Flat line, a bad thing!

It had been one of the busiest shifts that we had worked in awhile, maybe ever, for my partner and me. First emergency call came to us within about 2 minutes of our shift starting, didn’t even have time to give the squad our usual thorough check over. . . just the basics: green bag, blue bag, OB kit, AED, oxygen, check, roll!

Four hours later we finally get a chance to get fuel. Just as we are thinking about the shift coming to an end, at least the end is only two hours away, which means maybe one more call, our squad phone rings and dispatch asks if we are clear of fueling yet. “Just clear”, I respond. “Ok, got a 10-17 with fire coming to your screen.” The screen starts squawking with “emergency pending, emergency pending” being announced. As I hit the enroute button which silences the announcement and sends a signal to dispatch that we are rolling, I read the address out lout to my partner. She hits the lights and the siren and begins to maneuver the squad through the city streets, we’re 4 to 5 minutes away. The nature of call is “unresponsive”. As we approach the intersection from the north where we need to turn to the address given, we see the responding engine coming from the south. As in kayaking, the gross tonnage rule applies and we yield to them. As we turn the corner we see a group of people mid-block on the left, one of them is doing CPR on someone lying in the easement between the street and the sidewalk.

As we roll to a stop, the firefighters are jumping out, and we are doing likewise. There are now six trained professionals on-scene and the by-stander steps back. Without saying more than one or two words between the six of us, one firefighter readies the AED, which will also analyze the cardiac rhythm and deliver shocks as appropriate. My partner kneels at the head and carefully straightens out the neck to get a patent airway. I check for a pulse as another firefighter is checking for responsiveness. Non-responsive, no pulse and not breathing. We know what needs to be done and as if we had worked together as a team for ever, we set about the task of trying to save a life. As one firefighter readies the airway materials; I cut-off the person’s shirts so the AED can be attached. There are no visible signs of trauma. Chest compressions begin. AED is attached. Not a shockable rhythm, continue chest compressions. A paramedic rig arrives, along with several police cars. We lift the lifeless body onto the cot and place it in the back of the med rig. An IV line is started to get medications on board, they could make a difference. The patient is intubated and connected to a bag-valve mask that will force oxygen into the lungs, it’s all about getting oxygenated blood to the brain.

More police arrive and are canvassing the area. What happened to this guy? The medications work and bring the heart into what is analyzed to be a shockable rhythm, shock delivered. No change. Continue chest compressions. The firefighters take turns doing compressions, the effectiveness of compressions decrease as fatigue sets in, and doing chest compressions is hard work! At this point there’s not much for my partner and I to do. If we weren’t blocked in by all the other responders we could leave. I’m glad we can’t. Not only am I an EMT, but I also teach CPR, a real life experience to use in my teachings!

We answer a couple of questions the police have for us. I tidy up the equipment still on the ground where we started. As the patient (aka “code”) is worked, several police officers, along with my partner and I, stand at the back of the ambulance looking in at the lifeless body on the cot. Another shock is delivered by the AED, still nothing.

After about 50 minutes, and following their protocol, the paramedics determine that further efforts would not convert him. Compressions are stopped, the breathing via the BVM is stopped, the monitor turned off, and the body covered with a couple of sheets. A police officer with a mobile ID gadget takes a couple of finger prints and within a couple of minutes has a positive ID from the marvels of cyberspace.

In this case we know what the outcome is, which we often don’t. We still wonder why? What happened? What took the life of this 25 year old? We have a theory, but we will most likely never know for sure.

I’ve been called to the scene where someone was discovered a few days after dying, and I’ve had patients who were pretty close to death, this was the first “fresh” PNB (pulseless not breathing) for me. And, it was a good team effort between all the EMS on scene! Unfortunately this teachable moment doesn’t have a positive outcome, never-the-less it is a valuable experience.

Oh what a night!

Posted: April 24th, 2009 under Emergency Medicine, Uncategorized.
Comments: 4

Just completed day 5 of a 7 day Wilderness First Responder class that I’m an assistant instructor on–it’s the first of it’s type that I’ve assisted with.  Great students, great curriculum, great lead instructors that I’m privileged to be be working with.  Here, Chicago sea kayaker John Martin has managed to wrap himself around a tree while going to the aid of some of his friends.  The two students are working to stabilize him so he can be evacuated to a nearby trauma center.  By the way, the woman holding John’s C-spine stable is from Southern California–yep, she came here to take the class before heading off to Ecuador in a few weeks!  Can you say “climate shock!”

Posted: January 7th, 2009 under Uncategorized, Wilderness Medicine.
Comments: 2

One of the things that I’ve been fortunate with during the past several years has been the mentoring that I’ve received along my journey to become an Open Water Instructor Trainer with the American Canoe Association (ACA). During this journey Sam Crowley, an Instructor Trainer Educator, has been my mentor. Sam and I have spent countless hours together on the water, on the shoreline, in the classroom, around the table, on the telephone, over lunch, over breakfast, over dinner, over cyber space (email), as well as snail mail, and even over a beer. During these sessions Sam has provided me with the feedback to facilitate my becoming a better instructor, and an instructor trainer. I’m thankful for his time, energy, mentorship, for his professionalism, and his friendship! Thanks Sam!!!

For more about Sam checkout Sea Kayak Specialists web site.

As I start another chapter in my life, that as an instructor with Wilderness Medical Associates, I look forward to the mentoring I will receive from Ann Dunphy. I had the pleasure of assisting Ann last May with the Wilderness First Aid class for Rutabaga. Being the first class that I assisted with, I was pretty much an observer. In the coming months I will be teaching Wilderness First Aid and Wilderness First Responder classes with Ann, as well as other lead instructors. This past year I assisted four different instructors, all of a very high quality—which speaks highly of the process that WMA uses to select and train its instructors. I’m pleased to have Ann as my mentor, we have a lot in common—besides the love of teaching and emergency medicine, we both enjoy kayaking and a good beer! 

For more information about Wilderness Medical Associates checkout their web site at wildmed.com.

Posted: November 28th, 2008 under Friends, personal.
Comments: 1

I always have an interest in what’s happening on the lake, Lake Michigan–my home water.  Besides the weather links listed on the weather page (see Weather Links in the side-bar) on the site here, there are a few more links that you may find useful as well–at least I do.  So here they are, along with my comments.

If you have a favorite weather/conditions site, send it to me and I’ll get if posted.

Nearshore Forecast

This is a new and improved format (longer range and graphics) of the nearshore text forecast that we’ve used for many years http://forecast.weather.gov/MapClick.php?site=LOT&textField1=42.9916&textField2=-87.8159

Water Temperatures

Great Lakes Coastal Forecasting System—Lake Michigan Surface Temperatures (note:  use the two drop- down lists to navigate to additional data http://www.glerl.noaa.gov/res/glcfs/glcfs.php?lake=m&ext=swt&type=N&hr=00

Mid-Lake Buoy East Souteast of Milwaukee http://www.ndbc.noaa.gov/station_page.php?station=45007

CoastWatch

http://www.coastwatch.msu.edu/michigan/m.html

Note:  Cloud covered areas of the lake surface cannot be read accurately by NOAA satellites so the computer program colors them black. Areas near the black masked cloud cover may not be as precisely reported as those some distance from the clouds. CoastWatch images are generally representative of surface temperature conditions, they are not as accurate as your road atlas.  Some areas are masked with grey color because the computer program has indicated the temperatures presented are probably cloud temperatures. The air temperature at the tops of clouds can sometimes be very nearly the same as the surface water temperature of the lakes below. The grey-scale masking indicates that the accuracy of temperature reporting is lower at this time.

http://coastwatch.msu.edu/twomichigans.html

Webcam links of current nearby Lake Michigan water conditions (“nearby” to Milwaukee that is)

Milwaukee Harbor

ftp://ftp.glerl.noaa.gov/realtime/mil/mil1.jpg

Various possibilities for viewing current conditions in Milwaukee (warning:  can be a bit putzie)

http://www.lakefrontcam.com/

Sheboygan

http://www.visitsheboygan.com/BlueHarbor/view.htm

http://www.visitsheboygan.com/live/view.htm

Then there’s this bit of info, similar to the weather rope we used in the navy –

Posted: October 9th, 2008 under Lake Michigan, Sea Kayaking, Weather.
Comments: 1

Welcome to the new and improved site for Seakayakerjb Speaks and wildernessconnection.com!

(At least I think it’s improved.)

I decided to roll my long standing (dormant) web site (which I’ve had since 1993, long before web sites were as popular as they are today) and the blog together.  This combined blog and web site is something others have done and I really like how they flowed.

My goal is to post a blog at least once a week, and if I have something to say more frequently, well I just might post more than once a week.

I’d really like for this to be a communication means and look forward to comments from the visitors (yes that’s you)!  So, post your thoughts . . .thanks!

The web site is still undergoing some work, but it’s work is in progress!  Some of the things to look forward to include a section for students where they will find materials related specifically to their class they took from me (sea kayaking, wilderness first aid, or CPR).

I hope you find this useful and I do look forward to your input.

Posted: August 15th, 2008 under Ramblings, Uncategorized.
Comments: 3

In just a few days now the Vernal Equinox will be upon us (March 20th this year).  Canoecopia has come and gone, which is the beginning of spring for the paddling community around here.

 St. Patrick’s Day is also on the horizon . . . many will drink green beer, which I don’t understand at all.  I prefer a simple toast with a pint of Guinness, or a glass of Irish whisky, which I shall do.

 All that’s left is for the weather to cooperate and get on with it!!!  SPRING–let there be SPRING!

Posted: March 16th, 2008 under Ramblings.
Comments: none

Now that you are over the shock of me actually posting something to my blog, ok so you aren’t over it yet . . . one thing that you’d better get over pretty soon is warm weather paddling, the warm weather and water is gone, and it won’t return for several months (at least here in the upper Midwest)!!!

A few months ago at one of our early morning rendezvous for coffee (aka “2 fellas at Bella’s”) Silbs spoke of the longer periods of darkness, and how he is needing to find a routine to occupy his time before the sun comes up (I guess some people do have that problem, but I’m not there yet ;)). He mentioned doing some yoga, some palates, reading the paper, and writing his blog. Ok, so that takes him to about 0630 (1.5 hours), so what to do with the other 1.5 hours? — That is the question, at least for him. And, of course there’s the rest of the day, before darkness sets in again, for taking those brisk hour long walks (sorry Ansel these are brisk walks, not stop and sniff, and whatever else it is that you do).

Fast forward to a couple of weeks ago, and again after one of our 2 fellas at Bella’s meetin’s, Silbs went and joined a local fitness (aka athletic) club, something that I had been subtly encouraging since we (Oz, my spouse for those of you that don’t know) did last winter.

So, what the hell am I talking about? The battle of the bulge? Not really, though that might be a result of decreasing activity, even without increasing the caloric intake, and something that Silbs seemed to become increasingly obsessed with. In the August issue of Atlantic Coastal Kayaker magazine, Wayne Horodowich wrote about losing one’s edge; and, about knowing where the “edge” is (and respecting it). (If you want to read more about these topics from Wayne, go to his web site (www.useakayak.org) and click on the “Reflections” button on the left. Some really good thoughts/information/”reflections” there.)

Wayne speaks of a “Yakism” – “We are either training or un-training.” This reminded me of something that I read in the BCU Coaches’ Handbook regarding the “regression principle”. “When an athlete stops training they will lose any gains they have made relatively rapidly . . . ceasing training, dependent upon the period and degree of detraining (ranging from normal active life, but no training to complete bed rest), will result in a loss of fitness gains made through previous training.”

As we moved through fall, many paddlers cut back on their paddling activities—thus entering into a period of “un-training”. For some, the boats were stored away, well before Thanksgiving, only to be returned to the water in April or May (that’s nearly 6 months!). Now we’ve moved to winter, and even those who paddled frequently during the fall are finding themselves “locked-out” off the water by the cold, or hard water (ice).

Those gains made this year from paddling may have looked good when the paddling began to become less frequent, or not at all, but how will they be next spring? How are you going to maintain the flexibility that you developed in the last six months? And what about the skills themselves? Skills are dynamic, that is they are constantly changing—for the better and not so. The other thing about skills, if you don’t use them, you will begin to lose them (the “un-training”). (I studied Chinese language for two years, but having not used it in 30+ years, I’ve been un-trained, guess I should have studied Spanish . . . but I digress.)

The time to plan for the “off-season” has pasted by, but it’s not too late! Do as Silbs has done, start with some yoga and palates. Add in some strength training and some cardio, and mix well. Get into a routine—you’ll feel better physically and mentally, and keep a log of your workouts and observe the improvement.

Additionally, educate yourself; books, DVDs, magazines, blogs, websites, coffee klatches. How about some pool sessions or a winter break down south? Join a fitness club. And, of course, you could extend the paddling season by getting, depending on where you live a wetsuit—or a drysuit!

Minimize the “un-training”, keep your edge!

Sounds like a good New Year’s Resolution !!!

Posted: December 27th, 2007 under Fitness.
Comments: 2

As many of you have heard, a Waukegan Illinois man apparently drown off of Waukegan on Sunday, October 28, 2007. It has been reported that this was his first time out, having just purchased the kayak the week before. Walter Doroba was last seen around 3:30 p.m. on Sunday afternoon by another (power) boater. Some time later (around 5:00 p.m.) the same boater saw Walter’s overturned kayak along with a “life jacket” (PFD) floating in the water and notified authorities.

The weather was nice on Sunday, with the air temperature at Chicago’s O’Hara airport reporting a high of 56° F at 1454, with SW winds at 13, gusting to 16 mph. The water temperature on Lake Michigan, in these parts is running in the low 50’s. Waves were forecasted to be in the 1 to 2 foot range on Sunday.

For the prepared and experienced open water kayaker the conditions were benign to say the least. However, for the unprepared and inexperienced, the conditions were deadly!

When submerged in water, we lose heat 25 to 35 times faster than when not in the water. With water temperatures in the 50 to 60 degree range, it is estimated that a person becomes exhausted, or unconsciousness in 1 to 2 hours, with an expected survival time of 1 to 6 hours. In 40 to 50 degree water the exhaustion or unconsciousness comes in 0.5 to 1 hour, and the expected survival time drops to 1 to 3 hours. (There are a lot of variables, but these times are for someone not in “protective” clothing, i.e., wetsuit, drysuit, etc.)

Ironically, the December issue of Sea Kayaker Magazine arrived last week, and contains the story of the death of an experienced (20+ years) kayaker, in circumstances not too terribly different than Doroba’s.

We know the most about the death of Len Goodman, thanks to the article in Sea Kayaker Magazine. Len, 76 years of age, was the president of the California Kayak Friends (CKF), which is an organization of approximately 200 members in southern California. Len is described in the article as being a “conservative paddler” who often “preached” safety. Running late to a group paddle, Len called one of the group’s members and told him not to wait for him, that he would divert from the planned paddle and do a solo one instead.

The weather was warm and sunny, the winds calm in the early morning, but the Santa Ana winds picked up around 9:00 a.m. and brought strong offshore winds in the 20 to 30 kts range, with gusts of 35 to 40 kts. At some point, Len capsized. His only means of recovery was a paddle float reentry as he didn’t have a roll, nor did he have a reentry and roll. His overturned kayak was found about 3.5 miles offshore, with the paddle float inflated on the paddle, and the paddle attached to the kayak. The vessel finding Len’s kayak radioed the Coast Guard and enroute to the scene they found Len floating in the water about 2.5 miles from shore. CPR was performed as the Coast Guard rushed to shore to hand Len over to the EMTs waiting to transport to the hospital. Upon arrival at the hospital Len’s core temperature was 80°F. Continuing CPR, the hospital staff began rewarming him and after 2 hours his core temperature was recorded at 88°F, but still no cardiac activity. The official cause of death was drowning, and the time was listed as being between 9:00 a.m. and 1:00 p.m.

Although the group that Len paddled with practiced rescues and rolls frequently, Len usually didn’t participate because he chilled easily. Len had taken a class three years earlier that involved a lot of rescue work. At the conclusion of that class, the instructor counseled Len on not paddling alone or in rough conditions until he improved his self rescue abilities. Additionally, Len was advised to get a properly fitting wetsuit (his was too loose and allowed the flushing of water between the suit and the skin). (When I sold wetsuits, people would always complain that they were too tight and wanted the next size – or 2 sizes larger. I’d tell them that if they didn’t feel it, it wouldn’t do them much good.)

Len’s VHF radio had stopped working quite some time ago, and he had not replaced it yet.

Lot’s of lessons to be learned from both of these tragic events.

While Len had lots of experience kayaking, and Walter had little to none (I don’t know if he had ever been in a kayak, or had formal instruction before, just that this was a new kayak), Len didn’t have, and Walter apparently didn’t either, the necessary recovery skills to paddle alone on open water.

Reliable, in good working order, signaling devices are necessary when things do go wrong. There is a high probability that both Len and Walter would have been successfully rescued if they had a VHF radio available to call for assistance. Not to mention flares, smoke, and other signaling devices. I NEVER go on open water without my VHF radio. Regardless of where I’m paddling, I always have my flares (6 of them) with me, along with a strobe (secured to the shoulder of my PFD), signaling mirror and whistle (granted the whistle isn’t much good unless someone is really close by, but it is louder than I can yell). The VHF radio, flares, mirror and whistle are all on my PFD. And, I usually carry my cell phone in a waterproof container in my day hatch, not that I think it will be all that effective while actually in the water.

I always wear my PFD and have it properly secured/tightened. Walter’s was found with his kayak, either he wasn’t wearing it, or he slipped out of it because it was not properly secured, something many people do in favor of a more “relaxed comfortable fit.” I recall one paddler telling me that he once thought he was going to slide right out of his PFD before he could get the straps tightened after capsizing in rather heavy conditions. Again, I NEVER paddle without my PFD on, and I consider myself to be a decent swimmer.

Lastly, I always dress for immersion. I ignore the “rules” that I’ve heard some say, e.g., “if the air + water temperatures are greater than 120 degrees, you’ll be ok without protective clothing.” Think about that, how often do we have 50 degree water and 70 degree air temperatures? Would you want to take a swim without a wetsuit? Personally, I wouldn’t want to without a drysuit!

While I could go on, let me just say Practice, Practice, Practice!!!

Just as I’m posting this, I’ve received a posting from CASKA (Chicago Area Sea Kayak Association) that is on point, and merits passing on. Take a look at Safety Center and pass it on!

Posted: November 6th, 2007 under Safety.
Comments: 3

As many of you have heard Australian adventurer Andrew McAuley has been reported as “missing” during his 1600 km (approximately 1000 miles) solo crossing from Tasmania to Milford Sound New Zealand, something never accomplished before. Andrew’s kayak was found 80 km (50 miles) from his goal. There has been no sighting of Andrew at this time. Given the calculated time in water and the water temperature of 15 degrees C (59 degrees F), the situation does not look good.

For those who don’t know, Andrew launched on January 11th from Tasmania on a 1600 km crossing to Milford Sound. Andrew was on schedule to arrive in New Zealand on Sunday morning (February 11th). Last Friday, someone reported receiving a distress signal from a VHF radio, it was thought to be from Andrew. A SAR (search and rescue) event was begun.

During his crossing, Andrew had faced 10-meter (33 feet) swells, 40kt (46 mph) winds, and multiple capsizes. Needless to say, those are conditions that few could even begin to endure, at all–much less in a sea kayak. But, Andrew is an adventurer in the true sense. What makes him special to many of us is that he is a sea kayaking adventurer. For details on Andrew’s accomplishments, check out his web site. The other thing that has made Andrew’s latest adventure so much in the “here and now” for so many of us is the Internet. Andrew’s crossing has been followed by many of us on the event’s site as well as at the site of Derrick Mayoleth, Kayak Quixotica.

While the “official” search may be drawing to a close, I’m sure that there will remain an ongoing search for Andrew.

Between the tears of sadness and those of compassion–something that I experience whenever I learn of someone lost at sea, I have been thinking a lot about Andrew and his family. There’s a special connection between those of us who have spent time at sea, be it in the seat of our sea kayak, or on the decks of the larger ships at sea–I am privileged to have done both. And, but for the grace of God, . . .

As always happens, some are already beginning to question Andrew’s decisions, and I’m sure others will follow. It is not for us to judge whether Andrew undertook a journey “without the proper precautions and equipment.” I’m certain that Andrew knew the risks involved and made decisions that were based on his comfort level. On any trip you have to decide what to take, and what to leave behind. His decision to not take an immersion suit was his decision based on his comfort level with his other equipment, his skills, and the challenge at-hand.

How many points of protection does a mountaineer place . . . just one more? Where does it end?

Andrew took on a challenge, that’s what adventurers do. He had previously started out in early December, only to return when he wasn’t satisfied with the protection he had from the cold. He made some adjustments and departed again, a month later.

I salute Andrew McAuley, and will hold Vicki and Finlay in my thoughts during this most difficult of times.

I also want to pay tribute to a friend, a colleague, a paddling partner, a fellow blogger, an Irish whisky drinking partner, and a blooming adventurer himself—Derrick Mayoleth. When Derrick received the breaking news of Andrew possibly being in distress, he stayed with the events as they unfolded a half-a-world away. Derrick kept the rest of us up-to-speed through his blog. While many of us were sleeping, Derrick was collecting information and posting it so we (from around the world I might add!) could have the latest information. It truly is amazing what this Internet thing can do! Great job Derrick—-what’s your favorite coffee (or Irish whisky)? The trucks will be pulling up with deliveries soon!

Another blog about this event that I found of particular interest was that of a kayaking mentor of mine, Sam Crowley. Sam is in the midst of preparing for his kayaking adventure this summer when he will circumnavigate Ireland. Sam provides a personal perspective that is worth reading.

And, one more link for you to look at is the New South Wales Sea Kayak Club’s tribute to a member, Andrew McAuley.

Wishing you safe journeys, near and far!

May Peace Be With You!

Posted: February 12th, 2007 under Uncategorized.
Comments: 4

Yes it is cold outside, and taking a “page” from Derrick, just this once, I’m reminded of lyrics to a classic song by the same title—Baby, It’s Cold Outside.

Now many of you may have never heard this classic, which won the Academy Award for Best Original Song at the 1950 Oscars–the film was released in 1949 same year as my birth! And, taking a bit from Silbs. . .but I digress

Show tunes for $50—In what movie was Baby, It’s Cold Outside performed that earned it the Oscar for Best Original Song?

Show tunes for $100—How many times was Baby It’s Cold Outside performed in the film?

Show tunes for $200—Who sang Baby, It’s Cold Outside in the film from which it won the Oscar in 1950 for Best Original Song (hint: it was sung as a duet, by two different sets of actors)?

Now, some of you may be amazed that I know all of this, and to be honest with you, most of it I didn’t know until the magic of Google (which MS Word still underlines in red!) a few minutes ago. I do, however, remember listening to the song many times as a youngster, singing along with the old scratchy recording that my mother had of Ella Fitzgerald and Louis Jordan (no they didn’t sing it in the movie)—now me singing, there’s a scary thought, even in my pre-teen years (but, I again digress)!

So, Derrick thinks there’s another Ice Age coming, Silbs has grown very wary of winter, and Milwaukee, and I’m still saying that if I were to win the lottery (either a real big one or two small ones) I’m outta here—going south to Tybee Island Georgia, or some other more kayak friendly place. I do think that after this year, I’m going to need to plan a mid-winter break to go to a warmer place and paddle for four or five days. Perhaps I’ll be able to get a teaching gig somewhere south for a week. Hell, the way I’ve felt the last couple of days at the office, I’d leave in a minute if the financials worked out anywhere close. Let’s see if there are any job listings in a year-round kayaking friendly climate for a sea kayak instructor, who also happens to be an EMT, as well as a Wilderness EMT, and an American Heart Association CPR/ECC instructor—should be able to put something I’d think.

The picture above was taken a couple of years ago on a winter day’s paddle on Lake Michigan north of Bradford Beach—even as cold as it’s been I don’t know that we have the ice bergs out there yet. . .maybe in a couple more weeks we will.

Until next time, stay warm!

Oh, you want to check your answers to the Show Tunes Jeopardy quiz, ok . . .

Baby It’s Cold Outside was performed twice in Neptune’s Daughter, by Ricardo Montalbán and Esther Williams, and by Red Skelton and Betty Garrett.

Posted: February 6th, 2007 under Uncategorized.
Comments: 1