In bergundsteig #109 there was a report on the use of the rescue blanket as temporary UV protection. In the current article, the authors want to give an overview of other possible uses of the rescue blanket in the event of an accident.
An article by Markus Isser, Hannah Salchner, Franz J. Wiedermann, Bernd Wallner and Wolfgang Lederer - first published in the journal mountaineering
August 19, 2020. While downhilling, a young athlete overlooks a step on the trail and then falls over the handlebars of his bike. When the mountain rescue team arrived, he was shivering from the cold and reported severe pain (7 on an analogue scale from 0-10) in the area of his left shoulder with a malposition of his collarbone that was visible from the outside.
After applying a knapsack bandage, the pain is significantly lower (1-2 on an analogue scale from 0-10). The transport down to the valley until the patient is handed over to the rescue service can be carried out almost painlessly.
Contents: Possible uses of the rescue blanket
- Rescue blanket as a makeshift tourniquet
- Rescue blanket as a makeshift pelvic sling
- Rescue blanket as a makeshift knapsack bandage
- Rescue blanket as a makeshift chest seal
- Rescue blanket as a makeshift stretcher
- The rescue blanket for heat management
The multifunctional rescue blanket
The thin, aluminum-coated polyethylene terephthalate (PET) film was originally developed in the early 1960s as a "space blanket" by the NASA Marshall Space Flight Center to protect spacecraft from heat. The film was first used to protect people from the cold by participants in the New York City Marathon in 1978.
The small and light tool in the first aid kit is becoming increasingly popular. In the Tyrolean mountain rescue service, various installation techniques for a wide variety of purposes have been trained for a long time within the framework of "tactical alpine medicine".
In cooperation with the University Clinic for Anesthesia and Intensive Care Medicine, a number of studies to test the effectiveness have recently been carried out. In experimental studies, rescue blankets were tested, which are currently used by mountain rescue and air rescue in Tyrol and by the Austrian Red Cross.
The tough rescue blanket
Using a material testing machine, tensile tests were carried out to determine the tear strength of rescue blankets. The ends of the longitudinally folded blanket were connected with weaver knots and the resulting ring was stretched in a cable machine.
The breaking load of the rescue blankets unfolded lengthwise (ÖRK, LEINA) was between 2812 and 4797 N and thus proved to be more than sufficient for a wide variety of applications under tensile loads. The detailed study was published in the journal Wilderness and Environmental Medicine.
In the following, we describe six different application techniques that are suitable due to the stability and multifunctionality of the rescue blanket.
1. Rescue blanket as a makeshift tourniquet
Under special circumstances, in the case of life-threatening bleeding from injuries to the extremities, a Binding recommended.4 If no commercially available tourniquet is available on the mountain, a makeshift tie is better than none. (Study on the Safety and Efficacy of Improvised Tourniquets by Maarten Philip Cornelissen et al.)5
Not only the tear strength, but also the width of 6-7 cm of a lengthwise folded rescue blanket is particularly suitable for tying off an extremity.
The rope of the rescue blanket is placed twice around the extremity and tied tightly with a weaver knot. To build up pressure, a makeshift gag is put through the knot and tightened until the bleeding stops. The gag is then fixed to the free ends of the blanket. A rod-shaped object is best suited as a gag, as this is easier to fix than a carabiner.
It is important that after tying off a bleeding extremity with the help of an improvised tourniquet, it is checked whether a significant reduction in blood loss can actually be observed.
A first responder must also recognize how much pressure is necessary in each individual case in order to achieve a sufficient arterial tourniquet, so that unnecessarily high compression forces do not cause a additional tissue damage is caused.6
On the other hand, if too little compression only causes a congestion of the venous return flow, the blood loss can even be increased. In this case, it is better to remove the ligation immediately as an ineffective tourniquet is worse than no tourniquet.
Potential complications of a tourniquet include nerve injury, tissue ischemia consistent with compartment syndrome, venous thromboembolism, and post-ischemic reperfusion injury.
Surprisingly, the frequency of injuries reported in the literature due to the emergency ligation of extremities in the event of prehospital bleeding is not high. (Tourniquet Safety and Appropriateness Study by Michelle H. Scerbo et al.)7
2. Rescue blanket as a makeshift pelvic sling
Pelvic fractures occur again and again in alpine accidents. For emergency care of an unstable pelvic fracture, the use of a professional pelvic sling is recommended, but rarely available to a first responder.
Therefore, the improvised method with a rescue blanket is again an option. The rescue blanket is unfolded to form a longitudinal strand of 20-30 cm width, placed under the pelvis and the ends tied with weaver knots under tension.
With the help of a carabiner between the two knots, the compression pressure can be adjusted and the makeshift lap belt can be fixed. The height of the application on the pelvis is based on the greater trochanter (trochanter major, the bony prominence at the upper end, on the side of the thigh) - this should be located in the middle under the strand of the rescue blanket.
If the pain increases under tension, the makeshift pelvic sling must be removed again.
3. Rescue blanket as a makeshift knapsack bandage
With its high tensile strength and length of 210 cm, the rescue blanket is also perfect for an improvised knapsack bandage in the event of a broken collarbone. Pain can be significantly reduced (see application example in the introduction).
The rescue blanket is placed over both shoulders like the shoulder straps of a backpack, guided backwards under the armpits and tied with both strands using weaver knots between the shoulder blades.
One of the free strands is threaded up under the tab at the neck, then pulled back down and tied to the second strand under tension. As a result, the shoulder girdle is pulled backwards, which leads to relief in the case of collarbone fractures.
As always, the same applies here: If the pain increases under tension, the makeshift knapsack bandage must be removed again.
4. Rescue blanket as a makeshift chest seal
In an accident, a hole in the chest caused z. B. by an ice tool, have fatal consequences. Air is sucked in from the outside between the lung and chest wall, the lung collapses and a pneumothorax develops.
If air that has entered the lungs can no longer escape, the lung tissue becomes more and more compressed and a life-threatening tension pneumothorax develops. A valve bank commonly used in military medicine can prevent the development of a fatal tension pneumothorax after penetrating chest injuries.
Since this association is hardly available in civil emergency care, first responders have to resort to alternatives. In a test setup, we were able to show that the rescue blanket, with its smooth surface, is very well suited as a valve bank.
A moistened, approx. 20 x 20 cm piece of the Rescue blanket is placed close to the wound on the chest – this prevents the inflow of air between the lungs and chest when inhaling, but not the outflow of air.8
5. Rescue blanket as a makeshift stretcher
The amazing tear resistance of the rescue blanket also allows it to be used as a carrying ring. Here, the blanket is used in a strand, whereby the two ends are connected with weaver knots. The resulting ring is suitable for people to wear.
With a blanket you can carry an injured person using a seat ring. If you have two rescue blankets or rings, you can create a perfect backpack.
The patient climbs into a ring with one leg at a time. The first aider shoulders the two rings and can thus carry the patient on his back like a rucksack. A lying patient can be transported short distances by two rescuers by placing a ring under the patient's shoulder and buttocks.
It should be noted that the material properties of the various products available on the market can vary and therefore different tear strengths are also possible.
Likewise, objects with sharp edges such as stones, branches, but also zippers on clothing can tear the film. It should also be noted that rescue blankets for the improvised forms of use must be relatively new - as they can become brittle over the years.
The results of our experimental investigations are limited to the two products tested under laboratory conditions and do not replace an outstanding clinical user study. It is important that even improvised techniques must be well practiced and trained.
6. Thermal management rescue blanket
The original use of the rescue blanket in first aid was intended to protect against heat loss. On the one hand, heat transfer (thermoconvection) and evaporative cooling (evaporation) are reduced and on the other hand, the thermal radiation emitted by the body is reflected.
In mountain rescue, so-called diaper technology is used for heat management. The rescue blanket is pulled through under the clothing on the back and spread out. It is important that the foil is above the bottom layer of clothing.
Direct skin contact would cause heat conduction (thermoconduction). cooling effect be brought about.9At the upper end, the blanket is fixed over the head, thereby creating a head covering at the same time.
At the lower end, the foil is pulled through between the legs and fixed on the stomach side like a diaper. With this application technique, the patient can continue to move without restrictions and the rescue blanket does not pose a hazard if a helicopter is used.
Our test series have also shown that it is irrelevant which side of the rescue blanket faces the patient.
Whether the silver or gold side was facing the patient, the results showed no significant differences.10
It is also worth mentioning that rescue blankets can have a negative impact on searches using thermal imaging cameras. Persons completely wrapped in a rescue blanket are not recorded by a thermal imaging camera.
The rescue blanket is only recorded by the camera as a black spot, which shows a noticeably colder temperature than the surroundings on the thermal imaging camera. It is recommended that when a search drone or helicopter approaches, people in distress should Remove the rescue blanket from the body for a short time.11
Concluding remark
We have been researching the little marvel of a rescue blanket for a good three years now and our projects are not yet complete. We are convinced that this will also be the case in the near future other new areas of application to examine and present.12 One thing can be said with certainty - the rescue blanket should not be missing on any mountain tour.
bibliography
- 1) National Aeronautics and Space Administration. Spinoff 2006. Reflecting on space benefits: a shining example. 56-57.
- 2) Isser M, Kranebitter H, Kühn E, Lederer W. High-energy visible light transparency and ultraviolet ray transmission of metallized rescue sheets. Sci Rep. 2019;9:11208. https://www.nature.com/articles/s41598-019-47418-8
- 3) Isser M, Kranebitter H, Fink H, Wiedermann FJ, Lederer W. High resistance to tear forces increases multifunctional use of survival blankets in wilderness emergencies. J Wild Environ Med. 2020;1: https://doi.org/10.1016/j.wem.2019.12.012
- 4) Kragh JF Jr, Dubick MA. Bleeding control with limb tourniquet use in the wilderness setting: review of science. Wilderness Environ Med. 2017;28(2S):25-32.
- 5) Cornelissen MP, Brandwijk A, Schoonmade L, Giannakopoulos G, van Oostendorp S, Geeraedts L Jr. The safety and efficacy of improvised tourniquets in life-threatening hemorrhage: a systematic review. Eur J Trauma Emerg Surg. 2019; ) –> Up to here everything is in the text
- 6) The Boston Trauma Center Chiefs' Collaborative. Boston marathon bombings: an after-action review J Trauma Acute Care Surg. 2014;77(3):501-3.
- 7) Scerbo MH, Mumm JP, Gates K, Love JD, Wade CE, Holcomb JB et al. Safety and Appropriateness of tourniquets in 105 civilians. Prehosp Emerg Care. 2016;20(6):712-22.
- 8) Schachner T, Isser M, Haselbacher M, Schröcker P, Winkler M, Augustin F, Lederer W. Rescue Blanket as a Provisional Seal for Penetrating Chest Wounds in a New Ex Vivo Porcine Model. Ann Thorac Surg. 2021;S0003-4975(21)01379-5. doi: 10.1016/ j.athoracsur.2021.06.083.
- 9) Peterson GP, Fletcher LS. Measurement of the Thermal Contact Conductance and Thermal Conductivity of Anodized Aluminum Coatings. heat transfer 1990; 112(3), 579-585.
- 10) Kranebitter H, Isser M, Klinger A, Wallner B, Lederer W, Wiedermann FJ. Rescue Blankets-Transmission and Reflectivity of Electromagnetic Radiation. coatings 2020, 10(4), 375, https://doi.org/10.3390/coatings10040375
- 11) Isser M, Kranebitter H, Kofler A, Groemer G, Wiedermann F, Lederer W, Rescue blankets hamper thermal imaging in search and rescue missions. SN appl. science 2, 1486 (2020). https://doi.org/10.1007/s42452-020-03252-6
- 12) Wallner, B.; Salchner, H.; Isser, M.; Schachner, T.; Wiedermann, FJ; Lederer, W. Rescue Blankets as Multifunctional Rescue Equipment in Alpine and Wilderness Emergencies—A Narrative Review and Clinical Implications. international J. Environ. Res. Public Health 2022, 19, 12721. https://doi.org/10.3390/ijerph191912721
About the magazine bergundstieg
Bergundstieg is an international magazine for safety and risk in mountain sports and illuminates the topics of equipment, mountain rescue, rope technology, accident and avalanche knowledge. Bergundstieg is published by the Alpine Associations of Austria (PES), Germany (DAV), South Tyrol (AVS) and Switzerland (Customer Service).
That might interest you
- Belay construction for multi-pitch climbing | tips
- Strength endurance: You should avoid these 7 training mistakes
- Huge highball: This is how Keenan Takahashi climbs A little Life (8B+) | Video
+ + +
Credits: Cover picture Mountaineering