Generic ISKA Modules

‍Group Dynamics

Customer service and group management skills: Leaders should have the ability to lead a variety of personalities and make every effort to encourage all members of an expedition to achieve the aims and objectives initiated in the planning stage to paddle with a positive outcome.

‍

Create and maintain shelter, rescue strategies

Using a variety of techniques, candidates should be able to construct emergency shelter. These skills may have to be utilised in the event of damaged tents or lost equipment. Leaders may use either a tarp or other natural materials, and to understand how best to seek protection from the elements.Rescue: Guides must have a working knowledge of rescue techniques as well as having in place an emergency action plan.

‍

Fire-skills

Candidates should be able to demonstrate that they can light a fire using a variety of methods and in a variety of conditions including wind and rain. Demonstrate a suitable ‘Leave No Trace’ dismantling of fire and camp sites

‍

Hygiene

Guides should be able to prepare food that has been foraged from the coastal environment in a hygienic manner and should have the appropriate food hygiene qualification, relevant to their home nation and the laws that govern the area of operations.

‍

Packing a kayak, group equipment

The guide must be able to demonstrate effective loading of a sea kayak to other group members, demonstrating trim for effective kayak handling and a suitable itinerary for individual and group members on a multi day expedition.

‍

Camp selection

An understanding of a suitable camp selection should be demonstrated. Camp locations must take into account the prevailing weather conditions as well as size, shelter, risk management, impact, local laws and group requirements.

‍

Trip planning, single day & multi day

The guide will have the ability to plan multi-day expeditions to allow for individual needs and desires within the group. The guide needs to show that they can utilise environmental factors to achieve expedition goals and they can organise resupply strategies and put in place emergency action plans to facilitate casualty and group evacuations.

‍

Equipment

As well as personal equipment the guide must be able to provide and arrange group equipment for a client based expedition including spare food and emergency shelter.

‍

Provisioning and foraging

The candidate should have a basic knowledge of wild foods that are available along a journey to supplement provisions and a safe method for acquiring potable water. The guide should be familiar with the food sources that are available in the areas they are operating in and be able to provide adequate nutrition in the event of an emergency to sustain energy levels within the group until they can implement their emergency action plan.

‍

Wild life & ecology

A good level of knowledge of geological history and a knowledge of the different animal species which are encountered in the areas of operating should be demonstrated.In the event of an emergency an effective individual and group rescue plan can be initiated quickly and effectively. Guides must adhere to an established wildlife code, which shows consideration towards the environment and wildlife interaction, minimising disturbance yet still satisfying clients that they too have a right to co-exist in the natural environment.

‍

ISKGA First Aid: Under the expert guidance of Dr Anna Shekdar, Dr David McNeil and Advanced Para Medic Paul Cahill ISKGA has developed its own sea kayak specific wilderness first aid program. This program which is titled the ‘Marine First Responder‘ is aimed specifically at the professional sea kayak guide that is operating in remote coastal wilderness environments where the level of first aid knowledge and practical experience needs to be extremely robust and fit for purpose. At present it is not required that all ISKGA guides need to hold this new level of award, but it is expected that when due for renewal, guides will seek out the opportunity to update their present qualifications with this award.

The advantages of this award over other wilderness first aid awards is the level of practical, scenario based marine training that the award offers to the guide. Most wilderness first aid programs have content that is aimed at the mountain guide operating at altitude. eliminating these areas of the award has allowed us to focus in greater detail to the requirements of the sea kayak guide operating in the 'Marine Coastal Environment'.

Medical Training Requirements:

The ISKGA guide will be working in many different environments around the globe, with different skill sets and knowledge required for each, as well as having to manage the many different risks in the areas involved. No single set of guidelines can match such diverse environments and defined skills are specifically required for each. Therefore the onus is on the ISKGA guide to ensure that within his or her group, they have the medical skills knowledge and experience to match the particular environments they work in and the clients within their group.

Although it is not a requirement to be a medical professional to be an ISKGA guide, it is a requirement that each guide should have extensive skills and knowledge appropriate to a lay person working in austere environments.

‍

Competency Based Model:

ISKGA will define medical competences required by its guides rather than qualifications from specific organisations. Internationally three levels of outdoor appropriate emergency care training are recognised and defined by both contact hours and core subjects.

The levels are:

1. Remote / wilderness first, aid 24 hours contact time.

2. Advanced First aid / wilderness first responder. 60 hours contact time. These 60 hours are often taken as entry training with no previous experience with the consent of the training organisation.

3. Wilderness EMT / Physician led wilderness training. 70 hours contact time. This is not an entry level for non-medical personnel. Medical professionals who hold registered professional licenses can enter at this level but would benefit from some previous wilderness emergency care training.

‍

Characteristics of training courses:

The training guides take should be orientated towards the remote environment. All emergency care training is relevant but urban based training has significant omissions that would leave guides poorly equipped to deal with medical emergencies in remote environments. Those holders of professional medical qualifications such as paramedics nurses and doctors should hold a specific qualification in wilderness emergency care or alternatively prove to have significant experience and knowledge of wilderness care by other means. Most wilderness physicians have taken formal training in wilderness care and often hold the wilderness command physician qualification. Non-physicians should where possible develop a relationship with a wilderness command physician to have a direct mentor to aid in their continual professional medical development.

‍

Continual Professional Development Log:

ISKGA see training courses as the beginning of a guides training in emergency medical skills. To maintain core competences guides should regularly revise core material and practice core skills. These activities should be recorded in a CPD log as proof of continued advancement.

‍

Appropriate training and competences for different environments:

ISKGA has identified 3 general environments within which guides will operate. Each of these environments calls for different minimum standards of training and competency in emergency care. These levels are defined below with the minimum standard of emergency care provision defined. These are minimum standards and guides are encouraged to develop their emergency care abilities to the highest standard regardless of environment.

Sheltered Bay / help within one hour maximum. 24 hour basic outdoor orientated first aid course. Should include the core competences of :

Assessment of Scene / Mechanism of Injury / Safety / Need for further help

Vital signs assessment / Primary and Secondary Surveys

Airway / Breathing / Circulation Assessment and Management.

Resuscitation , CPR , Choking

Bleeding / Shock / Wound Management

Fracture / Dislocation / Sprain / Strain Management

Head, chest, abdominal and spinal trauma

Environmental Emergencies: Hypo / Hyperthermia, Drowning, Basic Marine Envenomation’s / Injuries

Medical Emergencies: Asthma , Epilepsy , Diabetes , Chest Pain, Anaphylaxis , Drowning

Miscellaneous: Burns , Pain Management , Eye Injuries , Dental problems

Introduction to basic personal medication use, eg: inhalers (salbutamol) and emergency medication use eg: Intramuscular adrenaline

‍

2. Exposed Costal Environments 1 to 24 hours from help. Advanced First Aid / Wilderness First Responder 60 hours contact time.

‍

These levels include all the core subjects of a basic course but examined in more detail and the students are expected to have a deeper understanding of the pathophysiology  of injuries and illness included in the program. Apart from the additional subjects named below the principle benefit of this level of training is the opportunity to include more extensive and complex scenario simulations. In these scenarios students have the opportunity to begin to develop greater skills of vital signs assessment, differential diagnosis (basic), scene management , team leading , communications and treating patients.

Advanced Vital Signs including blood pressure , breath sounds , oxygen saturation assessment without a probe.

Advanced fracture management with the use of flexible, rigid and traction splints, including improvised splints.

Fitting of commercial and improvised cervical collars.

Emergency medication use including salbutamol and administration of intramuscular injections.

Familiarisation with advanced expedition medical kits and wilderness medical pocket guides.

Communication with supporting doctors / ambulance personnel.

Scenario based discussions on preventing and dealing with common medical problems whilst on expedition: Hydration and dehydration, diarrhoea and constipation, and genitourinary tract disorders.

Practical sessions on environmental hazards including sea survival and cold water immersion response, hypo and hyperthermia, and dealing with lightning injury.

3. Wilderness coastal environments up to a week from rescue. 70 additional hours of physician level training. An example of this training is the Wilderness Emergency Medical Services Institute, wilderness emergency medical technicians course / wilderness command physician programme. The key characteristics of this level of training are:

Direct physician oversight, at least one doctor should be present to give clinical direction as complex medical training requires this level of clinical oversight. Various sessions will be delivered by clinicians at different levels but ultimate responsibility for protocol rests with the clinical director.

Most training at this level is underpinned by the practice guidelines of the Wilderness Medical Society. This is a large international society formed largely of doctors who base their recommendations on research. They meet regularly to discuss the latest developments and research in the area of wilderness medicine. Any training at this level should be based on international best practice and current high quality research.

The core subjects and competencies at this level are those defined in the Wilderness Medical Society’s practice guidelines.

‍Module: Incident management: The ISKGA Incident Management course is a four day course. This can be logged as a stand alone two day course with two bolt on modules or alternatively can be run over a four day period.

Day 1 & 2: Developing a logical thought process that works under pressure, rescues-getting the basics right, rescue strategies, controlling your group, leadership under pressure, emotional influences, adrenal effects.

Day 3: Safety & rescue: The surf zone

Day 4: Safety & Rescue: Rock Gardens

‍

Module guidelines

Mind set – Pro-active/passive – Casualty or Victim

Effective identification in the difference between a paddler whom is pro-active with regards to his safety or a paddler who is passive/in-active with regards to his own safety and to be able to assess quickly these actions during an incident in dynamic conditions.

‍

Adrenalin – To fully understand the effects of ‘Adrenal fix’ and how to control these negative/positive influences on the group

Pre fight, in fight and post fight effects of adrenalin should be understood. Trainer should be able to highlight the areas where these influences occur and to highlight the signs, symptoms and actions required to recognise and deal with adrenal overload.

‍

SAFER – Stop, Assess, Formulate, Execute, Review.  To be able to show a working knowledge of the SAFER process.

Candidates should show a logical thought process during an incident not rushing in and instead assessing the situation formulating a plan then executing that plan and reviewing the outcomes.

‍

Lost person protocols – Methods of dealing with a lost person from your group.

Have an understanding of effective protocols for dealing with a lost person whilst on an expedition or during a day/night paddle.  Standard Operating Procedures for the lost person protocol. Meeting points, communication, search patterns, engagement of outside agencies.

‍

First Aid –

Have a wider knowledge of how to apply first aid to an incident until responsibility of an incident is handed over to an outside agency.

‍

Outside agencies – Methods of raising outside assistance during an incident.

Candidates should understanding that although prevention is better than cure, they must be able to recover control of his/her group, harnessing correct delegation and concurrent activity as well as having a working knowledge of being able to engage outside agencies for evacuation purposes.

‍

Scenarios – Candidates should be able to deal with a wide variety of scenarios. During this four day course, day 1 & 2 will deal with developing the logical thought process, the understanding of emotional influences on the group during a crisis and getting the basics right. Day three and four are environmental modules, which are interchangeable, these are the ‘Rock Garden Safety & Rescue’ and the ‘Surf Zone Safety & Rescue’.

Candidates should be able to deal with a variety of incidents on the sea and understand the importance of training.  Incidents to include, lost equipment, damaged Kayaks,(lost hatches, holed kayaks), damaged Paddlers (dislocated shoulder, unconscious person, hyperthermia, spinal injury, heart attack). Panicked and trapped paddlers, hostile followership, lost and separated paddlers, multiple incidents.

The ISKGA Sea Survival course has been developed to meet the needs of the sea kayaking community and is a one or two day course depending on resources available to the center/individual instructor:

ISKGA Guides that can provide this module will have a tick on there profile against the Sea Survival Module.