How to Deal with Emergencies in the Wilderness
Smart planning is your best defense in a wilderness emergency
by Betsey Foster, MPH, and C. Ben Woodard, WEMT

It's a beautiful day in the mountains. You and your friends are hiking out after a long day on the trail. Martha, the leader of your group, is leaping from rock to rock with a 20-pound day pack. Suddenly, you hear a gut-wrenching scream and see her crumpled among the boulders.

When you reach her, you see her leg wedged between the boulders. It looks like she has a kneecap where her shin should be. Martha has suffered a fractured fibula. You and the rest of the group are still above tree line, clouds are moving in, and there is only one hour of daylight left. What do you do next?

The best question is, what should you have done before the accident.
The answer is to avoid the accident before it happens. Most mishaps happen because a group has not planned their trip and is ill-prepared. In Martha’s case, planning would have put the group on the trail earlier and well below the tree line before the days end. As most accidents happen toward the end of the day when people are tired and less cautious, plans should always call for an early finish.

Develop an itinerary
How many miles will you hike in a day? The guidelines for distance are one mile per hour on elevated terrain, and two miles per hour over flat terrain. Look at a topographic map and plan your trip accordingly. Plan the trails you will hike and the locations of your campsites. Leave this itinerary with someone at home. If you don't show up at the end of the trip, they’ll know where to send help.

Bring the right gear
This includes a map and compass, rain gear, food and water, extra clothing, a stove, and sleeping bag. Test your gear before you leave. Malfunctioning equipment could make a bad situation worse. Be prepared for an emergency and you may well avoid one.

Check the weather forecast and plan accordingly
Before you leave, do a last-minute weather check. If it looks like a storm is coming in, don't hesitate to reschedule your trip.

Bring a first aid kit and know how to use it
Always include protective surgical gloves and anti-bacterial clean-up pads to reduce your exposure to blood or other fluids. Your clothing, sunglasses, ski goggles, and other gear can also block blood-borne pathogens. Be aware of these dangers, even with a good friend.

Know the members of your group
What are their expectations? If one member of your group absolutely must reach the peak, you may want to consider how you'll deal with this person if any situation requires turning back before you reach the summit. Deal with this before heading up the trail.

Select trips appropriate for the group
Consider the strength and endurance required for your trip. You may have to suggest an alternate plan. The adage, “You are only as fast as your slowest person,” is very true.

Be aware of any pertinent medical history
Make sure any member of your group who requires medication has not forgotten it, and know where it is packed. Knowing this information should be part of your plan. Investing in wilderness emergency training is also a sound option.

First response
Unfortunately, no amount of planning will guarantee safe passage. When you do find yourself in a wilderness emergency, the first pulse you should check is your own. Step back from the situation, take several deep breaths, and remind yourself that you are not the victim. Make sure you are not in danger. Account for everyone and inform the group of the situation.

The important thing to remember is to take care of yourself first. You do not want to create a second victim by acting impulsively. You need to remain safe. Protect yourself from potential infection by putting on surgical gloves from your first aid kit and any other protection you may have. If you have first aid training, check the victim’s ABCs (airway, breathing, and circulation).

Assuming the injured person is conscious, ask where it hurts, what happened, and ask permission to help. Keep the victim warm and comfortable. Then develop a plan of action with the rest of the group. If the victim can't walk to safety, you must first decide how to secure help. Since you should have made certain there were at least three members of your group (three is the minimum number for safety), decide who to send for help. Decide where this person will go and make sure they know which trails to use. Make sure they are properly equipped to avoid another incident. Write a note explaining the time and location of the accident. Describe the nature of the injury, your plan of action, and where you will be waiting for the cavalry. This is important information that will help the rescue team.

When disaster strikes on the trail, stay calm, protect yourself from danger, assess the situation, and develop a plan. Better yet, plan ahead to minimize the risk and potential impact of any emergency. �

Betsey Foster, M.P.H., is marketing director for Wilderness Medical Associates (WMA). C. Ben Woodard, WEMT, is executive director of WMA.  Wilderness Medical Associates

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