangerous situation, adjust arousal as needed and then let them down, “now i need you all focused, no time for chatter”, but have to let them down, your level of interaction with students adjusts the level of arousal

Incident Management

1: emergency, 2: assume emergency position (metaphorically/ spend adequate time on scene assessment), modeling of this can be a big difference, 3: reduce immediate risk, 4: PAS

-be calm, center of the universe, who else can manage the situation beside me?, have an incident manager for the day, train people for that position, be flexible with contingency plans, it’s raining now, how have plans been changed?

Evac. Management: you will make mistakes, they are natural, anticipate them, don’t get tunnel vision as a result of mistakes, pull the mistakes outside your immediate focus, concentrate on issues at hand, keep the rest of the crew in mind

-don’t lie, if you have to make a course correction, big or little, acknowledge the mistake and move on

                                                       Basic First Aid and Safety

-PAS, 1- Scene Assessment: MOI, Dangers, Numbers, 2- Initial Assessment- respiratory system/airway/breathing, circulatory system/pulse/bleeding, nervous system/spine stable/LOC, 3-Secondary Assessment- exam, vital signs, AVPU, history/AMPLE, 4-SOAP note- ,

5- Monitor, repeat surveys, look for anticipated problems, revise SOAP

-familiarize myself with SCAs medical history

-review WFR skills with crew, review radio procedure and use with crew, keep on reviewing until it is clear they are getting it

-stress on positive assessment of MOI, difference between ASR and true shock, actual shock/big three boogie: nervous system, respiratory system, circulatory system

-take down resting pulse and BP of students before going in field, also when pumped up, do TILT test for dehydration

-what is swimming ability of students?

-talk to girls about hygiene, wipe front to back, baggy clothes, cotton underwear, how to pee, tell me if you get any problems, tell them what is in first aid, try to stay as clean as possible, diet considerations/refined sugars, stress

-bring duct tape wrapped on canteens and other gear, multi-use items

-make sure everyone has a whistle

-not jive, arbitrary rules, but real stuff, wilderness emergency is very serious, entirely unlike city

-group plan if I get injured or incapacitated, roles that people will take, how to proceed: scene assessment, initial assessment, secondary assessment, radio procedure, evacuation procedure, stay calm, cooperate, don’t be rash, follow steps and be rational

-it takes time to get your emergency information together, situations either stabilize or they die, no rush to call dispatch, take care of patient first, do PAS, if there is an initial assessment problem, that is a big three boogie, get on radio with request for evacuation, description of MOI, extent of injuries, location, numbers, follow ERP

-we are too far away from immediate help to be careless, need to be conscious and focused

-proper lifting techniques

-sometimes we’ll need to pump up the safety awareness, to a higher level of arousal, then let it down, seat belts/distracting the driver

-personal safety and good judgement equals group safety, each crew’s knowledge and behavior is vital to over-all safety of group, each person has a big impact just by not getting in safety trouble

-I can’t be put in a position where I am always second guessing and worrying about your judgement, lack of respect for safety is cause for dismissal

-have to actively focus on safety issues, can’t be passive about safety

-don’t have the mentality of trying to get away with risky behavior behind my back, don’t abuse the trust I put in you to go off without me

-an emergency or dismissal messes things up for the crew, the agency and the SCA, your actions ripple out and have consequences for more than just yourself, that puts responsibility on you

Environmental Hazards

cliffs/gravity, rubble/footing, weather/lightning, distance/geography, poisonous plants, H2O purity, night, heat, sunlight/UV, insects, rivers/streams/floods, rain, elevation, waterfall/suction, fire

Hypothermia- wet, wind, shivering is first sign leading to impaired brain function

-conduction, convection, radiation, evaporation, protect body temperature/core temperature, shell/core effect

Hyperthermia- heat cramps, heat exhaustion, heat stroke, intertwined with hydration, core/shell effect, take the time to cool off if getting too hot

Dehydration- is a problem, need to make a conscious effort to drink a lot, clearness of urine and frequency of urination are ways to tell if hydration level is OK, mental state starts to deteriorate first, cranky, headache, sore eyes, nausea, stomach cramps, malaise, discomfort, lack of motivation and energy, AVPU scale = A-impatient

-coffee is a diuretic and can contribute to dehydration, lose one and a half cups for every cup of coffee

-people lose one quart per hour with moderate to heavy work

-diarrhea, lose a lot of fluid, need to rehydrate

-hygiene, don’t drink from same bottles, taste off kitchen spoon, share toothbrush, always wash up before eating

-dehydration can lead to constipation and fecal impaction

Human Hazards

-judgement, safety awareness, experience, knowledge,  ego, decision making, emotion, leadership ability, attitude, peer pressure, fatigue, motivation, intention, culture, strength, communication, diet,  etc. etc. anything that humans bring that interacts with the environment

Where the environmental hazards intersect with the human hazards, there is an envelope of accident potential. The object of safety awareness is to make that envelope as small as possible. Rules stand in between the environmental and human hazards and effectively separate the two, as for example with a rule of no diving. Acceptable risk (we are out there and life is a risk) and unacceptable risk (serious diversion from ground rules), I understand teen power struggle and questioning authority, but I say what is and isn’t acceptable. In addition to rules, way to separate factors is environmental briefing, i.e. information. Have briefing be focused, clear beginning, clear end, frame the awareness, do it for anything new, can be one hour or one minute. Best regulation is self regulation, same principle as in conflict resolution

Daily Cycle of Energy, keep it in mind

-lack of awareness, mistakes, injuries happen most right before lunch and before dinner

-have to eat right and a lot

-need to eat breakfast

-energy is related directly to amount of sleep, hydration, groceries on board and temperature

Boot and Foot Care

-blisters are incapacitating, untreated they can turn into a systemic infection

-it’s more worth it to do preventative moleskin that to have a two week incapacitation

Infections

-tell me if you have an infection!

- a systemic infection is very bad news, can easily die from it

-vaginal infections are brought on by stress, diet change, poor hygiene, use a vinegar solution douche, don’t eat refined sugars, eat high acid foods, yoghurt, cranberry juice

Wellness

check in frequently, eating, sleeping well, regular shits?, happy here? muscles hurt?, like work?, enjoy camp life?, homesick?, suggestions for improvement?

                                                            Hiking/ Walking/ Swimming

-exposure

-think before you step

-substrate can be unpredictable and dangerous

-observe and learn characteristics of different substrates: slippery rocks, wet rocks, leaves, moss, rubble, incline, decline, cliffs, brush and logs, boulder fields, baseball hat - branches poke you in the eye

-low-impact aspects of walking on different substrates: cause least disruption as possible

-carrying pack, weight, balance, branches, rock out croppings can catch the corner of a frame pack and throw a person down

-staying together, leaders need to wait up and not get attitude about slower hikers -BIG ISSUE

-regroup at all trail junctions and streams, pay attention to junctions, look for markers

-consequences of getting lost

-spacing, critical on hills, rubble, steep down slope, rocks, streams, domino effect, kicking out loose rock onto those below

-if fatigued, say “I need a break”

-WATER- stream crossing, how to walk in and across streams, unbuckle pack, take off socks, wear, boots, use sandals if you have them, never rope a person crossing a stream, confluences equal stronger current and deeper water

-swimming rules: not without me, period, no diving, watch out for quicksand, cut feet, slippery logs and rocks, have to really watch the substrate for cut feet, better to use sandals in the water

-everyone needs a whistle

-always tell me where you are going if away from group

-establish camp boundary, need to ask to go further, can go to a previously arranged special spot

-two hours unscheduled loss of communication equals activation of ERP

-hiking alone and out of communication is really touchy, hiking off trail is not good, better to stay in groups of three on a hike or just go to special spot

Hike In- anticipate problems, get up as early as possible and start getting ready, will take kids a long time to get ready, teenage nervous breakdown, preventative blister check and treatment, weed out unnecessary gear for storage, help pack and fit packs properly,

Camp- establish routes to water source, swimming, latrine, kitchen, tents, etc. get flagging tape, impact on soils and plants, impact on substrate during breaks and lunches