Outdoornut
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Just wondering...would you guys (and gals) be up for a wilderness scenario?? 
Maybe for something different??
- Thread starter Outdoornut
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LucidResq
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Please please please please.
foxfire
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Oh yeah!!!!!!
8jimi8
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where's the scenario?!
Outdoornut
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where's the scenario?!
It's coming...see above ^ =)
Outdoornut
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Apparently you can't go back and edit lol...Here is is
Here's the first part of the scenario:
You are one of three leaders on a three month backpacking expedition. You are leading three groups of 5 students...college aged who are all very experienced within the wilderness context (given the three months!) each student has a topo map and compass and know how to use them. It is early April in the mountains of North Carolina and the weather is ‘spotty’ with rain/drizzle at lower elevation and snow/ice at higher elevation. However, your entire group is prepared for whatever weather changes might occur and sport 20lb packs to prove it!
Your group is now at “base camp” which is 20 miles from the road (note: it is the first clearing that has been large enough for your entire group to stay together…the previous nights your group had to split up into three separate camps). “base camp” is right beside a fork in the trail…both of which end at another campsite (which is 2,000ft above where you currently are) but one has gradual elevation being 8 miles long and the other very steep elevation and hazardous trial but is only 5 miles. You and the two other leaders have been giving the group of students opportunities to ‘fend for themselves’ and decide that this would be a great learning experience. The night before there was some slight flurrying but now (around 9-10 in the morning) though the air is chilly, the sky is clear and only a few patches of snow/ice are visible on the ground. You and your fellow leaders will take the shorter trail at higher elevation to the second campsite and the three groups of students will take the longer trail and meet up with you there. You tell the students to take their time and enjoy themselves but to get to camp before dark which is possible (they have been averaging about 6-8 miles a day in their individual groups of 5).
You and your fellow leaders reach the campsite before any of the students (as expected) and go about setting up camp (getting firewood etc..) gradually students start to arrive in groups of twos and threes and gradually it starts to get darker as late afternoon settles in. The groups busy themselves in collecting more firewood and getting food cooking…the temperature is starting to drop, the wind is picking up and it looks like it may start to snow at any minute. It is not until everyone is standing around the large campfire when someone makes a discovery…Ryan is missing. Somehow the 22 year old sports and recreation major never made it to camp and noone knows where he is.
You and your two fellow guides decide to wait another hour to make sure Ryan isn’t simply hiking slower (he has a minor in photography and has been stopping throughout the trip to take pictures). An hour goes by and no Ryan. You decide to ask Kenneth, Ryan’s roommate and best friend, to see when the last time it was he saw Ryan. The other student frowns and tells you that he hasn’t seen Ryan since “base camp” that morning when Ryan woke up not feeling well and they separated into their different groups of five. You and your fellow guides casually question the rest of the group without success…no one remembers the last time they saw Ryan but they do know that he wasn’t feeling well and apparently had been taking a lot of bathroom breaks that morning before they left.
You and your fellow guides are facing a dilemma. Ryan is a severe diabetic but hasn’t had any trouble during the entire duration of the trip (three months, which he himself has admitted is ‘crazy’) and usually carries snacks with him ‘just in case’. But this disappearance has red flags written all over it.
What should you do? It is now nearly 9pm, it’s not completely dark but the group is starting to look for their headlamps and more layers as well…it’s steadily getting colder…you can now see your breath in the air and many of the students are shooting you concerned looks (up until this trip you have been camping in lower elevation and this will probably be your coldest night so far). Already Kate, 18 year old English major from Arizona, is shivering and standing so close to the fire she’s basically in it (she’s so cold she’s claimed not to be hungry and has given her share of the dinner to Matt who is scarfing it down joyfully). Others in the group are also picking at their food and a couple have already put up their tents and have gone to bed.
Ok….what would you do in this situation?? For current purposes you get to decide what you and what the other guides are going to do. What your concerns are within the larger group, what to do about Ryan etc…
NOTE: You are in the wilderness. The guides have cell phones but they do not work where you currently are or even back at your ‘base camp’. The road that is 20 miles from base camp is gravel, one lane and has ‘patchy’ cell service (the road it 2 hours from an ‘urban’ town).
Your outside contact won’t contact proper authorities unless he doesn’t hear from you in 48 hours (at which time you should be over the peak of the mountain and within cell phone service).
For this particular trip (which is only 6 days long) you have 6 regular med kits (two per group of five) each holds various sizes of gauze, scissors, basic medications, an assortment of things categorized for ‘bites/stings’ including two epipens (always wondered how we got permission to get them) an irrigation syringe, ice pack, ace bandage, tweezers, band aids, ‘blister stuff’, and some triangular bandages thrown in for good measure. Ryan carries his own ‘emergency kit’ which has his insulin, sugar tablets, meter with strips, and extra snacks. If you assume Ryan has his pack, it also has in it his ration of food for the day, two extra pairs of pants, four extra shirts, four pairs of extra socks, camp shoes, sleeping bag (0 degree), sleeping mat, headlamp (with extra batteries) and personal toiletries and trekking poles.
Hehe….go for it!!
P.S. Let me know if anything is unclear (I think I went a bit overboard) once you decide what you would do…I will tell you where Ryan is and his current medical status (aren’t you curious…??)
Here's the first part of the scenario:
You are one of three leaders on a three month backpacking expedition. You are leading three groups of 5 students...college aged who are all very experienced within the wilderness context (given the three months!) each student has a topo map and compass and know how to use them. It is early April in the mountains of North Carolina and the weather is ‘spotty’ with rain/drizzle at lower elevation and snow/ice at higher elevation. However, your entire group is prepared for whatever weather changes might occur and sport 20lb packs to prove it!
Your group is now at “base camp” which is 20 miles from the road (note: it is the first clearing that has been large enough for your entire group to stay together…the previous nights your group had to split up into three separate camps). “base camp” is right beside a fork in the trail…both of which end at another campsite (which is 2,000ft above where you currently are) but one has gradual elevation being 8 miles long and the other very steep elevation and hazardous trial but is only 5 miles. You and the two other leaders have been giving the group of students opportunities to ‘fend for themselves’ and decide that this would be a great learning experience. The night before there was some slight flurrying but now (around 9-10 in the morning) though the air is chilly, the sky is clear and only a few patches of snow/ice are visible on the ground. You and your fellow leaders will take the shorter trail at higher elevation to the second campsite and the three groups of students will take the longer trail and meet up with you there. You tell the students to take their time and enjoy themselves but to get to camp before dark which is possible (they have been averaging about 6-8 miles a day in their individual groups of 5).
You and your fellow leaders reach the campsite before any of the students (as expected) and go about setting up camp (getting firewood etc..) gradually students start to arrive in groups of twos and threes and gradually it starts to get darker as late afternoon settles in. The groups busy themselves in collecting more firewood and getting food cooking…the temperature is starting to drop, the wind is picking up and it looks like it may start to snow at any minute. It is not until everyone is standing around the large campfire when someone makes a discovery…Ryan is missing. Somehow the 22 year old sports and recreation major never made it to camp and noone knows where he is.
You and your two fellow guides decide to wait another hour to make sure Ryan isn’t simply hiking slower (he has a minor in photography and has been stopping throughout the trip to take pictures). An hour goes by and no Ryan. You decide to ask Kenneth, Ryan’s roommate and best friend, to see when the last time it was he saw Ryan. The other student frowns and tells you that he hasn’t seen Ryan since “base camp” that morning when Ryan woke up not feeling well and they separated into their different groups of five. You and your fellow guides casually question the rest of the group without success…no one remembers the last time they saw Ryan but they do know that he wasn’t feeling well and apparently had been taking a lot of bathroom breaks that morning before they left.
You and your fellow guides are facing a dilemma. Ryan is a severe diabetic but hasn’t had any trouble during the entire duration of the trip (three months, which he himself has admitted is ‘crazy’) and usually carries snacks with him ‘just in case’. But this disappearance has red flags written all over it.
What should you do? It is now nearly 9pm, it’s not completely dark but the group is starting to look for their headlamps and more layers as well…it’s steadily getting colder…you can now see your breath in the air and many of the students are shooting you concerned looks (up until this trip you have been camping in lower elevation and this will probably be your coldest night so far). Already Kate, 18 year old English major from Arizona, is shivering and standing so close to the fire she’s basically in it (she’s so cold she’s claimed not to be hungry and has given her share of the dinner to Matt who is scarfing it down joyfully). Others in the group are also picking at their food and a couple have already put up their tents and have gone to bed.
Ok….what would you do in this situation?? For current purposes you get to decide what you and what the other guides are going to do. What your concerns are within the larger group, what to do about Ryan etc…
NOTE: You are in the wilderness. The guides have cell phones but they do not work where you currently are or even back at your ‘base camp’. The road that is 20 miles from base camp is gravel, one lane and has ‘patchy’ cell service (the road it 2 hours from an ‘urban’ town).
Your outside contact won’t contact proper authorities unless he doesn’t hear from you in 48 hours (at which time you should be over the peak of the mountain and within cell phone service).
For this particular trip (which is only 6 days long) you have 6 regular med kits (two per group of five) each holds various sizes of gauze, scissors, basic medications, an assortment of things categorized for ‘bites/stings’ including two epipens (always wondered how we got permission to get them) an irrigation syringe, ice pack, ace bandage, tweezers, band aids, ‘blister stuff’, and some triangular bandages thrown in for good measure. Ryan carries his own ‘emergency kit’ which has his insulin, sugar tablets, meter with strips, and extra snacks. If you assume Ryan has his pack, it also has in it his ration of food for the day, two extra pairs of pants, four extra shirts, four pairs of extra socks, camp shoes, sleeping bag (0 degree), sleeping mat, headlamp (with extra batteries) and personal toiletries and trekking poles.
Hehe….go for it!!
P.S. Let me know if anything is unclear (I think I went a bit overboard) once you decide what you would do…I will tell you where Ryan is and his current medical status (aren’t you curious…??)
At the moment, this seems to be a search and rescue.
Bad on the company that organized this for not making sure there was a satellite phone or radio available for emergencies, but since we have to deal with what we have, and not what we'd like to have, no use crying over it now. Presumably, this means additional resources would be very difficult.
So, it's nighttime, it's dark, and it's freezing cold. You have a group of kids. The first decision to make is whether to start the search now, or sit tight, wait for daybreak, and hope that your missing person makes it through the night. Given the lack of experience in the group, this still might be the best option. You have one victim now, but you run a serious risk of creating several others bumbling around on a steep trail in the dark.
Do you at least know what trail the missing hiker was on? Better to search 8 or 5 miles than 13. Was the trail clearly marked, or was there a distinct possiblity of wandering off the plot? What is the distance to get over the mountain to an area where help can be summoned? Is it likely to take longer to get over the mountain, or to hike the 30ish miles back to the road? Either way, you're probably looking at 2 days to additional help. Damn, wish we had that satellite phone right now. Oh, well.
This situation is all kinds of bad, because if he's in a hypoglycemic situation, he could be dead (of that or hypothermia) before you can find him. I'm not liking his chances. By the way, my experience is that if he's not capable of walking out for whatever reason, you're going to be taking a day or more to carry him. You'll be lucky to cover a mile an hour with an improvised litter carrying your hypowrapped patient.
Bad on the company that organized this for not making sure there was a satellite phone or radio available for emergencies, but since we have to deal with what we have, and not what we'd like to have, no use crying over it now. Presumably, this means additional resources would be very difficult.
So, it's nighttime, it's dark, and it's freezing cold. You have a group of kids. The first decision to make is whether to start the search now, or sit tight, wait for daybreak, and hope that your missing person makes it through the night. Given the lack of experience in the group, this still might be the best option. You have one victim now, but you run a serious risk of creating several others bumbling around on a steep trail in the dark.
Do you at least know what trail the missing hiker was on? Better to search 8 or 5 miles than 13. Was the trail clearly marked, or was there a distinct possiblity of wandering off the plot? What is the distance to get over the mountain to an area where help can be summoned? Is it likely to take longer to get over the mountain, or to hike the 30ish miles back to the road? Either way, you're probably looking at 2 days to additional help. Damn, wish we had that satellite phone right now. Oh, well.
This situation is all kinds of bad, because if he's in a hypoglycemic situation, he could be dead (of that or hypothermia) before you can find him. I'm not liking his chances. By the way, my experience is that if he's not capable of walking out for whatever reason, you're going to be taking a day or more to carry him. You'll be lucky to cover a mile an hour with an improvised litter carrying your hypowrapped patient.
(I've never done real SAR, so this is just for kicks. I'm curious about doing it someday, so feedback is welcome.)
I'm making a few assumptions. If the weather's bad, I'm not going to bet that the usual cell phone spot will be working. I'm also gathering it'll take as long to get there as it will for our emergency contact to call authorities (?), so forget it.
One team leader and the kids stay put for the night. In the morning, if the weather's alright, they can follow us back along the trail until we meet up. If we don't meet up, they hike out for help.
Meanwhile, I'd take the other team leader, a tent, a kit, supplies for a few days, and go back along the trail. I wouldn't deviate from it unless I saw some concrete signs that Ryan had gone that way. In that case, I'm not going any farther if we lose his trail, and I'm going to leave all sorts of signs wherever we turn off for the benefit of the rest of the group. If the weather gets scary for us, we hunker down for the night and resume in the morning. I'm assuming we're properly dressed for the weather, have some great battery life and spare batteries for the headlamps, and all that good stuff. If we reach base camp without finding him, we wait there for the rest of the group and for SAR, which will be on its way before we can reach a place where we can contact anyone (again, assuming I'm reading it right). We won't split up.
Oh, and I'm gonna talk Kate into eating at least a little before I go. And give a lecture about the buddy system. And have a talk about getting a satellite phone with the company, whenever I get back.
I'm making a few assumptions. If the weather's bad, I'm not going to bet that the usual cell phone spot will be working. I'm also gathering it'll take as long to get there as it will for our emergency contact to call authorities (?), so forget it.
One team leader and the kids stay put for the night. In the morning, if the weather's alright, they can follow us back along the trail until we meet up. If we don't meet up, they hike out for help.
Meanwhile, I'd take the other team leader, a tent, a kit, supplies for a few days, and go back along the trail. I wouldn't deviate from it unless I saw some concrete signs that Ryan had gone that way. In that case, I'm not going any farther if we lose his trail, and I'm going to leave all sorts of signs wherever we turn off for the benefit of the rest of the group. If the weather gets scary for us, we hunker down for the night and resume in the morning. I'm assuming we're properly dressed for the weather, have some great battery life and spare batteries for the headlamps, and all that good stuff. If we reach base camp without finding him, we wait there for the rest of the group and for SAR, which will be on its way before we can reach a place where we can contact anyone (again, assuming I'm reading it right). We won't split up.
Oh, and I'm gonna talk Kate into eating at least a little before I go. And give a lecture about the buddy system. And have a talk about getting a satellite phone with the company, whenever I get back.
Mountain Res-Q
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So, commuications are basically out of the question... so... your first responsibilty is to the group; the needs of the many outweight the needs of the few. If you say that as a group you are prepared for winter weather conditions, fine... now worry about the missing man. If the safety of the group is in question, get them moving out if condition allow, otherwise stay put and keep them astable. First priority is not to play hero... that is my job 
. If conditions safely allow, choose your best two people (most fit, most experience, and knowledgable) to hightail it out to make a SAR Notification. Remember that statistically, a true outdoor survival situation last no more than 3 days. Statistically if you are lost in a wilderness environment and you are missing for more than 72 hours, your chances for suvival drop to 4%. Therefore it is VITAL that TRAINED RESCUERS launch a mission ASAP; that means people with the training and capabilities in Lost Person Behavior, Search Managaement, Man Tracking, Nordic Rescue, OHV Rescue, Mounted Rescue, amd other SAR Disciplines get going NOW! Search is an Emergency! I would rather be notified and cancelled a hour latter than only get notified after the suject has been overdue for a day or more, which will only increase the size of the search area and decrease survival chances.
After that, the most likely course of action for the rest of the group could also be the most costly unless everyone is capable, and based on the group dynamic, they are not. As a leader of the group you would likely wish to either utalize the group to search for the missing man or take a few capable folks with you to search, leaving the rest behind at camp with instruction to stay or push on the following day. From a SAR standpoint, I HATE THOSE OPTIONS and just know that those are the choices that will be made and either result in locating the missing man (and would seem to justify the action) or will turn into a SAR NIGHTMARE when the Professionals arrive and now face a dozen+ college students wandering in the woods without communications as they yell out "Marco".
However, if I was the Group Leader, with my background, I would, after sending out two of the best to make the notification to SAR, backtrack with one other to the PLS and start my own Hasty Search, utalizing my knowledge and abilities in Mantracking, Signcutting, and Lost Person Behavior to do what every SAR Team tries to do at the start of every search, move fast and try to locate the subject in those first crucial hours.
The Medical information provided does little to change the choices I make. Yes, from a SAR Standpoint, the subjects Medical Status factors into the Search Urgency Classification, but should not be a motivating factor that prohibits me from make objective desicions that might (if influenced) endanger the group or Rescuers.
As a SAR Professional that will likely get the page for this mission around 0300 hours, and be ready to go by 0305, here is my opinion. Based on the information provided, this suject rates a 18 to 21 out of 33 on the Standard Search Urgency Chart, or a "Measured Response" that could be viewed as a "Urgenct Response" by some. I want to move fast (and safe) if possible. Secure Maps, Communications, and send in your Hasty Team by the fastest route and means available; where they will do as I would have; signcut and track. Get additional resources in play for deployement at first light; this includes Tracking Teams, a GREAT Canine Trailing Team, Mounted Teams, OHV Teams, and possibly Nordic Teams. Depending on the extended weather forcast, also look into a helo for aerial search. All Teams WILL have at least an EMT or OEC in the group. ALS/Technical Rescue group should also be in play for rapid Access, Stabilization, and Transport (LAST). Deploment of Teams: Tracking and Canine Trailing at the PLS/LKP. OHV, Nordic, Mounted and Area Search Dogs will be deployed inward; trailing running, trail blocks, passive search tactics, and clue awareness are KEY for these Teams with the goal of containing him and making the Tracking and Trailing Teams more effective. Area Dogs to be delployed upwind and at high points. Nordic Teams to th high elevations (hopefully by helo to work down). Mounted, OHV, and Ground Pounders along trails on the search parameter to be owrk in to the PLS. The Helicopter should be dirrected to search areas based on Lost Person Behavior as extablished by the Search Manager and Command Staff.
Lucid, War, Summit, am I missing anything?
. If conditions safely allow, choose your best two people (most fit, most experience, and knowledgable) to hightail it out to make a SAR Notification. Remember that statistically, a true outdoor survival situation last no more than 3 days. Statistically if you are lost in a wilderness environment and you are missing for more than 72 hours, your chances for suvival drop to 4%. Therefore it is VITAL that TRAINED RESCUERS launch a mission ASAP; that means people with the training and capabilities in Lost Person Behavior, Search Managaement, Man Tracking, Nordic Rescue, OHV Rescue, Mounted Rescue, amd other SAR Disciplines get going NOW! Search is an Emergency! I would rather be notified and cancelled a hour latter than only get notified after the suject has been overdue for a day or more, which will only increase the size of the search area and decrease survival chances.After that, the most likely course of action for the rest of the group could also be the most costly unless everyone is capable, and based on the group dynamic, they are not. As a leader of the group you would likely wish to either utalize the group to search for the missing man or take a few capable folks with you to search, leaving the rest behind at camp with instruction to stay or push on the following day. From a SAR standpoint, I HATE THOSE OPTIONS and just know that those are the choices that will be made and either result in locating the missing man (and would seem to justify the action) or will turn into a SAR NIGHTMARE when the Professionals arrive and now face a dozen+ college students wandering in the woods without communications as they yell out "Marco".
However, if I was the Group Leader, with my background, I would, after sending out two of the best to make the notification to SAR, backtrack with one other to the PLS and start my own Hasty Search, utalizing my knowledge and abilities in Mantracking, Signcutting, and Lost Person Behavior to do what every SAR Team tries to do at the start of every search, move fast and try to locate the subject in those first crucial hours.
The Medical information provided does little to change the choices I make. Yes, from a SAR Standpoint, the subjects Medical Status factors into the Search Urgency Classification, but should not be a motivating factor that prohibits me from make objective desicions that might (if influenced) endanger the group or Rescuers.
As a SAR Professional that will likely get the page for this mission around 0300 hours, and be ready to go by 0305, here is my opinion. Based on the information provided, this suject rates a 18 to 21 out of 33 on the Standard Search Urgency Chart, or a "Measured Response" that could be viewed as a "Urgenct Response" by some. I want to move fast (and safe) if possible. Secure Maps, Communications, and send in your Hasty Team by the fastest route and means available; where they will do as I would have; signcut and track. Get additional resources in play for deployement at first light; this includes Tracking Teams, a GREAT Canine Trailing Team, Mounted Teams, OHV Teams, and possibly Nordic Teams. Depending on the extended weather forcast, also look into a helo for aerial search. All Teams WILL have at least an EMT or OEC in the group. ALS/Technical Rescue group should also be in play for rapid Access, Stabilization, and Transport (LAST). Deploment of Teams: Tracking and Canine Trailing at the PLS/LKP. OHV, Nordic, Mounted and Area Search Dogs will be deployed inward; trailing running, trail blocks, passive search tactics, and clue awareness are KEY for these Teams with the goal of containing him and making the Tracking and Trailing Teams more effective. Area Dogs to be delployed upwind and at high points. Nordic Teams to th high elevations (hopefully by helo to work down). Mounted, OHV, and Ground Pounders along trails on the search parameter to be owrk in to the PLS. The Helicopter should be dirrected to search areas based on Lost Person Behavior as extablished by the Search Manager and Command Staff.
Lucid, War, Summit, am I missing anything?
mycrofft
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First step getting in cell range.
Lawyer up.
Lawyer up.
Outdoornut
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To elaborate a bit more...
You'tr not positive which trail Ryan took. He was told to take the longer trail with his group and you have no reason to believe he would deliberatly disobey your orders (he is a friendly, trustworthy guy, eager to learn and a quick learner too!). As for the trails: you are in the backcountry...every couple hundred feet or so there is a white blaze painted on a tree....but other than that the trails are not marked and are only wide enough for one person (with a pack on) to walk on. The trail "switch backs" so it would be relativley hard to miss it (on one side of the trail the ground is always going down and the other is always going up).
Your trip is only 6 days. You still have three more to go...it is roughly 15.5 miles to get 'over' the mountain. To get on top of the mountain it's only 1.5 miles but it goes up 1,200ft elevation in that short hike and for every 100ft of elevation one goes up you have to add an hour to hiking time...not to mention that you probably would be hiking through 4-6 inches of untouched snow which would probably add a couple more hours.
P.S. Just let me know when ya'll want the next part of the scenerio. I suppose I could have just given you the second part (in all it's medical glory) but this was a scenerio we were given in one of our "crisis management" lessons and I wanted to give you the entire effect.^_^
You'tr not positive which trail Ryan took. He was told to take the longer trail with his group and you have no reason to believe he would deliberatly disobey your orders (he is a friendly, trustworthy guy, eager to learn and a quick learner too!). As for the trails: you are in the backcountry...every couple hundred feet or so there is a white blaze painted on a tree....but other than that the trails are not marked and are only wide enough for one person (with a pack on) to walk on. The trail "switch backs" so it would be relativley hard to miss it (on one side of the trail the ground is always going down and the other is always going up).
Your trip is only 6 days. You still have three more to go...it is roughly 15.5 miles to get 'over' the mountain. To get on top of the mountain it's only 1.5 miles but it goes up 1,200ft elevation in that short hike and for every 100ft of elevation one goes up you have to add an hour to hiking time...not to mention that you probably would be hiking through 4-6 inches of untouched snow which would probably add a couple more hours.
P.S. Just let me know when ya'll want the next part of the scenerio. I suppose I could have just given you the second part (in all it's medical glory) but this was a scenerio we were given in one of our "crisis management" lessons and I wanted to give you the entire effect.^_^
LucidResq
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I definitely agree with your priorities. Activating SAR would be first on my list, and I'd want to send one of the leaders along with one or two of the best students to do so.
I'm wondering if it would be faster to get to the road for cell service, or if you might gain cell service by gaining altitude. Again, I'm not familiar with the NC mountains, but I've found in many places out here in the Rockies, you won't have service forever but if you get in the right clearing high enough, you'll have perfect service. Just a thought. Better to not risk it though, probably, and go where you know you've had service.
It's hard to say without actually knowing the group, being familiar with the area/climate/terrain or being in the weather conditions, what I'd do about starting our own search. I'm considering two options:
a) Leave a leader at base camp with any kids who aren't ready to go out tonight, and take a small group of the most well-prepared, willing and in best shape with me to head back down the longer trail, because if he did get started, it seems like this is where he'd most likely be. Hasty search with plenty of audibles. Instruct the second group to start down the shorter trail in the morning and meet us at base camp and we'll go from there.
b) Take the whole group down to the base camp tonight. Since I have another leader with me, it doesn't seem unreasonable to have us split up, one leader with each group and each take a trail down. Like Mountain mentioned, it kills me to break the group up so much, but I'm hoping this other guide is competent enough to manage any problems that might come up, and at least we know where the other group is and where they're headed.
The reason I'm anxious to start the search immediately is that we'll be waiting forever otherwise, there's no guarantee the weather will be good tomorrow, and if these kids get too cold or what not, at least they will be with leaders and we can stop and set up quick shelter and get warm at any time.
Either way, if we all reach the base camp, still haven't found him and still don't have help, I'd want to do a quick hasty search of the area surrounding the camp and a bit of the trail leading up to it, and then we're all coming back and having a quick lesson on line searches.
Now that we've thrown out a variety of ways to try to find him, can we find him?
Outdoornut
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and your patient...
Ok.
You and your leaders make this decision. You, a second leader and 4 of the most experienced, best in shape students will head back down the longer trail the students took (because Ryan is an experienced hiker and knows his way around a map and compass you figure that it’s more likely he has gotten injured or is having a medical emergency than is lost). Since you questioned the other students and the only responses you have gotten is that Ryan was last seen at “base camp” you assumption is that he is probably there or near there.
You will take enough food for your group of six and Ryan for two days and all of your packs (and two med kits). The third leader will remain with the larger group of students (monitoring each for signs of hypothermia and keeping a special eye on Kate) the next morning will start down the shorter trail to “base camp”.
Your group of rescuers head back down the trail without any signs of seeing Ryan. Since it is dark and your entire group is starting to get tired your pace is steady but not very fast. You reach “base camp” let’s say around 5am. At this lower elevation there is no snow but it is damp from what looks like recent rain fall and the white sky looks like it may rain again…the air is humid but a slight breeze gives a chill to the air.
Your group separates to head to the designated ‘bathroom areas’ your group had set up the night your entire group spent there. You are alerted from a shout from your fellow leader…Ryan has been found.
You quickly follow the call through the middle of “base camp” into the woods and down a hill about 20 yards. Ryan is lying horizontally across the hill; his right leg and shoulder are up against two random trees. He’s covered almost completely in dirt as well as several scratches, his pack is lying next to him and it looks like he attempted to retrieve the sleeping bag from it as it is laying half on his upper body and half of it still in the pack.
As you kneel down next to him he is shivering slightly but Ryan opens his eyes to look at you. First he looks slightly confused and then attempts a weak smile “what took you so long?” he mumbles, his speech is slurred. He slowly tries to tell you what happened in slurred short sentences but keeps stopping…forgetting what he is saying you piece together the following:He started hiking with the rest of the group the day before, but was slightly behind them as he had had to run to the bathroom right when everyone was leaving. He started on the trail behind them but a couple miles in realized he had forgotten his emergency kit back where he had gone to the bathroom. He headed back to get his kit, got sidetracked taking some pictures and when realizing how late it was (and far behind he was) he attempted to hurry…slipped coming up the hill, fell and rolled down it before hitting the trees where he came to a stop.
Ryan tells you that he did hurt but nothing really hurts anymore. He also tells you that he was shivering worse but “he’s not as cold anymore”. While you have been talking to him your other guide has been working on a head to toe assessment and informs you of the following. Ryan’s HR and RR are both slow and weak, the cuts on his face/neck are superficial, his skin is pale and cold, his right shoulder is dislocated with a possible broken arm as well (it’s hard to tell because it is still jammed up next to the tree), and he has a right mid shaft femur fracture (CSM is nearly non-existent in his right foot) and his LOR seems to be slowly decreasing and to top it off…it’s starting to drizzle.
It’s now around 7am. The other members of your search party (the 4 students) are waiting for your orders. You have around 8-9 hours before the larger group wanders into camp and remember you are 20 miles from the road that has “sketchy” cell service and then 2 hours from town.
Let me know if you need any more info.
Ok.
You and your leaders make this decision. You, a second leader and 4 of the most experienced, best in shape students will head back down the longer trail the students took (because Ryan is an experienced hiker and knows his way around a map and compass you figure that it’s more likely he has gotten injured or is having a medical emergency than is lost). Since you questioned the other students and the only responses you have gotten is that Ryan was last seen at “base camp” you assumption is that he is probably there or near there.
You will take enough food for your group of six and Ryan for two days and all of your packs (and two med kits). The third leader will remain with the larger group of students (monitoring each for signs of hypothermia and keeping a special eye on Kate) the next morning will start down the shorter trail to “base camp”.
Your group of rescuers head back down the trail without any signs of seeing Ryan. Since it is dark and your entire group is starting to get tired your pace is steady but not very fast. You reach “base camp” let’s say around 5am. At this lower elevation there is no snow but it is damp from what looks like recent rain fall and the white sky looks like it may rain again…the air is humid but a slight breeze gives a chill to the air.
Your group separates to head to the designated ‘bathroom areas’ your group had set up the night your entire group spent there. You are alerted from a shout from your fellow leader…Ryan has been found.
You quickly follow the call through the middle of “base camp” into the woods and down a hill about 20 yards. Ryan is lying horizontally across the hill; his right leg and shoulder are up against two random trees. He’s covered almost completely in dirt as well as several scratches, his pack is lying next to him and it looks like he attempted to retrieve the sleeping bag from it as it is laying half on his upper body and half of it still in the pack.
As you kneel down next to him he is shivering slightly but Ryan opens his eyes to look at you. First he looks slightly confused and then attempts a weak smile “what took you so long?” he mumbles, his speech is slurred. He slowly tries to tell you what happened in slurred short sentences but keeps stopping…forgetting what he is saying you piece together the following:He started hiking with the rest of the group the day before, but was slightly behind them as he had had to run to the bathroom right when everyone was leaving. He started on the trail behind them but a couple miles in realized he had forgotten his emergency kit back where he had gone to the bathroom. He headed back to get his kit, got sidetracked taking some pictures and when realizing how late it was (and far behind he was) he attempted to hurry…slipped coming up the hill, fell and rolled down it before hitting the trees where he came to a stop.
Ryan tells you that he did hurt but nothing really hurts anymore. He also tells you that he was shivering worse but “he’s not as cold anymore”. While you have been talking to him your other guide has been working on a head to toe assessment and informs you of the following. Ryan’s HR and RR are both slow and weak, the cuts on his face/neck are superficial, his skin is pale and cold, his right shoulder is dislocated with a possible broken arm as well (it’s hard to tell because it is still jammed up next to the tree), and he has a right mid shaft femur fracture (CSM is nearly non-existent in his right foot) and his LOR seems to be slowly decreasing and to top it off…it’s starting to drizzle.
It’s now around 7am. The other members of your search party (the 4 students) are waiting for your orders. You have around 8-9 hours before the larger group wanders into camp and remember you are 20 miles from the road that has “sketchy” cell service and then 2 hours from town.
Let me know if you need any more info.
Possible head injury, or could be a sign of a hypoglycemic reaction/the advancing hypothermia.
Possible trauma, what is the approximate distance he traveled?
He is in advanced hypothermia, and should be wrapped in a blanket/sleeping bag (if possible to do so without aggravating injuries).
again, hypothermia.
The right foot is a high priority, as it seems to be in stages of frostbite. He needs to be warmed up, and should be wrapped a dry covering, such as a sleeping bag/blanket. Continue to talk to him, and attempt to have him consume warm fluids, while setting up a tarp or other structure to keep the rain off of him. I honestly don't know how extricate a possible broken limb from confinement, unless the tree can be cut out enough to splint the arm and move it down to his body.
I think it is safe to say that this trip will not be continuing in the near future, can 2 of the students find their way back to the rest of the group, and have them return to your location? You should task the other two students in setting up shelters/preparing fluids. When the rest of the group returns, I would task an adult and student to return to the road and attempt cell phone service, planning out where they are to go ahead of time (so we don't lose two more members). The rest of the group should make camp near the pt. and attempt to make both warm fluids/liquid meals (I am assuming traditional backpacking fare, it should be liquid-y enough for him to consume if he does not have head/neck injuries.)
They should also work on making a signal for SAR crews to spot them from the air, is there room enough to make a fire?
I have no official WFR or W-EMT training, only skills from boy scouting.
Mountain Res-Q
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Priority 1 remains the same, and I wonder why it has not been done yet. Get outside help started. You may think you can do this on your own, but experience has proven to me that this is an arrogant belief that can lead to disaster. If nothing else, outside SAR resources are a backup, just in case. And no matter what the OP writes, his little group are neither searchers or rescuers. They lack the training to act in those roles at 100% effectiveness, something that true SAR Teams train in religiously; SAR Teams respond when NO ONE else can get the job done and have no backup, meaning that we need to be 100% prepared. GET SAR RESOURCES NOTIFIED ASAP.
Meanwhile, medically you are on your own in what appears to be a FA/BLS capacity. Fine. All medical findings are secondary to one: hypothermia, which the subject is obviously close to, if not in, severe hypothermia. A couple facts that should direct you thoughts and actions:
1. When your liver temp (your core) reaches 92F you start losing the ability to clot blood. Why is that important? Because this subject also has trauma and internal injuries. What good is splinting and patient packaging if you subject bleeds out in a hour?
2. Contrary to what people are led to believe, YOU CAN NOT REWARM A SEVERELY HYPOTHERMIC PATIENT IN THE PREHOSPITAL SETTING FAST ENOUGH TO MATTER, especially in the wilderness setting. All the "tricks" they teach you (warm fluids, heat packs to the groin/armpits, your body heat, etc...) are effective to an extent in moderately hypothermic patients. Why? Because the subject’s body is fighting to warm itself from the inside-out. You are supporting that by removing the outside heat draining influences and replacing it with a warmer environment. When the subject stops shivering (which he is close to), the body has virtually given up on warming itself. So now all your interventions are on their own and (at best) will slow down the process of hypothermia and maybe stabilize their peripheral temperature. Consider what hospital staff will do for a severely hypothermic patient: lavage by way of every orifice they have, hot water circulating blankets, heat lamps, warm air ventilation, warm IV fluids, etc. and all that together may raise the core temperature by 1-2 degrees an hour. So we do not have all that in the pre-hospital word, and surely not in my backpack, do you really think you can raise the core temperature fast enough to matter? Not that we do nothing:
So, I would: take my road flare out of my pack (yes I said road flare) and start the biggest fire I can... I have a Team Leader for my team that started an entire tree on fire (on purpose) for 2 moderately hypothermic subjects. While I am doing this, someone else needs to strip the patient and get in a bag with them while others build a shelter out of mylar blankets that has only one opening pointing straight at the fire. Those blankets might be laughed at by most, but this shelter will reflect heat in a matter that can turn the shelter into a sauna.
Food and water is key; so we need to get stuff warmed up. People will say that warm fluids will help raise the core temperature. BS! Just try this experiment: Take 100 litters of 90 degree water and add one litter of 130 degree water... now what temperature does the 101 litters have? Do you think that adding a canteen of warm water to a severely hypothermic patient is gonna raise the core temperature at all? The reason I want water in this subject is that hypothermic patients need the ability to circulate blood to the entire body in order to get heat (carried by blood from the core) to where it is needed to battle the cold. Dehydrated patients (which he probably is) have blood that is sludge; blood that has lost the ability to circulate heat effectively. Food is energy. Energy is heat. He needs the calories. Now, newbie EMTs will say, "no food and water to any patient." Why? What is the worst that you can do? You need to throw every heat producing thing you have at the patient in this case or else he will die of exposure slowly. Nothing is worse than death. Not to mention the possibility for diabetic issues in this patient... so he needs the sugar.
As far as the other injuries go, what can you do past stabilizing possible fractures and dislocations temporarily? The hypothermia is the most important thing and everything else is secondary! If he is in an odd position when found, move him gently into a situation that makes warming easy... fracture and spinal care be damned... do nothing to make those possible injuries worse, but do not focus on them yet.
In SAR we have the acronym LAST. Locate, Access, Stabilize, Transport.
Now, you located the subject as fast as possible already. Access to the subject was not an issue. Stabilizing is in the works. Transport to a Hospital is a priority that needs to be moved into the works ASAP since you need to get him out. That is why the SAR Notification that should have been put in the works long ago is key. No one is gonna come to help if you do not ask adn you can not provide hypothermic care effectively if you throw the patient in a makeshift litter and haul ***... he will be dead by the time you get him out (a struggle that will take FOREVER). Stabilize... then transport. While most would want a Helo in this case, hate to be the one to break it to ya, but not always possible in the mountains with bad weather. But, I have other ways. Until SAR gets there, you need to make stabilizing a priority, followed by make considerations for transport. Occupy the group with tasks, inclusing making a litter and finding a clearing to set up a signal out of logs/rock that can be identified by a helo, just in case.
Until then do EVERYTHING you can to warm him. Stabilize fractures as long as this does not interfere with warming. Spinal Care? Not a priority compared to warming him; move the patient gently (as you should otherwise) and continually assess all possible injuries, but let no treatment interfere with warming!
Meanwhile, medically you are on your own in what appears to be a FA/BLS capacity. Fine. All medical findings are secondary to one: hypothermia, which the subject is obviously close to, if not in, severe hypothermia. A couple facts that should direct you thoughts and actions:
1. When your liver temp (your core) reaches 92F you start losing the ability to clot blood. Why is that important? Because this subject also has trauma and internal injuries. What good is splinting and patient packaging if you subject bleeds out in a hour?
2. Contrary to what people are led to believe, YOU CAN NOT REWARM A SEVERELY HYPOTHERMIC PATIENT IN THE PREHOSPITAL SETTING FAST ENOUGH TO MATTER, especially in the wilderness setting. All the "tricks" they teach you (warm fluids, heat packs to the groin/armpits, your body heat, etc...) are effective to an extent in moderately hypothermic patients. Why? Because the subject’s body is fighting to warm itself from the inside-out. You are supporting that by removing the outside heat draining influences and replacing it with a warmer environment. When the subject stops shivering (which he is close to), the body has virtually given up on warming itself. So now all your interventions are on their own and (at best) will slow down the process of hypothermia and maybe stabilize their peripheral temperature. Consider what hospital staff will do for a severely hypothermic patient: lavage by way of every orifice they have, hot water circulating blankets, heat lamps, warm air ventilation, warm IV fluids, etc. and all that together may raise the core temperature by 1-2 degrees an hour. So we do not have all that in the pre-hospital word, and surely not in my backpack, do you really think you can raise the core temperature fast enough to matter? Not that we do nothing:
So, I would: take my road flare out of my pack (yes I said road flare) and start the biggest fire I can... I have a Team Leader for my team that started an entire tree on fire (on purpose) for 2 moderately hypothermic subjects. While I am doing this, someone else needs to strip the patient and get in a bag with them while others build a shelter out of mylar blankets that has only one opening pointing straight at the fire. Those blankets might be laughed at by most, but this shelter will reflect heat in a matter that can turn the shelter into a sauna.
Food and water is key; so we need to get stuff warmed up. People will say that warm fluids will help raise the core temperature. BS! Just try this experiment: Take 100 litters of 90 degree water and add one litter of 130 degree water... now what temperature does the 101 litters have? Do you think that adding a canteen of warm water to a severely hypothermic patient is gonna raise the core temperature at all? The reason I want water in this subject is that hypothermic patients need the ability to circulate blood to the entire body in order to get heat (carried by blood from the core) to where it is needed to battle the cold. Dehydrated patients (which he probably is) have blood that is sludge; blood that has lost the ability to circulate heat effectively. Food is energy. Energy is heat. He needs the calories. Now, newbie EMTs will say, "no food and water to any patient." Why? What is the worst that you can do? You need to throw every heat producing thing you have at the patient in this case or else he will die of exposure slowly. Nothing is worse than death. Not to mention the possibility for diabetic issues in this patient... so he needs the sugar.
As far as the other injuries go, what can you do past stabilizing possible fractures and dislocations temporarily? The hypothermia is the most important thing and everything else is secondary! If he is in an odd position when found, move him gently into a situation that makes warming easy... fracture and spinal care be damned... do nothing to make those possible injuries worse, but do not focus on them yet.
In SAR we have the acronym LAST. Locate, Access, Stabilize, Transport.
Now, you located the subject as fast as possible already. Access to the subject was not an issue. Stabilizing is in the works. Transport to a Hospital is a priority that needs to be moved into the works ASAP since you need to get him out. That is why the SAR Notification that should have been put in the works long ago is key. No one is gonna come to help if you do not ask adn you can not provide hypothermic care effectively if you throw the patient in a makeshift litter and haul ***... he will be dead by the time you get him out (a struggle that will take FOREVER). Stabilize... then transport. While most would want a Helo in this case, hate to be the one to break it to ya, but not always possible in the mountains with bad weather. But, I have other ways.
Until SAR gets there, you need to make stabilizing a priority, followed by make considerations for transport. Occupy the group with tasks, inclusing making a litter and finding a clearing to set up a signal out of logs/rock that can be identified by a helo, just in case.Until then do EVERYTHING you can to warm him. Stabilize fractures as long as this does not interfere with warming. Spinal Care? Not a priority compared to warming him; move the patient gently (as you should otherwise) and continually assess all possible injuries, but let no treatment interfere with warming!
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mycrofft
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Remember to balance your "oughta's" (tasks)...
...against time (before sunset, before rescue, before you collapse), manpower, and relative benefit.
...against time (before sunset, before rescue, before you collapse), manpower, and relative benefit.
"Sir, you're familiar with satellite phones?"
"And you're familiar with the area?"
"And you knew there was no cellular phone reception?"
"And yet you didn't see the need for a more robust means of communication?"
Yeah, that's going to go well.
I agree. You're going to need help. You might need evac for him, givne his condition. I stand by my original assessment of the whole situation as a soup sandwich. Little good can come of this.
I agree. And don't forget the possibility of a fem-fem bypass. But either way, he needs rewarming. And yes, I agree - once the patient is into the stage of severe hypothermia (a core temp of less than 90F), then he cannot be effectively rewarmed in the field.
Also, remember that when the body gets cold, blood flow to the extremeties essentially cuts off. The return of peripheral circulation is what causes the secondary drop in body temperature when rewarming is begun. Therefore, you want to focus your direct rewarming efforts on the core.
I would go with the fire, but I would also make a hypo wrap for the patient with at least two sleeping bags and some vapor barriers - tarps if you have them, if not, then tents. Warmed nalgenes or charcoal heat packs on the neck, armpits, and groin.
Absolutely strip him out of the cold wet clothes - that gives you a chance to take a better look at his injuries anyway. Oh, and don't forget to make him a diaper - a plastic garbage bag, his coat, and some duct tape will do you. Cold diuresis is going to make him pee. A lot.
The "no food" thing doesn't apply in the wilderness context. I agree, he's going to need to get his blood sugar back up, because his body needs it to generate the heat.
He's stopped shivering, which is an ominous sign of severe hypothermia. Given the effects of hypothermia on the heart (he'll start producing J-waves, for instance), I agree that's the top priority, though pain and hypovolemic shock (exacerbated by his likely dehydration) is also going to be a concern.
Okay, so, let me see if I have a full AA'P list here... In order from greatest to least concern based on what we know now.
Assessment
1. Severe Hypothermia
2. Possible Hypoglycemia
3. Unable to clear spine 2* AMS
4. Possible FX of femur/pelvis
5. Dislocated R Shoulder
6. Broken R Arm
Anticipated Problems
1. Continued hypothermia w/ cardiac complications. Death.
2. Insulin Shock
3. Unstable Spinal Injury
4. Continued Pain. Hypovolemic Shock.
5 - 6. Continued Pain. Damage to Shoulder and arm.
Plan
1. Hypothermia wrap. Rewarming. Evacuation.
2. Monitor BGL, provide simple sugars.
3. Monitor. Stabilize. Attempt to clear if pt. becomes A&O.
4. Splint.
5. Consider reduction of shoulder dislocation.
6. Splint.
Of course, if you have wilderness medical people with you, you can reduce the shoulder possibly, and improvise a traction splint for the femur FX with some rope and a hiking pole.
This is a high risk patient. Immediate evacuation is called for.
I'll just dial them up on my trusty satellite phone... oh, wait.
By the way, if you choose to walk him out, it'd take probably 2 days plus to hike the 20 miles. I don't think that's a good idea. For now, I'd probably bivvy down and, if I haven't already, send someone to summon help. With a GPS hack if you can get one.
Now I'm going to be carrying a road flare on backpacking trips, never really thought about signaling for rapid SAR before.
Out of curiosity, Mountain Res-Q, what would you recommend taking along as a basic first aid set while doing multi-night (but not dramatically extended) backpacking trips?
Out of curiosity, Mountain Res-Q, what would you recommend taking along as a basic first aid set while doing multi-night (but not dramatically extended) backpacking trips?
Mountain Res-Q
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I am a minimalist. Everything should have at least two purposes. When it comes to medical gear that is hard to do. I kinda follow the thinking of the Old-Timer SAR Medic and Current FACEP/Trauma Center MD that istructs us from time to time. His personal (non-SAR) medical gear consists of 1 4x4, duct tape, IBU, and MS. No lie. He believes that if your boo-boo is more than 1 4x4 can manage than you need to get the hell out of there anyway. Slap the 4x4 on, tape it, use whatever other gear can be used to make splints and bandages, hit yourself up with some IBU or MS if needed and GET OUT on your own.
If you try to prepare for every medical posibility, you care likely to be carrying WAY TOO MUCh unused gear with you... gear that can be replaced with other items that you are carrying with you or can be found in nature. And it is not the possibilities I can prepare for that are likely to be encountered... it is the really wierd crap.
I recommend to my First Aid Team members go to Wally World, buy a $10 FA Kit, tear it open, add in some personal meds and call it good. For the EMTs, OECs, and Medics, we may carry more than that, but not much, in your standard Blitz Pack. If specific medical gear is needed and can not be fashioned using your greatest tool (YOUR BRAIN) than it can be brought in to you and you will just have to make do. Think of all teh things you carry in your pack that is non medical that can be used medically. Why carry splints and trianglar bandages taht just add weight and take up space when you have hiking poles, sticks, clothing, etc that will do the job intended but does nto look as cool. That is what makes a real wilderness provider; not the certification or training, but the ability to take a really screwed up situation and setting and do just what you would in the urban setting, but with less gear, delayed transport, less manpower, and issues that can not be contemplated until you sit there and realize, "crap I need XXX" or "what about XXX" and realize that you need to think on your feet and do what needs to be done however it neesd to be done.
My medical gear includes: A few 4x4s, tape, mini shears, assorted meds, ashesive bandages, tweezers, 2 military issue trauma dressings, and 2 triangular bandages. And that is overkill. If I was not an EMT and SAR Medical Team Leader, my entire medical gear would consist of the military dressings and asorted medications.
P.S. As far as the Sat Phone thing goes... I have never had success with them and will not carry one. I do have my Radio, but even if I did not, when you enter the wilderness you do so on it's terms... do not expect help to be there fast or at all... you entered that environment for a reason... LIVE WITH IT... or Die because of it.
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