When things go wrong out there

admin51097
1 day ago
6 min read

Remote area first aid for fencing contractors: what to carry, what to do, and why the kit on the ute is not enough.

Fencing is one of the few trades where you will regularly find yourself genuinely remote. No cell coverage, no-one within earshot, and a drive out that takes longer than any ambulance is going to get to you. Agriculture is one of PracMed’s biggest client sectors, and fencing sits right at the sharp end of that risk profile. Often solo or paired. Physical work with tools that cut, crush, and put serious tension on steel wire.

Most injuries on the job are sprains, strains, minor wounds, and punctures. The kind of thing that hurts but will not stop you getting home.

This article is about the smaller category that will not wait.

It is worth being direct about something upfront: a standard first aid course spends a significant chunk of the day on CPR and defibrillation. If you work alone in a remote area, that training has limited application. You cannot do CPR on yourself. If you suffer a cardiac arrest out in the back blocks with nobody nearby, the outcome is not going to be good. It is entirely out of your hands. Our Remote Areas First Aid course is built around a different question: what are the things most likely to go wrong, and what can you actually do something about? That is also what this article is about.

The kit on the ute problem

If you have rolled a quad, gone through a fence, or had the post driver land on you, your first aid kit is probably wherever the ute is. Which, if you are badly hurt, is the same as it not existing. This comes up in our Remote Areas courses regularly because it is a real lesson from real incidents.

The gear that matters needs to be on your body. Think about it in two layers:

On your person, always have:

A tourniquet. The SOF-T Wide is our pick. It is the easiest to apply one-handed to yourself, it has been legitimately quality-controlled, and it has a proven track record in muddy, wet and hot conditions. Your belt will not work. Neither will whatever is on Temu. This is not the place to cut corners.
A compression dressing. We like the Olaes Modular Bandage. It is a multi-purpose tool that does more than a standard dressing, takes up almost no room, and weighs very little.
A PLB. Personal locator beacon. On your body, not in the pack, not on the quad. If you need it, you may not be able to get to either.

In your pack or on the vehicle

Additional dressings and gloves.
A quality hypothermia management system. More on this below, but the single-layer foil blanket commonly found in commercial first aid kits is not enough for serious NZ conditions.
Eye flush. Even a pump bottle with potable water will do. Foreign bodies in and around the eyes is a potential mechanism when fencing.
Kit for the annoying but not life-threatening stuff. Minor wounds, punctures, blisters, splinters. The everyday injuries that do not need a hospital but do need managing on site.

The injuries that can kill you

To frame what follows, we have pulled a serious fencing injury from the FCANZ archives. We were not there, and those on the ground may have acted differently for good reason. Consider us couch coaches for this one.

The incident: a fencer’s hand crushed under a post driver weight causing significant bleeding and tissue trauma.

Bleeding: what to do

A crush injury to the hand or fingers with significant bleeding is most likely manageable with direct pressure. Without being there or seeing the injury we are hypothesising, but that is the point of this exercise. Understanding how to expose a wound, assess it, and make a decision about how to manage it is a core skill in emergency trauma care, and something we teach at PracMed.

In this case, good direct pressure and a solid bandaging job is the likely intervention. The Olaes Modular Bandage is an excellent option here. It can be self-applied, contains four feet of gauze that can be used independently, and has velcro along the roll that helps maintain even pressure during application.

Wire injuries are another potential mechanism. Cutting wire under tension, or a roll springing off the bar, are potential sources of lacerations to the forearm or face. Same principle applies: direct pressure, compression dressing, assess severity.

Good pressure means firm, direct, and continuous. Hold it. Do not keep lifting to check. One hand, both hands if needed. The bleeding stops when you make it stop.

What if it is worse

Now imagine the same mechanism but worse. The driver comes down on a forearm, or a wire under extreme tension snaps back resulting in serious arterial bleeding. That is a different category of injury entirely.

An arterial bleed above the wrist or ankle can cause someone to expire much faster than an ambulance will arrive in an urban setting, let alone out in the back blocks. This is where the tourniquet comes in. Applied on the limb above the injury and tightened until the bleeding stops, these devices have received unwarranted criticism and there is a lot of misinformation around their use that is frankly ridiculous and has no evidence to back it. Tourniquets are life saving devices with over 20 years of research backing their use when indicated. Understanding the indication is key, and training is something we have seen make a huge difference in making the right call.

Once significant injuries have been managed, or concurrently if you have a second person able to assist, this is when the PLB comes out. Arterial bleeding requiring a tourniquet, chest pains, entrapment or impalement, open fractures, suspected strokes: someone presenting with any of these is not driving themselves anywhere. Get help coming to you now, not after you have tried everything else.

The threshold is straightforward: if they cannot self-evacuate, activate the PLB. Same logic applies to vehicle and ATV accidents, falls, or anything else that leaves someone unable to move under their own steam.

Hypothermia and the link with Trauma

People associate hypothermia with cold weather and exposure. What often gets missed is that significant blood loss results in a triad of problems, one aspect of this triad is hypothermia – regardless of the season. Mid-summer, a significant bleed, a casualty lying on the ground not moving: their core temperature will drop faster than most people expect.

This matters because hypothermia and serious bleeding are a lethal combination. Once core temperature starts dropping, the body’s ability to clot blood drops with it. Keeping yourself or the casualty warm is not a comfort measure. It could have a massive impact on the outcome.

Get them off the ground to stop heat loss through conduction. Get wet or blood-soaked clothing off. Wrap them properly and reduce airflow. A quality multi-layer hypothermia management system is worth having in the kit. A single-layer foil blanket does something, but it is not built for serious conditions.

This is a serious consideration in fencing given the remote and exposed nature of the job; this simply compounds risk of hypothermia regardless of mechanism.

Lower limb fracture

A broken leg is not necessarily immediately life-threatening, but in a remote area it becomes an evacuation problem immediately, especially solo. Do not splint unless trained properly in checking for pulse, motor function, sensory and presentation pre and post splint. Stabilise, keep yourself or the casualty warm and off the ground, get help inbound and activate your PLB so emergency services know where you are.

Have a plan before you head out

Self and buddy aid are the foundation of remote area first response. Solo or paired, the principles are the same: someone needs to know where you are, when to expect you back, and what to do if they do not hear from you.

A lot of fencers already have informal versions of this. A call to the farm manager at the end of the day, a rough idea shared with a partner. Formalise it a little. Agree on a check-in time. Know what the plan is if check-in does not happen. It costs nothing and it is the difference between someone raising the alarm and someone assuming you stayed late.

And if something happens and you can get yourself out, go. Contractors have a well-documented tendency not to seek help when they need it. A chest pain, a head injury, a bleed that seemed to stop. Get it checked out.

Competence over false confidence

Carrying the right gear is a start. Knowing how to use it under pressure is the crux.

A tourniquet in a kit you have never opened is better than nothing, but not by much. Knowing when to apply it, and how to apply it correctly, one-handed on yourself or someone else, is a skill that only comes from functional, hands-on training.

Remote areas first aid with PracMed NZ

PracMed NZ’s Remote Areas First Aid course is built for people working in exactly these environments. Our instructors have worked in austere, high-risk settings with a proven track record of immediate point-of-injury care. It is practical, hands-on, and focused on

the injuries and situations where your actions in the first few minutes make a real difference.

Ad Salutem – To Save Lives.

Written by Simon Carkeek

Managing Director, PracMed NZ

pracmednz.com | contactus@pracmednz.com