Free time in the outdoors is challenging. As an experienced outdoor ed teacher other than lightning, high winds and trees falling over, free time is always my biggest concern. “Why’s that?” you ask. “Isn’t this just quiet down time?”
No!!!! Who told you that? It’s actually the causation of the majority of injuries on outdoor programs. “What?” I hear parents scream in the distance. Yes, that’s true, it’s not the activities such as abseiling, or high ropes which have a very high level of perceived risk that are the problem and causation of many injuries. It’s the sitting around doing nothing at outdoor centres which leads to many of the injuries we see in outdoor programs.
The Budawang and Etrema Wilderness areas are some of the most rugged and challenging areas in which to hike in NSW. Having led many groups through both these wilderness areas over the years, filled with snakes, hippies, crazed possums and often a shortage of access to fresh water and evacuation routes, the thought of simply hanging around on an outdoor campus with a group of students for free time, is more worrying than anything I ever could have and did encounter in those tough, unforgiving wilderness areas.
In recent years, I’ve noticed a changing phenomenon. Kids are really rubbish at doing free time, especially when there’s no structured activity going on. Most children’s lives, especially with two working parents, have become so over-structured that the idea that they might have to entertain themselves or find happiness in quiet time is something completely foreign. This is a real problem for our over-stimulated children, who on camp generally don’t have the option of pulling out their phone to play pointless addictive and life-wasting games to stave off the threat of a lack of over-stimulation and having to socialise in a meaningful way.
Unfortunately, what happens as a result of children who are not used to free-time being given lots of free time, is that stupid and poorly thought out games start. These can often result in running around dangerously in areas with which they’re unfamiliar and not always well-supervised in. The other potential negative scenario is that to cure their boredom, they look for other unhealthy things to do, such as picking on each other in unpleasant ways. It’s no surprise that the majority of outdoor education injuries occur during this time.
There’s a false sense of security which goes with being in a hard-top cabin style outdoor ed location. The idea is that it’s not really that risky compared with the activities that were being done during the day. How can you compare that high ropes course which scared the life out of everyone, with sitting around talking or more likely running around madly. Sometimes, teachers can think that once the activities are over, then it’s also their own ‘free time,’ so they can relax a little. Sadly I’ve seen far too much of this over the years and ultimately, if you’re on duty and sitting on the lounge inside a building where you can’t see any children and thinking you’re providing suitable supervision and an effective duty of care, then you’re a moron and should not be teaching. If you’re reading this blog, I would suggest that’s not you, but I’ve seen it first hand and it’s unsurprising the majority of injuries on outdoor programs happen during free time at outdoor centres.
How do we reduce the incidence of injuries when we know kids are finding it increasingly difficult to do free-time? Firstly, don’t employ idiots! This is a good basis upon which to start. However, if you’re lucky enough to have a good staff, as part of your pre-program safety briefing, highlight this as a key risk that you need everyone to look out for. Give a couple of examples if you’ve seen things as I have of what can and does happen when supervision becomes laxed, or a false sense of security is created by the differential between an activity such as abseiling and hanging around dorms.
However, one huge opportunity is to run some structured games during this free time. Sure, it means teachers have to run another activity, but that’s far preferable to the trip to hospital and the awkward phone calls back to home and school to explain what happened and why there’s a student in hospital after ‘free-time’ injury. To be honest, I’ve had to make a lot of phone calls over the years in regards to injuries, but the most awkward and difficult ones to deal with are the free-time ones, because they’re really hard to explain the reasons as to why they happened. A fall from a mountain bike which caused a broken wrist is far easier to explain and manage and has less blow back, than trying to explain why a shoulder was dislocated inside a dormitory.
The reality is that children do find free-time increasingly difficult due to the over-stimulation and over scheduling of their lives. Whilst it would be great to think they can have some much needed free-time, this has often proven to be some of the most risky periods of time during outdoor ed programs where the most injuries occur. The best option is to ease students into the idea of free-time by structuring some initiative games, group activities, or light exercise during these times, rather than just ‘free-time.’ As a result, you’ll spend less time patching kids up, going to hospital and having awkward conversations.
As soon as you read the title of this article, you either thought ‘hmmm how interesting’, or ‘wow this is going to be boring…’
One of my frustrations as an outdoor ed teacher and director has always been the quality and timelines of incident reports. They’re often too brief, fail to mention important details and arrive days after the event through a great deal of chasing! Sound familiar?
This comes down to a few things, which include the level of training and experience staff have had in responding to incidents and injuries, the culture within the organisation and the type of reporting methodology being used.
Training is an interesting one, as first aid training doesn’t usually cover the how and why you should do an incident report. Some of them do, but often it’s fairly basic training to call emergency services and let them handle things from there. However, if you’re responsible for students, you’d know that’s quite impossible from a practical point of view. More often than not, it’s not even a case of calling emergency services. It’s more about handling the situation at hand yourself. Therefore, some level of training is needed around what you should be putting in a report. Details such as time, location, circumstances, supervision, weather and others involved all become important to the equation. So if you haven’t read up or done anything around reporting, it’s definitely time to do that.
The second area is culture. Is there an expectation that you need to report? If not, I’d be concerned about the organisation. Legally, in Australia and most likely all other counties, you need to report any injuries or incidents as you have a duty of care within your organisation. Having said that, I’ve worked for places in the past that had a very casual approach to this, until something happened. Then it was a major drama, chasing reports and asking all the wrong questions way after the fact. Hence there needs to be a culture of reporting. Even if something were a near-miss. where no injury occurred, but could have been potentially catastrophic, you need to report it! I can’t stress this enough. There’s so much value that can be gained by reviewing near misses and incidents to develop better systems and practices for your organisation.
The last area is methodology. The harder it is for staff to do an incident report, the less likely you are to get one. Interestingly enough, this occurs at all levels of an organisation and just because someone is a manager, doesn’t mean they’re more likely to report. In fact, it’s the opposite. They’re less likely to report incidents which occur, maybe because they think ‘they’re in charge’ and don’t need to, or more likely, they address the issue and end up too busy with other things and forget about it. When nobody is chasing them the same way they chase others, then you can see why there’s an increased likelihood they won’t report something. This then feeds straight back into the cultural issue and has an overall negative impact on the organisation and its risk and reporting profile. This can end up with things just ‘slipping through the cracks’ to the point that the organisation suffers a major incident.
So basically from that, make it easy for yourself and everyone in the organisation to do a report. It was this arduous and cumbersome reporting process at one school I worked for which led me to designing and building the Xcursion platform. Basically, I had to solve my own problem to try and help what was in my opinion a dangerous and dysfunctional organisation get up to speed with its reporting. As a result, teachers could then have fast and secure access to student info and complete an incident report on their mobile which was sent back to school as soon as they hit the complete button.
Making this process easy for staff, not only massively improved the speed of reporting, but it steeled teachers through exactly what they needed to report. Consequently, this made a huge difference to the organisation’s attention to incident and injury reporting and helped to start building the culture of risk management which was so desperately needed.
Ask yourself, ‘How does your organisation look in terms of incident reporting? Is it easy and timely to do, or is it a time consuming pain? Is there an expectation that everyone reports incidents and near misses alike? Does everyone feel confident in the training they have to identify, manage and report on incidents as they happen?’
If you’re not confident of your response, then maybe it’s time for some staff training and new systems to be put in place to ensure that you are.
There’s always a lot to think about when preparing for an outdoor ed camp. Assuming you know where you’re going and what you’re doing sorted, then it’s time to prepare the finer details.
For most teachers, this is where it can become overwhelming. Often the feeling is, “I want to run an enjoyable and safe trip… but where do I start?”
The first thing to do is develop your risk management plan. Many other things will simply fall into place once this is done. Although the bane of many teachers’ existence, a good risk management plan can save you considerable time and effort down the line.
When building your plan, look at your daily routine and work out what the key risks are for each activity and how you will accept, eliminate or mitigate these risks. You’ll need to consider things such as time of year (season), weather, temperatures, location and emergency exit points. Add to this the specific risks for each activity in those locations at that time of the year and you’ll start to build a picture of what your key risks are and how you’re going to address them.
With your risk management strategy created, remember, this is a living document not a copy and paste job which just makes up part of the ‘annoying paperwork.’ All staff need to be aware of risks and mitigation strategies and be prepared to react and respond if and when it’s needed.
The next step is to sort permission notes, get updated medicals and provide a student packing list with all the items they need to bring (and things they shouldn’t). Have a detailed plan ready to go before you send this out to parents. You’re bound to get lots of questions so the more detailed the itinerary you can provide upfront, the better.
For the equipment list, clearly specify quantity and quality of what’s required. Whilst I know some parents might not be able to supply this, as a matter of safety, it’s important that you’re able to cater for any shortfall. One of the most important pieces of equipment is a set of thermals. Even in warmer months, it’s good safety practice to carry some thermals in case of emergency and if you’re running an autumn or winter camp, it’s essential that all students have a set. The reason being (not just to support our great wool industry), hypothermia is always a significant environmental risk due to wet and windy conditions in Australia.
With permissions notes, medicals and gear all sorted, it’s time to brief everyone! This is often overlooked, but it’s vitally important to run a pre-camp briefing for staff and students. This goes back to pro-active risk management. Set the scene, set the expectations and build the excitement for camp. After all, you’ve just spent weeks preparing something very special it’s now time to tell everyone about it! Showing images from a previous camp and location on a map, is a great way to put into perspective some of the experiences they’re about to have.
With all this done, it’s down to the last items and you’re ready to go! First Aid kits, spare Asthma Puffer, spare EpiPen, any medications, groups lists, medical summaries, food and you’re good to go! By the way… did anyone book the buses?
To really understand how incompetent some people are when it comes to reporting incidents, you need only look at my old school. Wait, no… not the one of which you’re thinking! Let’s go back further to when I was in a Government high school myself.
It was the 90s, an almost lost decade when the great fashion styles of the 80s were now dead and replaced with slightly more conservative hair cuts and mobile phones that came in a bag. Yes that’s right, A mobile didn’t fit in your pocket. It came in its own bag. They were enormous! I remember that everyone thought that people who carried their own bag phone around, must have been either super important, or a complete tosser! In reality, it was the latter, but I digress.
Whilst I prefer not to talk about my high school experience, because it could lead to far too many expletives being used in every sentence, the remarkable thing about life is the fact that we can learn some great lessons from complete idiots. Just take a look at the Darwin Awards, which is a great testament to this fact. Sadly, I don’t have another contender for the Darwin Awards on this occasion. However, there’s no shortage of idiots involved, so for those of you involved in risk management, this is what not to do when your school bus gets hit by a semi-trailer.
Now it wouldn’t be fair to talk about the day trip to Narrabri without putting it into some sort of context. Why were we travelling two hours from Tamworth in Northern NSW to Narrabri just to have an argument?
For me, this was one of the most exciting days of the year. It was the regional debating championships and for one, it had me out of school for the day, which was always preferable. More importantly, it was one of the best debating competitions around. Sadly, the English staff who were supposedly running debating, didn’t share this view. Since it wasn’t Rugby League, the rest of the school had a dim view of it as well. The only time I’d actually been to Narrabri for the championship was two years before when I was in Year 7 and we did very well, getting into the finals but coming runner up at the end of the day. The next year however, one of the students slept in, and so rather than leaving one student behind, the stupid teacher waited and did nothing for an hour and a half, until the student got on the bus. We arrived massively late and forfeited every single debate. Yet another stellar moment for the English Department.
However, I’ll leave it at the fact that the English Department and I did not get along. There was some unpleasantness. I remember in Year 12, I was excluded from the debating team for apparently being too argumentative… but that’s a much longer story for another time!
Back to the matter at hand. I was thrilled to be heading off to Narrabri for the day of debating. It was a knock out impromptu debating competition, which I loved and given the previous year’s mess, I was eagerly anticipating getting there and at least competing in the first round!
Despite the fact that it had been raining overnight and drizzling that morning, all was going well. I was picked up on time in town, which was a pleasant surprise. Jumping on the bus, I found a seat right in the middle of the mini-bus on the driver’s side. It was on the outskirts of Tamworth when I first noticed the bus seemed to be all over the road. It was raining more heavily and the driver, one of the illustrious English teachers, had managed to slip the bus off the road twice into the soft verge at the side of the bitumen. On the second slip I banged my knee hard into the seat in front of me. “What an idiot,” I thought. (I was thinking worse than idiot… but I’m keeping this PG). This year we were in no hurry, but the teacher seemed hell-bent on racing the whole way there.
Another twenty minutes on and with a few more bumpy shunts all over the road, we were close to Gunnedah and approaching a narrow bridge over the Mooki River. It was raining. We seemed to be speeding in a bus that had already slipped off the road a number of times and now were approaching the narrow wooden Mooki Bridge. I glanced up to see a semi-trailer heading in our direction. It was half way over the bridge. Then everything suddenly slowed down.
I don’t remember hearing the screech of the wheels, but at some point the teacher had slammed on the brakes, the wheels had locked up and the bus spun around in slow motion 90 degrees. We were now sliding sideways straight along the road, completely out of control. Out my window, a massive bull-bar- covered grill was coming straight for me. Nothing profound was going through my mind as I grabbed to push my back hard into my seat and braced myself against the seat in front. There were no seat belts and we were about to be T- boned in the middle of the bus.
It was the quick thinking of the truck driver who saved us that day. As I watched helplessly from my seat, the massive bull-bar came closer and closer. Suddenly the rig of the semi-trailer veered sharply left. It’s wheels shifted and rumbled off the side of the road. The driver was now trying to turn hard left and the bull bar was facing slightly away from me, but with the truck close to us now and with nowhere left to go, I held my breath. The bus was deathly silent.
The most frightful, deafening sound of crunching metal smashed the silence. The semi had clipped the rear of the mini bus. The side windows shattered. Glass sprayed slowly through the air like a thousand diamonds hovering slightly, as the bus spun violently, before arcing to the floor. Glancing back, I saw the semi-trailer roll onto its side and into a ditch next to the road. We came to an abrupt stop. I sat there stunned as everything seemed to return back to normal speed. “I’ve got to get off the bus,” I thought. “What if it explodes?”
With my ears ringing, I could now hear screaming and shouting throughout the bus. All I could think of was what if another truck comes along and hits us? I scrambled off the bus. It sat awkwardly, still halfway across the road. The massive semi-trailer lay motionless.
Despite our teacher being a massive tosser, unfortunately he didn’t have an enormous bag phone, so we had to call emergency services 90s style!!
I ran across the old narrow wooden bridge to the other side. Sure enough, another truck was picking up speed as it headed out of town. Standing in the middle of the road I flagged him down. I can’t remember what I said, or even if it made any sense, but with wreckage strewn all over the road ahead, it was fairly obvious we needed help. The truck driver got on the CB radio and soon we could hear the sounds and see the flashing lights of the ambulance and police racing towards us.
A couple of students were still on the bus. The teacher had run off to the other vehicle and not bothered to check on any of us, despite the common sense rule of check your students! Given the fact he should have owned a bag phone, this wasn’t surprising in any way. As in every movie climax after the life or death conflict has been resolved, the flashing lights and uniforms around us seemed to create a sense of calm. I think I was too stunned and possibly concussed at this point to really be feeling anything. Although, I remember thinking, “We’re going to be late for the debate again!”
A couple of students and the truck driver, who in his superb efforts to save us had broken his leg, were loaded into ambulances and rushed off to hospital. We were loaded back on the bus which still could be moved and driven to hospital. To say I was reluctant to board the bus was an understatement, especially with that guy at the wheel, who in my opinion was completely responsible for everything that had just happened. However, the police determined the bus could be driven only about 4 km to Gunnedah Hospital.
We sat around and waited to be seen in hospital. One after another, a doctor checked us. My knee was sore and I felt exhausted. Otherwise, I was fine. For us, the ordeal was pretty much over, but for everyone else it had only just begun!
Thanks to modern forms of communication at that time (the CB radio), which could be easily listened into by anyone, the 8.30am local ABC radio news had already broadcast the accident informing all the northwest that “a bus from a Tamworth school had crashed.”
Panic arose for some primary school parents whose children had left that morning for Canberra. The 9am news stated, “The bus was not from Oxley Vale School.”
The phones at our school, those ones that plug into the wall, went into meltdown, as only a tiny bit of information was released on the radio. By 11am, the school was named. It didn’t say that it was the debating team, a significant point by which most parents would have known it didn’t involve their son. Everyone, however, had assumed it was a football team or some other excursion and thus many parents were trying to ring one phone number all at once. The parents with children in the debating team had also found out and couldn’t contact the school due to the phones being engaged.
If there’s one thing you should do in the event of a critical incident, it’s inform the parents of those involved as soon as you can! Release a detailed statement to the rest of the school community based on clear facts and in line with the needs of the community. Failing to do so, creates more problems. It creates panic and uncertainty and parents will fill in all the blanks you’ve left for them with their imagination. Soon parent imagination can turn into pseudo facts and you will have an even bigger mess on your hands. It’s hard to respond to that and much harder from which to recover.
Rather than using another phone line to call the parents of the students who were involved, the school did nothing. Yes, that’s right! Nothing at all! The hopeless response to this major incident is probably one of the reasons why I believe risk and incident management is so important. Seeing people do something so badly, usually prompts me to do the opposite and make sure it’s done properly.
A teacher at the school told my older brothers and gave them the tiny bit of information that was heard on the radio. One brother rang our mother at her work with the words, “The bus has crashed, but David is all right.” She in turn rang our father at his work and he kept dialling the school number to see if he should drive to Gunnedah or where.
The school sent a teacher in another bus to come and pick everyone up from Gunnedah Hospital. There wasn’t anything wrong with this in itself. We were collected at the hospital, driven back to Tamworth and dropped off either at or near home or at a parent’s work with no meet and greet to the parents, nor any sort of handover. I was the only student with immediate parent contact. One boy was set down in town and had to wait about three hours for his regular school bus to take him home to Manilla.
A number of students were dropped off at empty houses. After almost being killed in a horrible collision with a truck, the teacher somehow thought that dropping shaken teenagers off at an empty house was an appropriate thing to do! Even the most useless and incompetent teacher should have known better than that! Perhaps the teacher who picked us up should have been carrying two bag phones. As he was head of welfare for the school, it’s rather ironic that he appeared to know nothing about student welfare, but again that’s my opinion and a much longer story for another time in regards to what I believe was his incompetence and inability to fulfil an important role.
The idea that it was ok to drop students off at home when nobody was there after a traumatic road collision was stupid even for the 1990s. I remember being dropped off at Tamworth West Primary School where my mother was teaching her Year 4 class. I wandered in, still possibly concussed and remember lying down somewhere in the classroom and falling asleep. Mum sensibly refused to take me home in her lunch break.
What should have happened? All students should have been driven back to school. No one should have been left alone. Day boys could have been left under Matron’s watchful eye, until their parents arrived to collect them. Boarders could have been supervised by Matron and/or their dormitory master.
From an incident response and management point of view, the lack of communication was pathetic. It might have been a lack of training, a lack of response planning, or just the fact that I went to a school that appeared to be run ineffectively. The bottom line was that there was no plan in place if something went wrong. It was evident that everyone was simply making things up as they went.
Whilst critical incidents are fluid in nature and you may need to respond in an inter-active way to contain the initial situation, there is absolutely no reason why any school or organisation can’t have clear actionable steps in place to be able to respond quickly and effectively to a major incident. It’s vital that you inform parents and if needed, draw on resources in the wider community, such as local radio.
Over the past 25 years, at no time did anyone from the school contact my parents to let them know what happened! At no point was the incident ever debriefed! At no point did anyone ask about the debating! Two years in a row, we’d forfeited the most awesome competition in the region and to this date, the school still hasn’t officially told anyone that the bus crash actually occurred.
The Principal suddenly left the school and the questions about the crash, that parents asked at the P & C meeting, were unanswered.
Despite all of this, I learnt some very important lessons as to what not to do in a situation like this. One thing it highlights though, is the fact that for all the carry on I’ve seen over the years from people who don’t understand risk management and incident management, the fact remains, being on the road with students is one of the highest risk factors possible.
Driving to the conditions, avoiding peak periods of traffic and having a fatigue management policy and procedure in place is vital to reduce this transport risk that’s part of every trip away from school.
Let’s put this back in context. We were going to a debating competition!!! Sounds very low risk and not even worth doing a risk assessment on, yet had the truck driver not reacted the way he did, our bus would have been cut in two and a few more sun-bleached crosses would have stood scattered at the side of the road, lovingly surrounded by flowers, tended only, in decreasing frequency, by the broken families who were never told what really happened that day.
After talking about how awesome Twisted Sister were, I might have got you excited about the classic Chumbawamba song Tubthumping! Such a great song, but again another one-hit wonder that now occasionally finds its way to be played at awkward school reunions and trivia nights. However, as interesting as random bands are and as pointless as school reunions are, I am not going to talk about either. Instead, let’s talk head injuries!
Whilst for many people, a head injury might be preferable to going to their school reunion, I don’t want to seem blasé about one of the most significant issues with which we have to deal as teachers, coaches and outdoor instructors.
Concussions are what I would describe as a hidden injury. Whilst sometimes it’s extremely obvious that someone has suffered a concussion, when they’re struggling to remember what you said to them 30 seconds ago, there are also times where the injury goes quite unnoticed. Sometimes, after a hit to the head or a massive body collision, a proper assessment isn’t done and the student continues to play on.
One of the biggest problems with concussions, from a first aid point of view, is that the signs and symptoms are not blatantly obvious. If for example someone breaks an arm, especially if it’s a protruding injury, you can see it’s broken from satellite imagery. If it’s graze or laceration, there’s usually lots of blood and so it’s time to glove up and stop that bleeding. There is a reason why people say “bleedingly obvious,” and you’ll understand exactly what they mean, if you’ve treated someone with an open wound, let alone someone who’s taken a dive in a bed of oysters… but that’s a story for another time.
Head injuries and concussions however, that don’t involve lots of bleeding, aren’t always so obvious and nor is the recovery process. When you’ve broken that arm at right angles and passers by with no first aid training feel nauseated just looking at it, it’s obvious you need to get that looked at by a doctor. The process is quite clear from now on in. You go to the hospital, the triage nurse looks at you and goes ‘Oh woah! That’s broken!’ The old lady you sit down next to in the waiting room goes ‘Oh woah! That’s broken!’ and finally after a 6 hour wait in emergency, the doctor said ‘Oh woah! That’s broken, but we’d better get it X-rayed just to be sure!’
However, with head injuries, it’s not so clear cut. Because we can’t see an obvious trauma, we can often risk not even considering that an injury has occurred. The student after all got back up and is playing again. The student might not feel too bad, just a little dazed… but can ‘walk it off’. Unfortunately, inside the student’s head, the brain has just been bounced around and is suffering the effects of a mild concussion. If however, a student has a major concussion, it’s far easier to notice and remove the student from the field or activity. Thankfully, our awareness of and attention to major concussions has improved dramatically in recent years. However, it’s the mild concussions that worry me, as they can remain hidden for an extended period of time.
When someone suffers a concussion, they should seek medical advice and have a clear recovery plan laid out for them. However, with a mild concussion, medical advice is not always sought and the student doesn’t rest and recover, but instead, goes to the next training session increasing the risk of more significant trauma and then onto the next game, once again at increased risk. A concussion on top of another concussion, on top of another one can have a massive multiplier effect and lead to further damage to the brain being caused. Traumatic brain injury and/or CTE (Chronic Traumatic Encephalopathy) can result.
As I’m not a doctor, and there’s far better medical information and advice on the specifics around TBI and CTE I won’t go into all the details here. But as a first teacher, coach or instructor and often the first responder, we should be ensuring we are baseline testing our students prior to commencing high risk activists such as extreme sports and contact sports. We should be mandating helmets or head gear wherever possible and also remaining situationally aware throughout the activity or game looking for big hits to the body or head that might result in the mild concussion that can be so easily overlooked as it’s not bleedingly obvious to the old lady in the emergency department. It’s easy to test for a concussion, but much much harder to deal with the fallout if you don’t.
As educators, we want to challenge our students and help them get the most out of sports, the outdoors and every other opportunity that school affords them. We want them to out-live us and be forced to go to those awkward school reunions, so they can pretend to be far more successful than all the people they hated at school and claim they invented the ‘Post It Note’ or are now an internet Billionaire having invented ‘Fake Block’. Making our students suffer awkward conversations at school reunions to which we don’t have to go, is good! However, letting them suffer from a traumatic brain injury or CTE from multiple concussions when we can so easily check with something like the International Diagnostic tool, is unacceptable.
We do have a very high duty of care for our students and being aware of the risks involved in concussions and also how we can effectively respond and manage them, is vital for us as teachers, coaches and instructors. If you haven’t done so already, do some research, go to a seminar or listen to a podcast on this. The more we understand about concussions, the more we can do to recognise and treat them as we would any other traumatic injury.
For more clinic information speak with your doctor and a few useful resources below:
Malcolm Gladwell – Revisionist History Podcast
Pocket Concussion Recognition Tool - updated 2017
An operational management plan is essentially the standard operating procedures for your program. Now I hate the term SOP, because it always feels like it's a set of rules that's written down, which ultimately guarantees that nobody ever reads it. So what's the point? Like anything involving people, logistics and risk, it needs to be a living, breathing process that all staff are part of. It has to be clear in the minds of all staff what the process is to run a safe and effective program.
With any experiential education, you need to have some very clear structures in place to both ensure the smooth operation of activities, as well as contingency plans if something goes wrong. Some organisations are obsessed with risk management plans and waivers, thinking this is all the planning they need. They've kept their lawyers happy and there's a document they can produce to prove they at least thought about something before leading the group into the valley of death. Well, there's quite a lot more to it than that and this is where many organisations go wrong.
You’d think it goes without saying that you need a plan, an itinerary, a schedule, risk assessment, student medicals, permission notes, or at the very least a class roll! However, I’ve regularly seen the focus of planning to be on only one or two of these components, rather than properly addressing them all. You must address them all! There's no point in having an itinerary and risk assessment written and not having the logistics and staffing in place to execute your plans.
You always need a functional end-to-end operational plan, that is flexible enough to handle multiple contingencies. Therefore, you need to plan for everything from the perfect operation to various “what ifs” for minor hurdles, emergencies and full crisis response. An effective response though has more to do with the staff’s mental state and ability to respond and adapt to a fluid situation, rather than a rigid written plan that's immediately forgotten when confronted with a complex crisis.
I've seen this done very well, but also extraordinarily poorly, especially when people aren't operating programs all the time and they feel they need to make things up as they go. There's a huge difference between being adaptable and making stuff up on the run. So one massive hint here, Don't Make It Up As You Go! Have a well-structured, executable plan that everyone’s part of that can be quickly enacted if something goes wrong.
What if the weather changes? What if an emergency happens? What if a crisis happens? Are you prepared to switch it up and respond quickly and effectively? I've seen some great written risk assessments where I have mused, ‘wow they've thought of everything!’ but then looking further on, no contingency plans nor any real idea as to how to manage an emergency or crisis.
It's Never Nice Getting Hit By This
I've seen and worked on programs (thankfully not run them) where the organisation had a ‘nothing will ever go wrong’ approach. This is where everything is done on razor thin staffing, based upon the idea that everything will go exactly to plan and I mean exactly to plan! The danger of this, is firstly, it's idiotic in the extreme. When you're dealing with groups of students and staff in different locations and involving vehicles and equipment, something could eventually go wrong. If you have no flexibility and adaptability factored in, then you're asking for a lawsuit and in fact, you deserve the horrendous experience of being dragged through the courts for your stupidity. I never felt safe, nor comfortable on this program. Thankfully, when I brought it to the attention of the organisation and they couldn't see the problem with it, I left and found another place to work that did.
This ‘razor thin’ notion, usually done to ‘save money,’ that works off the basis that everything will go exactly to plan, just increases the pressure, stress and fatigue on staff, which adds to the inevitability of something going wrong. Philip of Macedon (Alexander The Great’s father) put it very nicely. ‘No plan survives contact with the enemy.’
So with that in mind, here's an outline of how I develop an operational management plan:
If you plan around these 10 steps, then you're well on the way to having a safe, enjoyable and rewarding experience for everyone involved.
Now thankfully this isn't something that happens every day, but it does happen. Given the fact that my first job was at a gun club, shouldn't mean the chances of being shot increases. Whilst many bleeding hearts will tell you the dangers of shooting, it remains one of the safest sports you can do. I've had far worse injuries from hockey than anything else. Mountain biking and skiing are right up there for the most dangerous sports. However, once again, I digress and so back to the topic.
I'd got my first job as many teens do at 15. However, it wasn't a fast food joint. It was a shotgun club. My job was to put the skeets on the hopper and fire them up so that people could shoot at them. It was a fun job that paid really well. Most of the time I just sat inside a concrete bunker waiting for the buzzer. When I heard that, I'd load the clay and off it would go. This would be followed by the sound of a shot gun and depending on how good a shot they were, it either shattered the clay pigeon, or it would gracefully sail back down to land in the field nearby. The only real hazard of the job was when a clay shattered inside the bunker as it flew out. You'd be shielding your eyes as you were peppered with tiny ceramic fragments as they ricocheted off the solid concrete walls.
The job was fun and often I'd get to shoot a few clays afterwards too, which added to the excitement of it all. One day however, we were on a different range. It was the field and game range. At this range, it wasn't the traditional skeet tower and bunker configuration that we usually worked with, meaning the clay pigeons would be fired from either a tower, or the bunker. Instead, we used a whole range of different styles and sizes of clays which could be bounced along the ground, thrown up into the air, down a gully or every which way possible. It added a remarkably different sort of challenge to it all.
That day, I was stationed high up on top of this rock. When I heard the buzzer, I'd fire two clays up over this rock and the shooter would see them as if they were birds through the trees. This was no worries at all as I was high up and protected by a rock. However, the next range over, something was being fired across the gully and unfortunately I found out the hard way that this side wasn't so well protected.
There had been a few shots now and then where I'd heard the leaves in trees above getting sprayed through with shot, but thought nothing really of it. I was protected by a rock. It was way above my head as it should be. It was all good. However, just as I was loading a double clay, I heard a boom and whipping sound coming at me. My arm suddenly stung before a hot painful burning sensation took over. I grabbed my right shoulder with my hand. Looking down I could see blood, lots of blood and my upper arm dimpled with telltale signs of a spray of shotgun pellets.
I don't remember screaming or crying in pain. It all felt so surreal. One second I was loading clays. Next I'd been shot in the arm and bleeding profusely. I felt my right hand release the clay hopper and I shot the two clays up into the air. It must have surprised the range officer, as I'd let them go too early. He was on the radio to see what was happening.
I said, ‘I think I might need some help. Can you come up?’
I remember the reply was one of grumbles, as if it were so much effort to get up the hill. (Actually, for most of the club members it was, given the fact that they weren't the fittest group of individuals.)
However, when he got up there and saw the blood, his attitude changed. Thankfully, someone in the club had some idea of first aid and it wasn't long before they stopped the bleeding and revealed some nice neat pellet holes in my right shoulder.
Whilst today, I'd be seriously looking into their risk processes and procedures to find out why there was such an horrendous failing in their safety, back then. After I realised that the wounds weren't too deep, the pellets had all been removed and I was ok, it now felt so cool to have been shot at work and as compensation, they gave me and extra $50. All in all, a great day at work.
Whenever you're running trips in the field, be it outdoor expeditions or sports trips, part of your planning should include someone who’s sole role is the safety backup person. Unfortunately, this is often an overlooked roll, or one that's totally under-estimated in its importance.
Whenever you're dealing with staff, students, vehicles and equipment, no matter how careful you are in the planning process, something could go wrong. When it does, you want to be able to respond quickly and effectively to contain the incident and mitigate any damage. If all your resources are tied up with the operation itself, then your ability to respond to unforeseen events is seriously compromised.
The process we used at one school I worked at was very effective. Staff were trained in emergency and crisis response management, had been on every single expedition we ran and rotated in and out of the safety office position throughout the year. This meant they always had their finger on the pulse as to what ‘normal’ operations should look like and they knew the local area extremely well, so when contingency plans needed to be enacted, they were able to form a swift and appropriate response.
The safety officer was the central command for all communications in and out to the groups. He monitored the group’s location, progress and knew of any specific needs of the group. All contact in and out was logged so there was a complete record of communication with the group.
Most of the time, this just meant the safety officer was sitting in the office and didn't have much to do. However, when something didn't go to plan, he was ready with a vehicle, comms and equipment to respond swiftly and in the most effective manner possible. No scratching of the head, no running around to grab supplies, they were ready to go immediately.
Why is it so important to have a person in this role? Why can't the person on the ground just deal with it? I've also worked for a school that thought this should be the case and their idea of someone on safety, was a person who was on-call on their day off, 2.5 hours drive away. Now I’ll let you be judge on how negligent this approach is. The reality is if you limit the resources to manage contingencies or not even have contingencies, then you seriously increase the risk of harm to staff and students.
The safety officer needs to actively monitor weather conditions, notify groups of any changes, or the issuance of extreme weather warnings. They need to remain appraised of other potential environmental hazards, such as bush fires, flash flooding, lightning, high winds, feral animal control or even other groups in operational areas.
I always enjoy the variety that this role brings. At times, it's a great way to have a quiet day in the office, simply checking weather, fire danger and logging communications. However, other times you're on the go all day, sorting out logistical and operational issues to smooth out daily activities, or occasionally taking a student to hospital (and sometimes a staff member).
The bottom line is that the safety officer is a vital, available resource that's ready to respond, provide additional support or effectively co-ordinate a larger scale operation in the event of an emergency or crisis. It's not just a cushy role for some inexperienced staff member to have a quiet ‘admin day’ in the office. You need to use your most capable staff because the difference that can make to the speed and effectiveness of the response, impacts significantly on the containment and mitigation of the incident.
In first aid training, it should be drilled into students more and more that Danger is the No. 1 consideration for First Aiders. It's often mentioned, but the massive importance of the issue is not always effectively addressed. Personal safety and personal protective equipment should be dominant factors in your decision-making process of, ‘To help or not to help!’ The tough reality is that if you're going to be at risk, then you always have the choice not to involve yourself. It's a hard decision, especially when you're trained and have a desire to help others, but sometimes it's the only choice possible if you’re going to end up in danger yourself.
One situation I found myself in where the danger to me proved far too great, was when I was in Colorado, in the US. I was skiing at Breckenridge, and coming down a home trail that links two of the peaks together, when a movement out of the corner of my eye caught my attention. I skidded to a stop. Glancing back I saw two figures scrambling desperately to get out of a creek bed next to the trail.
The first one popped up onto the side of the track. ‘Are you ok?’ I asked, seeing that he was a snowboarder.
‘Yeah, I'm fine,’ he panted.
He seemed distracted, turned back and scrambled towards the creek. I skated up and took a closer look. I could see his friend half way up the snow covered embankment, his head covered in blood.
‘Oh…’ I thought, suddenly switching modes and quickly assessing the area, the people and everything around me.
The guy who'd climbed out first was now becoming increasingly distressed.
I looked directly at him and calmly said, ‘Would you like me to call ski patrol?’
‘Oh yeah man… yeah… I need to get him out!’ he replied sounding confused and now appearing disorientated.
That was about the best indication I could get that this guy wanted help, so I called ski patrol and gave them a quick description of the situation and my location. At this point however, I’d only just seen the scrambling up, some blood and heard a bit of noise. I didn't quite understand the full extent of the injuries or anything like that.
As I got off the phone, I could see the second snowboarder grab the edge of the track and push himself up. I clicked out of my skis and stepped forward. Staggered to his feet, the snowboarder stumbled toward me. Taking one look, I stepped back. Blood was pouring down his face like a bubbling brook.
Taking another defensive half-step back I said, ‘My name’s David, I’ve called ski patrol and they're on their way.’
I got a mumbled somewhat confused response that at some point included an acknowledgement.
This whole time, I was still assessing the scene and evaluating the injured snowboarder. I'd determined the scene was safe. Given the mechanism of injury appeared to be snowboarding into a creek without a helmet, I wasn't that concerned about that happening to me. The next danger was that the snowboarder was now standing in the middle of a ski run and other skiers and snowboarders were riding past at speed. To manage this danger, after I took my skis off, I’d crossed them up hill from our location, so I was happy with the fact that I wasn't going to get hit where I was standing.
Next I moved to the human factor in my ongoing Danger assessment. I’d already determined that there was significant personal risk involved in providing First Aid. There was blood everywhere, I didn't know the person, he appeared to be under the influence of drugs and I had no personal protective equipment (gloves). This was too much danger for my liking and there was no way I was going to put myself at risk of a blood borne infection through providing assistance in this situation. At the same time, I also decided that I wasn't going to just walk away. I was going to be entirely ‘hands off’ as the casualty was at least able to do things for himself and help was on its way.
From a safe distance, I provided clear instructions to him and his friend, who was still wandering around in a panic. ‘Okay, ski patrol isn't far away,’ I said again to reassure the casualty. ‘What I suggest you do whilst you wait is just sit down on the side of the track and with your glove, press down on your head.’ I pointed to where I wanted him to sit, out of the way of others and demonstrated with my hand on my head to show him what I wanted him to do.
The blood kept streaming down the snowboarder’s face unabated, but there was little else I could or would do in this situation. He sat down and at least put some pressure on his wound. For at least 2 minutes, he was sitting there doing what I'd suggested he do.
This is where it became weird. His friend is still walking about in a panic and I was trying my best to calm him and reassure him. Then the casualty starts reacting to his idiot friend’s panic. ‘I've gotta get outta here man!’ he said.
‘Oh no,’ I thought. ‘Here we go!’
Now dealing with profusely bleeding drug tripping snowboarders isn't my idea of a good day on the snow, but I still had to try my best until I could hand this bloody mess over to ski patrol.
‘It's okay,’ I said again, ‘ski patrol is on its way. Just stay where you are, keep pressure on your head and you’ll be taken care of shortly.’
‘Nah, man I gotta go!’ he said, taking his hand off the head wound. Suddenly more blood streamed from his head as the pressure released. He proceeded to strap on his snowboard.
I tried reasoning with him some more, and when that didn't work, I tried reasoning with his friend. Not an easy thing to do with stoners! Dave definitely wasn't their man!
No matter what I tried, the guy was determined to go, so I certainly wasn't going to try and stop him. He skated off woosily, his friend chasing after him yelling, ‘You gotta see a doctor man!’
I quickly got back on the phone to ski patrol and explained the situation. ‘Do you know where he’s going?’ they asked.
‘No, sorry I don't know, but there's a pretty clear trail of blood leaving my location. Follow that and you're bound to find him.’
With that, it was the end of my involvement. Even though I provided some level of assistance, I remained completely hands off to protect myself from the clear and present danger. Having come across an injured person, I’d fulfilled my obligations under the skier’s code of responsibility, by stopping and calling ski patrol. However, in my assessment of the scene, the injury and the person involved, I’d decided very quickly during my initial danger assessment, I wasn't going to offer or provide first aid.
This can be a hard decision, as you're trained to help others in need. However, I've seen people rush in to situations and end up finding themselves covered with a stranger’s blood, which, even if you've only got a paper cut on your finger, could mean an infection. The last time I saw this happen, the person was a first responder to a car accident. He rushed in with another, started treating a casualty, no gloves, no danger assessment done at all. The irony was that there was a well-stocked First Aid kit with plenty of gloves in the back of the responder’s vehicle. If they had taken 60 sec to calm themselves, checked for dangers and put gloves on whilst they assessed the scene and its surrounds, they wouldn't have needed to go through the stress of a number of blood tests for infectious diseases. I can't stress enough DON’T DO THIS! If you're the first responder, your No. 1 priority is always to CHECK FOR DANGER! At the end of the day, you can't afford to put yourself at risk of harm and become the second casualty of the incident.
Nail Through Arm
Once again my three years were up. It’s almost like Logan’s Run with the light going red on my hand… Well not quite, but first aid certification in Australia only lasts three years. So last week it was back to the classroom for first aid update training!
Often the quality of basic first aid courses is pretty woeful. You sit there in front of an instructor who has the power point burning hot. He monotonously steps you through each and every pain-staking slide and reads everything to you that you could easily have read yourself. Most courses are simply the ‘compliance’ stuff you need to ‘maintain’ your qualification so you can treat a paper cut in the office or be eligible for the ‘official First Aid officer’ payment. If you can, avoid these sorts of courses at all cost, as they really teach you nothing more than CPR and how to dial 000.
Although most of the first aid you’re likely to be doing in your day to day work is going to be relatively sedate, you never know what will happen and you can get thrown in the deep end and find yourself outside your comfort zone very quickly. The reality is that most causalities don’t sit there calmly whilst you bandage their non-broken arm. If someone needs your help, there's usually going to be pain, covered in blood, collapsed, vomiting or all of the above.
Case in point, one day I was walking along the corridor outside the classrooms. One of my colleagues yelled out to me to come and help. I stepped into the room to see one of the students collapsed, fitting on the floor, frothing at the mouth and going blue in the face. Everyone in the room had frozen and didn’t know what to do. If you’re dealing with kids in particular, the reality is that something like this is eventually going to happen. You’re better to be prepared for it and not have it happen, than not to be prepared when it does. Walking into a confronting scene and being able to react appropriately is something that only training and experience can provide. The better the training, the easier it is to get your head around what needs to happen next.
I didn’t know what to expect from this course, as every course I’ve done over years has varied dramatically. Within the first hour, we were into scenarios and this was where it got interesting. Casualties were made up with some awesome looking wounds, injuries and scenes were staged with heavy machinery, vehicles and boats. With fake blood everywhere, it was scarily realistic!
First Aid Scenario
You’re thrown into each scenario with little or no information, which will be the case if you find yourself dealing with a similar situation in real life. It's up to you to work with the resources you have to contain and respond to the situation at hand. This is generally easy when you've only got one casualty, but add in two or three and a bit of anger and conflict to the mix, then you have some tough situations with which to deal.
The course was amazing with some short sessions of instruction, followed by a variety of these intense, realistic scenarios. Each and every one of them got the adrenaline pumping! From someone running at you yelling for help, to approaching a scene that's chaotic, full of noise, smoke, casualties, blood and screams, it was challenging. Even though you know it's setup, it still has the effect of raising your heart rate and throwing you in to manage what could be a real-life situation, a workplace accident, a vehicular accident or even an accident at home.
Training in this manner is important, as it helps you to pause, check for danger and potential risks and hazards as well as assess the situation in as calm a manner as possible. Many people rush into situations, which often puts them at risk of harm as well. Making situations feel real means that your brain is being pushed to make those informed decisions before you're confronted with the complex challenge of a real situation.
The great thing about the course was the fact that everyone was pushed. No matter how experienced we were, the scenarios pushed the limits and I certainly got a lot out of it. The remote area course was far more than just completing the 3 year compliance check. It was interesting, it was challenging, but overall it was rewarding, as I've come away with more confidence in how to assess complex situations that in reality might one day happen.
As a good guide for first aid training, forget Senior First Aid, seriously what's the point? In my opinion, it's a complete waste of time and money that won't really do anything more than train you in the most basic of first aid theories, which doesn't prepare you very well for the real thing. Look for something like a Remote Area or Wilderness First Aid run by a reputable provided such as Remote Safety Solutions. It's even better if it can be tailored to your specific areas of operation. It's well worth the time and effort to do this. You and your organisation will be far better prepared if something does happen.