Accidents happen. That's a sad fact of life, and although we hope to prevent most accidents, it's a good bet there will be a few at The Ranch each year. How we respond to those accidents can make a big difference in the lives of our friends.
It is important that each of us provide assistance when needed and follow a consistent response plan. This outline of The Ranch emergency response plan is designed to provide background for skydivers who lack medical training, as well as for certified Emergency Medical Service (EMS) responders. Every accident will be different, but the information included here should be used as a standard guide.
Activating 911
When an accident happens it is important that we summon help quickly. Yet, it is equally important that we not misuse the available rescue resources by calling for help when it is not needed. Occasionally an accident appears to be serious, but the "victim" is fine and doesn't want or need any medical attention. If an ambulance is called and dispatched, it cannot be cancelled until the rescue squad arrives on the scene, so it is critical that a real need for medical attention be confirmed before the emergency call is placed. With that in mind, we should strive to respect the services of our local volunteer rescue squad by not activating their services unless really needed.
Manifest has been designated as the primary contact for emergency medical services at The Ranch. If you see an accident that requires medical assistance, you should contact manifest immediately. Manifest will in turn activate the 911 emergency system. When we call for help, the dispatcher will always need to know the following:
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How many people are hurt? |
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What is the EXACT location of the injured person? |
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Is the injured jumper breathing? |
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Is the jumper conscious? |
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Is the jumper bleeding? |
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What are the obvious injuries? |
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What was the first point of contact? |
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Did the jumper hit the ground, a car, a wall, a tree or something else? |
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Is the injured jumper a male or female? |
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What is the approximate age of the injured jumper? |
When the emergency call is placed on a regular phone line from manifest it is automatically routed directly to Ulster County EMS, and the location is automatically displayed on the dispatchers computer screen. Once the local EMS dispatcher receives the call an ambulance can be quickly assigned. Manifest can also remain on the phone line, or the dispatcher can call back for additional information and needed updates. If additional cell phone callers contact the EMS dispatcher they may overload the phone lines, or tie up the available dispatchers, making it difficult for manifest to get through.
There have been a few recent cases when many jumpers have used cell phones to summon help by calling 911, but that option can actually take longer than a quick trip to Manifest. When you dial 911 on a cell phone at The Ranch your call will usually be directed to a State Police dispatcher in Highland, New York, or if the system is overloaded, cell calls may be directed to other dispatchers around the state, or even to out of state dispatchers. The dispatcher you reach will need to figure out where you are, and where The Ranch is. Once the correct county and town have been identified, the State Police will need to call a local dispatcher in Ulster County and relay your request. If several jumpers are all calling on their cell phones at once it adds confusion, jams the phone lines, and makes it difficult to arrange the needed assistance.
Whenever possible, we should try to make our requests for medical assistance to manifest so the call can be placed on a land line. In some cases the accident may happen off the drop zone. In that situation you can use a cell phone to call manifest, and they will relay the emergency request directly to Ulster county EMS. If it is necessary to call for help directly, you will need to know that you are located in the town of Gardiner, in Ulster County. The Ranch is located at 45 Sand Hill Road.
In every case, the EMS dispatcher will need to know where the accident is, how many people are injured, and the seriousness of the injuries. Whenever possible try to have answers to all the standard questions listed above. If there are special concerns such as an injured jumper stuck in a tree, or a fuel spill, you should be sure to share this information with manifest or the dispatcher.
First Things First
When a jumper is injured things can get hectic quickly. It is important to make sure that the accident scene is safe, that other skydivers are not swooping their parachutes in your direction, or that an accident on the runway is not presenting a threat to landing aircraft. Likewise, keep an eye out for moving aircraft and do not cross or drive on the runway if it will present an additional danger. Keep in mind that our pilots may not know you are responding to an accident and may not see you on the runway. If it is necessary to drive on the runway to reach an injured jumper you should try and let manifest know in advance so they can radio the pilots about the situation.
It is always important to provide an injured jumper with care, but it is equally important for that care to be appropriate, and not harmful. Every case is different, but here are some standard rules and procedures that have been established when responding to an accident. The most important immediate care issue is to ensure the injured jumper is breathing. The second concern is to make sure that the injured jumper's heart is still beating and providing circulation. The third concern is to make sure the injured person is not bleeding at an alarming rate. Other than those three critical elements called the ABC's (Airway, Breathing, Circulation), an untrained responder should simply keep the injured jumper still and safe until qualified help arrives. A responder without training should be careful not to take any action that might worsen the jumper's condition or aggravate the injuries. A jumper's rig should not be removed by untrained responders, nor should the helmet be taken off, unless this equipment is making it impossible for the injured jumper to breathe.
Ideally, the first person on the scene should ensure the injured jumper is breathing and is not in any danger of further injury. Then, quickly assess what happened and how the injury occurred. Try to determine what part of the body impacted first, and what other injuries may be present. Then, ask the jumper if he can talk, and what hurts. This information should be relayed to manifest as quickly as possible and also shared with the first trained responders to arrive. If possible, keep the jumper from moving. In many cases, there may be an obvious injury such as a broken arm or leg, but there may also be a hidden back or neck injury. If the accident involved a great deal of force it is especially important to keep the jumper still so his back and neck will not move, even if he feels fine and has no back pain. Once the ambulance arrives the jumper will probably be fitted with a stiff collar and carefully moved to a backboard, but until then it is critical to prevent unnecessary movement.
Important Tasks
Often an accident scene becomes crowded and confused. Once appropriate help arrives it is always a good idea for nonessential people to leave the area and let the trained medical team handle the emergency. There are a few critical things that can be handled by jumpers without any special training. People are needed to grab equipment from manifest, direct rescue responders to the accident, and assist with lifting the patient. Specific needs are as follows:
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A radio and a trauma response bag are stored at manifest. The trauma bag has equipment that may be essential to medical responders, and the radio will allow the on-site medical team to communicate directly with manifest, and to relay important information to the ambulance dispatcher. If you are near manifest, or can swing by, please pick up this gear before running to the accident. This is especially important if the accident is off the drop zone. Helping to establish a communication link between the accident site and manifest by delivering a radio with the trauma bag is probably the most overlooked rescue function. Please take a moment to swing by manifest and help out with this critical task. |
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The ambulance and Gardiner rescue team may need guidance to the actual accident. Once the location has been established somebody should determine the best place to stage the ambulance, and the best route from the main road. The route should be traced to be sure cars aren't blocking access and that the route can be traveled by an ambulance. A jumper familiar with the location should stand where he can be seen by the arriving rescue workers and then offer quick directions. The volunteers of the Gardiner Rescue Squad will be arriving in private cars, and the ambulance will usually follow. In some cases there may be two ambulances. It is critical that all these responders be directed to the accident site. This is especially important if the accident scene is away from the drop zone or not visible from the road. |
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A few people may be needed at the accident location to hold a parachute as shade, or to assist in making the patient comfortable. Several people will also be needed to help lift the stretcher, but trained responders often handle this task if there are enough qualified people on hand. |
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Friends of the injured jumper may be needed to provide personal information or to assist with control of the jumpers belongings, such as a rig or car keys. Likewise, friends are often needed to travel to the hospital and provide support, or perhaps offer a ride back to The Ranch after treatment in the emergency department. |
When Help Arrives
When qualified help arrives it is important to relay whatever information you may have about the accident and the jumper. If you witnessed the accident you should let the responders know what happened and how the jumper's condition has changed since you first arrived. If you believe your help will be needed again you should stand nearby. If the scene is congested, all non-essential people should move away and allow the trained rescue team plenty of room to work.
Arriving help will take many forms. The Ranch is fortunate to have a diverse group of club members with specialized skills. There may be doctors, nurses, paramedics, or Emergency Medical Technicians (EMT) already on the drop zone. Some of these responders may be experienced jumpers who are familiar with skydiving equipment and injuries, while others may be new skydiving students with extensive EMS experience but not much skydiving knowledge. Some of these responders may be licensed in New York, while others may have certification issued by other states.
The Ranch is well served by the volunteers of the Gardiner Fire Department and Rescue Squad. Gardiner rescue workers are trained as either Certified First Responders (CFR), or as EMT's. The rescue workers from Gardiner Rescue Squad have extensive experience dealing with accidents involving skydivers, and take care to protect our equipment whenever possible. Skydiving injuries tend to fall into several normal categories, and the local rescue squad has enough experience with our sport to quickly identify specific problem areas based on the type of accident and patient symptoms.
When manifest calls the Ulster County dispatcher the normal response will always include at least one EMT from Gardiner Rescue, and a paramedic will be often be dispatched as a back-up. The paramedics may be traveling from a much greater distance and will probably arrive after the Gardiner Rescue Squad. In some cases the ambulance may leave The Ranch and meet a paramedic team enroute to the hospital
In some extreme cases a medical helicopter may be called. The helicopter may take a while to arrive and will need a clear landing area. Local rescue crews have been trained in how to establish a helicopter landing zone, and will secure the area. Jumpers should be willing to assist with the establishment of a helicopter landing zone if asked, but should understand that official rescue workers have been trained in the unique coordination needed between ground and air teams. The Gardiner Fire Department will have final control over any helicopter landings, and their judgment must be supported.
Who Is In Charge
The Ranch usually has a crew of well trained responders, and the Gardiner Rescue Squad often has many responders as well. It is possible for confusion to make it difficult for rescue workers to establish a chain of command with clear decision making. We should all understand that skydivers with medical training will be in command of the scene until Gardiner rescue arrives, and at that time responsibility for care will be shifted to the dispatched rescue workers. Most of The Ranch skydivers with medical training are familiar with local management protocols and will handle the situation easily. If you have medical training you should try to identify the responder in command of the situation and let that person know what your level of training is, and then allow the established leader to use your assistance as needed. It is important to know that Ranch club members with established credentials will have initial control of the accident scene until dispatched responders arrive. If you have not been briefed in advance about emergency protocols you should yield control to trained responders, regardless of the level of training you may have.
What Hospitals Are Used
Jumpers who need medical attention are generally transported to the nearest medical facility with an appropriate emergency department. In our case, the two closest hospitals are in Poughkeepsie, about a 15 minute drive by ambulance, and about 25 minutes by passenger car. Most skydiving injuries are handled by St. Francis Hospital because they have an advanced level II trauma center. Medical problems such as heart attacks are generally handled by Vassar Brothers Hospital because their facility is optimized for medical conditions other than trauma. The ambulance team will decide what hospital emergency department to use based on the type of injury and the availability of services.
If a jumper is airlifted, the helicopter will generally go to either St. Francis or to a level I trauma center at Westchester County Medical Center. The primary difference between the trauma service at St. Francis and Westchester County Medical is the availability of specialized surgeons, and burn care.
A helicopter can only be requested by responding emergency workers, but the local dispatcher has the option of placing a helicopter on standby, or can initiate an auto-launch, based on the nature of the emergency or the anticipated travel time of a paramedic response. For this reason it is critical that manifest have updated information about the accident so that detail can be relayed to EMS dispatchers.
After The Accident: Keeping Everybody Updated
Jumpers at The Ranch tend to be a close group of friends, and we like to offer our own words of encouragement or support. If you have been inured, or you have a friend who has been hurt, please take a moment to call manifest and post an update in the Forums area of The Ranch web site. These posts will enable all Ranch members to receive an update in one central location, and will reduce the burden of multiple calls seeking information.
Most skydivers who have been in the sport for a while have been on hand for an accident or two (or perhaps more). We know that most accidents, while unfortunate, are easily handled, and most people who are injured in our sport recover in a relatively short time. We tend to think of most skydiving accidents as critical events, and at The Ranch, we have a quick and practiced response plan.
A Bigger Problem
While most of us would rather not think about the possibility of an accident involving our airplanes, this too is possible, and the emergency response will be significantly different than an accident involving just one jumper. As with a regular skydiver injury, an airplane accident will be handled by the local rescue squad, most likely the same Gardiner crew that responds to our other emergency needs. However, an airplane accident is more likely to happen off the drop zone, and may involve far more injuries. An airplane accident may also include twisted metal and a fuel spill, so there will be some unusual safety issue to consider. The Gardiner Rescue Squad conducts regular training to help them respond to large scale accidents like airplane or bus crashes. There are also written guidelines at the local and county levels to help immediately integrate all the needed resources when a large scale accident happens.
The initial response to an airplane crash will probably seem hectic and confused. It is important that jumpers responding to a crash consider their own safety first, as well as the general safety of the crash location. The first official responders will most likely take charge of the scene very quickly, and then begin the process of coordinating responders from many different towns and cities. Initially, skydivers may be needed to help establish a controlled traffic flow so rescue vehicles can get in and out of the scene. Local rescue workers may also need help moving patients and providing security. It is especially important that jumpers comply with the instructions of rescue crews when an accident scene is large or confused.
We should not spend an excessive amount of time worrying about airplane crashes, but we should know that fire departments throughout the county are prepared to handle large emergencies, and they practice their responses on a regular basis. The Ranch regularly participates in these large drills by setting up mock accidents so the local rescue teams can build their skills.
Obtaining Training
Emergency response training is available at many different levels of certification, and can serve different needs. The simplest training is in basic CPR and defibrillation, and is available from most local fire departments and the Red Cross. CPR training is sometimes offered at The Ranch if enough jumpers express an interest. CPR training can be completed in as little as a weekend afternoon, and can provide the lifesaving skills to help a friend or family member suffering a heart attack. Additional training can be arranged at the Certified First Responder or EMT levels. CFR and EMT training is usually conducted over several months of evenings classes, often for just a few hundred dollars. This training is available to anybody who wants to spend the time needed to learn the critical lifesaving skills needed by an emergency responder. Many small towns have volunteer fire departments that are always looking for local people to help out, and many of these fire departments will even cover the cost of your training in exchange for your time as a volunteer. Additional information about local training programs is available at http://www.hvremsco.org .