A Guide for Guides: Emergency First Aid
Ryan Barnes for SPLIT REED
I was on a hunt a few years back, on a field absolutely covered in geese. A couple of local friends asked if they could join us, as they had never been on a true layout field goose hunt. We invited them and showed them a few of the basics of how to shoot out of ground blind, what to expect, and how to go about hunting in a field. For anyone that’s done it, you know it’s much different than sitting in a duck blind waiting for ducks to dive into the decoys. The first flock came in, the shot was called, and we dropped a good few birds. Unfortunately one of the newcomers wasn’t able to get out of his blind in time. We laughed and teased a bit, then gave some helpful hints.
The next flock came with the same results. The gentleman clearly was struggling to throw his blind open, grab his gun, and get his shots off in time. By this time we all had about two birds apiece, except for him. The rookie was probably feeling a little pressure, as was I. I wanted him to experience a fun and successful hunt, but that wouldn’t happen unless he got some shooting in. The next flock started working, wings locked, but before they worked into range- “BOOM”. A shotgun blast went off. Everyone started yelling and cussing at the party foul of shooting too early and not waiting for the shot to be called. I looked over at the newcomer and realized this wasn’t intentional. It was a mistake that ultimately and unfortunately would ruin the hunt. Being eager to make the shot in time, he took his gun off safety, adjusted his position, and accidentally pulled the trigger. I sat and watched the hole in the bottom of the blind for a few seconds expecting the inevitable. The blood started to pool up at the bottom of the blind, and he started to scream out in pain. He had shot the top of his foot off.
We all scrambled to get him out of the blind, take the boot off, and assess the damage. It wasn’t good. Luckily we were within 15 minutes of a hospital so we did what we knew (or assumed) would be best. We wrapped his jacket around the foot, had someone with a stronger stomach than me apply pressure, and sped him to the ER. Fortunately, we were within spitting distance of help, but it got me thinking, “what if we weren’t?" What if we had been on one of our favorite fields out in the middle of nowhere and it had been a wound to somewhere more ‘vital’? What would a guide do if one of his clients was seriously hurt on his watch?”
I sat down and talked to former EMT and Search and Rescue Medic, Reed Montigo, to see what would be the best course of action.
So what is the best thing to do to handle an emergency in the field?
Montigo: “The best thing you can do is take preventative measures! We used to see this all the time, especially when we would get calls with hunting or fishing or whatnot when the guide either didn’t do his due diligence in preparing his clients, or they were stupid and found themselves somewhere they shouldn’t have been. There are certain things you can’t avoid, and you can’t plan for, but human error, like someone getting shot, you can ALWAYS avoid. If someone gets shot and injured on your hunt, that’s because the guide either was being careless or had them in an unsafe scenario.
Take 30 minutes before your hunt, or 30 minutes the night before, or whatever, and go over what you expect in gun safety, where to shoot, when to shoot, all that good stuff. The clients may think it’s petty, but if you’re strict about it, at least they’ll go home safe. I would even recommend if a guide sees a client being unsafe during the hunt, get them out of there. That’s a good way to get someone hurt. I’d rather see guides be strict and be an asshole about being safe with a gun, than being cavalier and just assume everyone is being safe, and then someone ends up getting shot in the guts and won’t be able to see their family anymore. Preventative measures are always the best way to make sure you’re going to prevent something from happening.”
Unfortunately, things do and will continue to happen, so what’s the best course of action to handle those situations?
Montigo: “Go get your EMS (emergency medical services) training. Learn how to perform CPR, learn how to properly apply a tourniquet to an extremity, and always, always, always have a high-end first aid kit with you! I’m not talking just bandages and tape. I’m talking about basically everything you would need to apply what you learned from EMS training. The nice thing about having that is 1- it will make you more appealing to prospective clients, and 2- if something does go wrong, at least you’ll be better suited for it.
I was called out one time where a deer hunter had fallen from a horse and believed he had injured his back. His guide had an EMS pack, brought back the neck brace, all the proper equipment to keep him stabilized, and actually did a great job of keeping him safe until we could get to him. We ended up life-flighting him to the nearest hospital and finding out it was a fracture in his spine. If the guide hadn’t acted properly, or tried to move him or put him on his horse and rode him back, it could have caused lifelong paralysis had it broke all the way through from further strain. I’m not sure. But it’s scenarios like that where you see a properly trained guide, doing things to keep his client from having his life turned upside down.
I know duck hunting is a bit different, but the principles are still there. For instance, say someone gets shot in the leg, or some other extremity, which happens multiple times a season, what do you do? As a guide, you should be able to react with the proper equipment until proper help arrives. You always want to try to stop the bleeding, that’s with a tourniquet, bandages, pressure to the wound, and if you can and if you’ve been trained, applying sutures. There are also scenarios where people have heart attacks, or people have seizures or allergic reactions. In those scenarios, it’s so important to be trained on what to do. Some aren’t as serious as others. For instance, if someone trips and breaks an ankle in a field, the best thing to do is get it in a splint and drive them to a hospital. If someone starts suffering from hypothermia after taking a spill and you’re on the water duck hunting, it’s wise to have some sort of thermal blanket that they can strip down and cover themselves with to stay warm until you get back. Like I said earlier, the key to all this is really just being prepared. You have to ask “What could go wrong?”, and then plan accordingly”.
How would you handle a scenario where someone has been seriously injured, possibly life-threatening?
Montigo: “I would imagine you mean a shotgun blast to the vitals. At that point, there’s not a whole lot that anyone can do if it’s to the organs. I’ve seen close-range shotgun blasts from guys being stupid, and very rarely are ever able to do much. Blood transfusions, surgery, all sorts of immediate and serious medical attention are needed. Shotguns do a lot of damage even in smaller loads. Shooting magnum loads that are used for waterfowl, I personally, and luckily, never saw one where a hunter was shot in the vital area, but I know if I was called on one, it would be blood bags and a whole lot of trying to fix what entrail organ damage we can. Unfortunately, at that point, there’s just not a lot someone can do other than call 911 and hope they get there in time.
Now if someone has been shot in an area that’s maybe not a vital area, but rather has arteries or an area with lots of potential blood loss, that’s when it can be a matter of life or death for the guide. That’s when that EMS kit and training can be the difference between the cost of a funeral or the cost of a medical bill. I know I’m saying all this like it’s easy, but for instance, say a guy shoots his gun, in the blind, and I understand accidents happen, and hits a guy on the other side of the blind on the inner thigh and clips an artery, now it’s on the guide to know how to place the tourniquet, where to place the tourniquet, and how to use the cauterizing powder (or whatever he may use from his kit, some training and scenarios may use different things) to get the bleeding to stop. As technical as it sounds, it’s actually pretty basic, stop the blood flow as best you can to the injured area, clean the wound as best you can, and stop the wound from bleeding, get professional help immediately or as soon as possible. That’s really all you can do. If someone takes a gunshot to the torso area, at that point, if they aren’t already gone, you’re dealing with organ damage, internal bleeding, and a whole myriad of things that even the professionals are going to have a hard time with until or if they get the patient stabilized.”
What would you say are the most important parts of field trauma safety?
Montigo: “From my experience, number one will always be planning and preparation. Plan for the worst, and be prepared to react accordingly. Number two will be cell phone service. Especially for guides, there’s no reason you shouldn’t have service. Garmin, Base Camp, all these satellite companies allow you to have service damn near anywhere in the world for these very reasons. Number three would be preventative measures. I know that kind of goes along with number one, but it’s just so important. And my real big one is getting your proper safety training. Most states require some sort of training, which I think is great because it protects both you and the client, but even if you guide in a state that doesn’t, you don’t want to be the guide that has to live with yourself after you watched one of your hunters bleed out because you had no idea what to do.”
Unfortunately, this is a grim topic, but it’s one that seems necessary. As guides, hundreds to even thousands of hunters entrust their safety to you each day of waterfowl season. Make sure you can live up to those expectations, especially if things go wrong. Be safe, hunt hard, good luck!
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