Maybe for something different??

[Outdoornut]

"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.

Haha...ok, ok. Point taken...you all can have your satelite phone!!
When we do scenerios we usually don't get one....I think simply because the last thing you want people (who are training to be wilderness leaders) to do is to be like "oh, it's cool...we called for help." which, don't get me wrong is VERY important but help is still 20 miles away, and you still have a patient to take care of.

But realistically, yes you would have a satalite phone as well as a couple cell phones and you would probably be checking in with someone once a day (this person would know your entire schedule, EAP, and keep you updated on the weather if it has changed at all etc..). But again, whether help is 2 hours or 12 hours away you still have to care for your patient until they arive....I think the reasoning behind this scenerio leaving out the satalite phones is because it is ment for those doing it to focus not on "help is coming, help is coming, help is coming" but rather what to do immediatly for the patient and then perhaps even how you would go about organizing getting help....but no clue...I didn't write it (stole it actually...shhh don't tell

Good responses though...so now that you have a satalite phone what would you do differently??

 

[Mountain Res-Q]

Haha...ok, ok. Point taken...you all can have your satelite phone!!
When we do scenerios we usually don't get one....I think simply because the last thing you want people (who are training to be wilderness leaders) to do is to be like "oh, it's cool...we called for help." which, don't get me wrong is VERY important but help is still 20 miles away, and you still have a patient to take care of.

But realistically, yes you would have a satalite phone as well as a couple cell phones and you would probably be checking in with someone once a day (this person would know your entire schedule, EAP, and keep you updated on the weather if it has changed at all etc..). But again, whether help is 2 hours or 12 hours away you still have to care for your patient until they arive....I think the reasoning behind this scenerio leaving out the satalite phones is because it is ment for those doing it to focus not on "help is coming, help is coming, help is coming" but rather what to do immediatly for the patient and then perhaps even how you would go about organizing getting help....but no clue...I didn't write it (stole it actually...shhh don't tell

Good responses though...so now that you have a satalite phone what would you do differently??

I agree with your scenerio having no commnications. If you rely on technology in this setting, you are asking for trouble. Cell Phones, Sat Phones, GPS, etc... take it if you must, but that is not a savior. Have other means to deal with communciations and navigation. Like I said, you are entering that environment on it's terms. If you are not preapred for that, GO HOME or be prepared to meet me...

 

[Mountain Res-Q]

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?

Close Line Grid Searching is a last resort. I would hold off on that. For your active search methods you should start with a Hasty, Tracking/Signcutting, Open Line, and then Close Line. And the Professionals shoudd get a shot at it before College Students destroy clues. Remember that in SAR we are never looking for the missing person... we are looking for clues. Clues led to the missing person.

"Can we find him?" LOL. Of course I will; dead or alive. I am a Professional despite what people think.

 

[mycrofft]

Maybe I'm ignorant...well, yes, I really am, but .....

....ring ring "Hello?"
"Ah, the satellite phone worked. Yeah we have a man down in a hiking group, he's pale" (yaddidda yaddidda for half a battery) " and ...".
"Sir/Madam, where ARE you?".
"Uh, hm...in a valley?".<_<

 

[Outdoornut]

....ring ring "Hello?"
"Ah, the satellite phone worked. Yeah we have a man down in a hiking group, he's pale" (yaddidda yaddidda for half a battery) " and ...".
"Sir/Madam, where ARE you?".
"Uh, hm...in a valley?".<_<

Two words: map and compass. ^_^

Even the places I have been that have been in the backcountry (which apparently is defined as being 8-12 hours from help) there is a topo map availible for the trails...or at least the area you are in and even if there is a trail...you use a compass to make sure you are where you need to be.

GPS is pretty neat but it would be kinda dumb to rely soley on that. They don't always work (bad weather, deep canyon, valley etc.) and personally...I think thee is something a little creepy about relying compleltey on a piece of technology (but it could just be me

 

[Veneficus]

I'm not even remotely an expert at this

but I have a few observations and questions.

First, I agree with EMSlaw, I would definately have a satphone with me. I wouldn't rely on it, but at some point you have to prepare that if something can go wrong it will. (especially if you have ever been in the wilderness with me) The satphone, while not really the tool of purists, has the potential to summon help fast, and that lone makes it worth the weight. Let's face it, in this day in age, there are way too many inexperienced, out of shape and unprepared weekend warriors, who overestimate their own capabilities. While calling for help may show "you couldn't handle it" I don't think it should cost somebody life or limb to prove they could or couldn't.

I also like the idea of being a minimalist. If I have to carry it in and out, it will be well worth it. Otherwise, it is not coming. I certainly am not filling my pack full of "what if" medical gear. Especially since as MTResQ pointed out, you can never be prepared for every eventuality. I am a black cloud too, even 10 minutes from a hospital I seem to get calls that there was no way to see or prepare for.

One thing I have learned in all of my varied experiences is: the fewer important/moving parts something has, the better it works. When you start getting into all kinds of electronics, you need batteries. Batteries are heavy. They always seem to fail when you need them the most too. electronics require special care, usually cannot get wet. (especially your batteries) Don't get me wrong, I am not foreign legion minimalist, with a piece of fishing line and a knife to survive in a tropical environment for a week, but the more you have the more something will go wrong, both with the equipment and or a person. (I have never had a sherpa to carry 1000 lbs of my gear)

Well I promised a question.

Does anyone get paid or offer to carry a bunch of medical equipment "just in case" for money? I knew a medic many years ago that made a living going on expiditions with people. From oil and gas exploration to vacationers in the outback. It seemed almost a unique job. I have never met anyone who did the same prior or since. If somebody is planning to carry around all kinds of medical crap, why not get paid for it no? There have got to be some weekend warriors who would pay for a "medic" to go with them. Maybe not enough to make a living, but a good side job. Especially if you have all kinds of SAR and wilderness quals. right?

 

[Outdoornut]

Well I promised a question.

Does anyone get paid or offer to carry a bunch of medical equipment "just in case" for money? I knew a medic many years ago that made a living going on expiditions with people. From oil and gas exploration to vacationers in the outback. It seemed almost a unique job. I have never met anyone who did the same prior or since. If somebody is planning to carry around all kinds of medical crap, why not get paid for it no? There have got to be some weekend warriors who would pay for a "medic" to go with them. Maybe not enough to make a living, but a good side job. Especially if you have all kinds of SAR and wilderness quals. right?

Some companies will...it depends on the organization. Most of the time outdoor organizations (such as NOLS) run so many 'small' expeditions at one time it's impractical to hire JUST a medical person for each party. However, if you are a guide/instructor and happen to be an EMT (or WEMT or whatever) you will be doing both...but you wouldn't be working in the context of being the "medical staff" you would be a guide and everything else would be secondary to that.

Now there are some major expedition companies (mountaineering companies for one) that do hire medical staff (only) but those staff are usually physicians or NP's that specialize in high altitude illnesses.

But again you might be able to find smaller companies that will hire you to go along as an assistant guide but mostly "in case" anything majorly medical happens (colleges/universities programs, boy scout troups, private groups, summer camps, wilderness therapy/youth at risk camps/programs etc..)

hmm, hope this is helpful...there are various "outdoor' job listings at NOLS.edu so you may find one there if you're interested. B)

 

[Veneficus]

Some companies will...it depends on the organization. Most of the time outdoor organizations (such as NOLS) run so many 'small' expeditions at one time it's impractical to hire JUST a medical person for each party. However, if you are a guide/instructor and happen to be an EMT (or WEMT or whatever) you will be doing both...but you wouldn't be working in the context of being the "medical staff" you would be a guide and everything else would be secondary to that.

Now there are some major expedition companies (mountaineering companies for one) that do hire medical staff (only) but those staff are usually physicians or NP's that specialize in high altitude illnesses.

But again you might be able to find smaller companies that will hire you to go along as an assistant guide but mostly "in case" anything majorly medical happens (colleges/universities programs, boy scout troups, private groups, summer camps, wilderness therapy/youth at risk camps/programs etc..)

hmm, hope this is helpful...there are various "outdoor' job listings at NOLS.edu so you may find one there if you're interested. B)

me and the great outdoors is inviting disaster, I was thinking more along the lines of a company that offers such services.

 

[Outdoornut]

there must be a story...

me and the great outdoors is inviting disaster, I was thinking more along the lines of a company that offers such services.

You don't get along with the outdoors? and disaster? There has to be a story behind that comment ^_^ or are you just a city slicker?

But yeah you can hire out guides that work for companies. You can go onto NOLS website today and hire one of their guides and I am sure many other companies would do that as well (rent-a-guides hehe...so many comments I could make!!). But I am thinking they are probably pretty expensive...then again you would have an experienced guide with medical knowledge (WFR, WEMT) probably some SAR experience as well...so yeah I can see it being worth the $$ (heck! it's how I am going to make a living!!).

 

[Mountain Res-Q]

or are you just a city slicker?

Flat Lander... :glare:

 

[Eydawn]

How does the pt. respond to you getting sugars into him? As you strip him down from the wet clothing, what do you see visible injury wise?

Your first fail as group leaders was not ensuring that EVERYONE had a dedicated buddy on this "fend for yourself" gig. So you've got a diabetic photographer kid? He gets a buddy, maybe 2, both with maps and extra supplies. No offense... hindsight being 20/20 and all that.

Pulse? Respirations? Skin color and temperature? Does he have peripheral pulses?

Package this guy as well as you possibly can- get a vapor barrier between him and the ground as your foundation. That way, when he's all bundled up, all you have to do is lift him on the tarp into the basket when your SAR folks finally get to you. I agree with improvised splinting of the femur; I would attempt manual relocation to re-establish CSM and splint in place with whatever materials are handy. With as screwed as he is, you're not going to compromise stability of fractures or decrease possibility of positive outcome much by doing this. If you're really worried about pelvic fx, do an improvised pelvic wrap as you bundle this kid up, and splint the arm beforehand as well.

What is your terrain like? You're 20 miles in on the trail... are there off-shoot access trails? Any juxtaposition to 4X4 trails? Are you near a decent helicopter landing zone? It may be faster to just have them shoot you the bird right off the bat if conditions and terrain permit. If you lead backpack treks in this area often, do you have coordinates for campsites on your trail that you can send out with your "contact" group? If not, now is a good time to start figuring out where you are and draw up some rough coordinates so at least there's SOMETHING more than general directionality to go off of.

As far as the chickie who was close to the fire and gave away her dinner, you may want to consider that she may become a second patient if you're not careful... she sounds like she's in the beginning stages of hypothermia as well. Food time for chickie!

I would also make sure everyone else in the party is well cared for. If you've got some sort of better/closer access than the trail, I'd string some of your people out along it within visual/shouting distance of each other to make it easier for SAR to home in on you... You're in for the long haul, that's for sure.

Wendy
CO EMT-B

 

[Outdoornut]

Flat Lander... :glare:

I don't even know what that means... :unsure:

 

[EMSLaw]

Flat Lander... :glare:

Is that what you mountain people call those of us who are not?

 

[Outdoornut]

How does the pt. respond to you getting sugars into him? As you strip him down from the wet clothing, what do you see visible injury wise?

Cuts, scratches, bruises...nothing to indicate internal injuries (yeah...poor guy might as well give him a break in something!)

Pulse? Respirations? Skin color and temperature? Does he have peripheral pulses?

I think I posted this ealier...?? :unsure:

What is your terrain like? You're 20 miles in on the trail... are there off-shoot access trails? Any juxtaposition to 4X4 trails? Are you near a decent helicopter landing zone?

Hmm. Ok, here's a bit more info on the trail: You are in the NC mountains, the trail is well-known (in other words, maps are availible, it's online etc.) but not easily accessible except by foot. The road that leads up to the trail head is gravel and winds up the hill in "switch back" fashion (one side of the road goes up, the other side goes down) the road is in the woods (heavily forested) and is one lane (one of those if someone is coming from the other direction one of us is going to have to pull over...somewhere deals). Once you reach the trail head there is a small clearing (to park maybe two cars) and the trail immediatly starts a gradual ascent up for about 200 feet. After that the rest of the 20 miles are moderate/sketchy (not to hard, lots of roots, rocks, couple trees in the middle of the path) the forest is thick around you. Your group had a hard time finding a place to camp and so they had to split up into two smaller clearings (about a quarter of a mile from each other). These campsites are not labled on the map..they are just 'clearings' backpackers have found/made. There is nowhere for a helicopter to land. Poor Ryan.

As far as the chickie who was close to the fire and gave away her dinner, you may want to consider that she may become a second patient if you're not careful... she sounds like she's in the beginning stages of hypothermia as well. Food time for chickie!

I would also make sure everyone else in the party is well cared for. If you've got some sort of better/closer access than the trail, I'd string some of your people out along it within visual/shouting distance of each other to make it easier for SAR to home in on you... You're in for the long haul, that's for sure.

Good thought! The one thing we're constantly told (and I do mean constantly) is that you have to constantly keep an eye the entire group (and each individual within the group) even if there is an injured person. The mistake now would be for all the leaders to direct all of their attention on Ryan and neglect the rest of the group. I would definitly have someone (probably another girl) assigned to Kate (I think this was her name...hehe) make her eat something, drink some warm fluids, make her a hot waterbottle to go to bed with.

I once went on a backpacking trip it was March and we ended up backpacking through 8 inches of snow with it snowing on us. We camped at about around 2,000 ft (give or take...we hiked up 1,000 but drove up quite a bit) in the snow. By the time we made camp everyone was cold, and tired no one wanted dinner we just wanted to go to bed. Our instructor gave us a lecture of which I would be giving to the rest of the group about the importance of eating and drinking when it is cold outside.

I bet even though the rest of the group (excepting Ryan and Kate) seems 'ok' they are dehydrated. When it is cold outside you don't think about drinking water...cause you don't have that gross sweaty feel and because your water is cold too. I would set a goal for them "in about say...two hours...that waterbottle needs to be empty".

Man...now I want to go backpacking!!!

 

[Eydawn]

At this point, if your closest access point is that trailhead 20 miles out, you'd be best off improvising a litter and having your group try to evac this kid partway out yourselves. You're looking at 4 days or so here what with having to send runners out the 20 miles to GET HELP, help deploying, and getting up the trail to you... I'd hunker down until dawn (but I'd send the strongest hikers/runners right now) and then get moving in the morning. Even if you can only make it 5 miles, that's still a reduction by 1/4 of the total distance SAR has to evac you out in.

Sounds like it's pretty hard for y'all to get lost on this trail, you have a known direction of travel back to civilization... so time to get creative. What kind of materials could you improvise a litter out of?

There's a good chance this kid is gonna die no matter what. That doesn't mean you have to just sit there and wait for it to happen...

Wendy
CO EMT-B

 

[Mountain Res-Q]

At this point, if your closest access point is that trailhead 20 miles out, you'd be best off improvising a litter and having your group try to evac this kid partway out yourselves. You're looking at 4 days or so here what with having to send runners out the 20 miles to GET HELP, help deploying, and getting up the trail to you... I'd hunker down until dawn (but I'd send the strongest hikers/runners right now) and then get moving in the morning. Even if you can only make it 5 miles, that's still a reduction by 1/4 of the total distance SAR has to evac you out in.

Sounds like it's pretty hard for y'all to get lost on this trail, you have a known direction of travel back to civilization... so time to get creative. What kind of materials could you improvise a litter out of?

There's a good chance this kid is gonna die no matter what. That doesn't mean you have to just sit there and wait for it to happen...

Wendy
CO EMT-B

So, you would start moving this kid immediately and ignore the BASIC principles that make up the SAR World? LAST!!! Locate, Access, Stabilize, and Transport. You do not transport until the subject is stable. In this case you can not expect the kid to survive being boardline severely hypothermic and moving him. Stabilize him first. As you say, he might die if you stay or go, so give him the best chance possible. Also, consider the weather. It will make your litter carry out REALLY hard and slow things down. On the other hand, if you stay put and work on keeping the kid alive and stabilized he may be in a position to asist in his evacuation if the hypothermia is stabilized (something you can not do on the "road") and (better still) you may be able to wait out the storm and allow for a break in the weather where you can get a helo in for evacuation.

I stand by my original posts. Priority 1 is SAR notification. Priority 2 is making sure the rest of the group is secure. Priority 3 is the patients hypothermia (remember what I said medically about hypothermia in the wilderness environment in previous posts). Priority 4 is the other injuries. Priority 5 is dealing with evacuation. Until 1-4 are handled, 5 should only be a considertion that you are planning for, NOT the plan itself.

 

[Mountain Res-Q]

Flat Lander: People from the Valley or Bay Area (urbanized areas in general) who have no place in my mountians for various reasons:

Flat Landers will walk down the middle of my 35 mph road and yell at me for almost hitting their kid that is running back and forth across it. Just because I live in the mountains does not make it an ammusment park.

Flat Landers will slam on their breaks and shut down a 55mph highway to take pictures of Free Range Cattle becasue (and I quote) they have "never seen cows in their natural habitat".

Flat Landers will go "camping" in my backyard and bring a boom box, generator, capacino maker, and complain that we do not have a McDonalds on every coroner. Then they (no lie) will get into a gun flight at a high alpine lake with a rival gang.

Flat Landers drown in my rivers becaue they do not realize that 38 degree water that is running at 3500 cfs is a bad deal... and then try to sue us for failure to rescue their child that they shoved in the water.

Flat Landers NEVER take their trash honme with them. They will literally dump bags of garbage on the roads and leave cans, bottles, and broken sleds in my backyard.

Flat Landers think that America has been subdued and is one giant playground. They have no clue that we still have environments that existed in the days of Indians and the Wild West... and it will kill you. And, no, we are not obligated to save you when you enter my mountians without a clue and screw up. We try... but reality is that we may not be able to.

Flat Landers wither drive too fast or too slow on Mountain Roads... Never a middle ground.

Flat Landers, although having the right to be in my Mountains, have no business here and are likely to kill themselves or others doing something stupid that makes sense from the perspective of someone that lives in an area where Starbucks, McDonalds, Wal Mart, Freeways, and the like are their ONLY reality... I live in the Mountains on it's terms and it is my reality... just I do not belong in urbania, many people have embraced a society that has rejected the wild, but wants to visit it with an urban mindset that WILL NOT work here... just MHO. B)

 

[EMSLaw]

I have to agree with Mountain. I think the kid is a priority evac0back to the world, but given the conditions, carrying him out is not likely to be an optimum solution.

One thing I've taken out of my own training is that it's a lot harder to carry someone any distance than you might think. Carrying a litter even a mile with eight strong, healthy, full-grown men left us all beat. You want to go 20 miles? That's an invitation to disaster.

I don't want to scream for a high-risk evac if I don't have to, but the location, inaccessible location, and patient acuity all militate in favor of risking a chopper evac.

That said, you have to summon help first.

 

[Outdoornut]

Flat Lander: People from the Valley or Bay Area (urbanized areas in general) who have no place in my mountians for various reasons:

Flat Landers will walk down the middle of my 35 mph road and yell at me for almost hitting their kid that is running back and forth across it. Just because I live in the mountains does not make it an ammusment park.

Flat Landers will slam on their breaks and shut down a 55mph highway to take pictures of Free Range Cattle becasue (and I quote) they have "never seen cows in their natural habitat".

Flat Landers will go "camping" in my backyard and bring a boom box, generator, capacino maker, and complain that we do not have a McDonalds on every coroner. Then they (no lie) will get into a gun flight at a high alpine lake with a rival gang.

Flat Landers drown in my rivers becaue they do not realize that 38 degree water that is running at 3500 cfs is a bad deal... and then try to sue us for failure to rescue their child that they shoved in the water.

Flat Landers NEVER take their trash honme with them. They will literally dump bags of garbage on the roads and leave cans, bottles, and broken sleds in my backyard.

Flat Landers think that America has been subdued and is one giant playground. They have no clue that we still have environments that existed in the days of Indians and the Wild West... and it will kill you. And, no, we are not obligated to save you when you enter my mountians without a clue and screw up. We try... but reality is that we may not be able to.

Flat Landers wither drive too fast or too slow on Mountain Roads... Never a middle ground.

Flat Landers, although having the right to be in my Mountains, have no business here and are likely to kill themselves or others doing something stupid that makes sense from the perspective of someone that lives in an area where Starbucks, McDonalds, Wal Mart, Freeways, and the like are their ONLY reality... I live in the Mountains on it's terms and it is my reality... just I do not belong in urbania, many people have embraced a society that has rejected the wild, but wants to visit it with an urban mindset that WILL NOT work here... just MHO. B)

Ha!! I love it!! Especially since I totally admit to once having been a flat lander (still have the tendencies from time to time...will admit to having driven more than two hours to get a Starbucks ^_^ ). Moved to the mountains a few years ago...definitly was a different place to live...lots of trees, 'real' wild animals (never forget the day the trash company had to come move our dumpster outside our apartment because bears had broken into it). Now...can't stand not being in the mountains...even without a Starbucks

 

[Eydawn]

So, you would start moving this kid immediately and ignore the BASIC principles that make up the SAR World? LAST!!! Locate, Access, Stabilize, and Transport. You do not transport until the subject is stable. In this case you can not expect the kid to survive being boardline severely hypothermic and moving him. Stabilize him first. As you say, he might die if you stay or go, so give him the best chance possible. Also, consider the weather. It will make your litter carry out REALLY hard and slow things down. On the other hand, if you stay put and work on keeping the kid alive and stabilized he may be in a position to asist in his evacuation if the hypothermia is stabilized (something you can not do on the "road") and (better still) you may be able to wait out the storm and allow for a break in the weather where you can get a helo in for evacuation.

I stand by my original posts. Priority 1 is SAR notification. Priority 2 is making sure the rest of the group is secure. Priority 3 is the patients hypothermia (remember what I said medically about hypothermia in the wilderness environment in previous posts). Priority 4 is the other injuries. Priority 5 is dealing with evacuation. Until 1-4 are handled, 5 should only be a considertion that you are planning for, NOT the plan itself.

I didn't say you should move him before stabilizing him. I'm saying that with your extended time window, you should consider getting him closer to your access point as soon and as safely possible. You have a lot of hands available. You don't have to he-man rah rah up the trail and bounce the crap out of the kid; you don't have to go while the weather is still craptastic. You can definitely take your time and make sure the kid is nice and stable (as much as he can be) before you attempt to move. If moving isn't working, then you can hunker down 300 yards away from where you started.

Nowhere did I indicate that it was preferable to take off in bad weather without stabilizing... I assumed that it would be inferred that those would be considered first. My bad.

We've already established that a helo is not an option unless we have the option of calling in military resources for a live lift with a penetrator. Is that possible in this scenario? If it is, that changes the picture a bit. As it stands, I'm going on the assumption of no helos.

At this point, I'm assuming we've provided for the safety of the group, as no further information on that has popped up. I'm assuming we've splinted the injuries and begun rewarming as much as we can for this kid. Of course you're not going to move someone who's not stable.

What I am saying is that it may be advantageous to decrease the total evacuation time by being proactive.

As far as the LAST acronym, your location is on this trail (as long as you stay on it, they're going to find you there), your access point is 20 miles away, you've already initiated stabilization, and it's going to be a lot easier on rescuers to use a litter/wheel for 15 miles after hiking in than it will to go for 20 miles. (Again, I've reread the posts and is there potential for any 4x4 access? ATv's? Something?) It also will keep the college kid group from freaking out. The best thing you can do to keep up their morale and make them more proactive is to give them something constructive and useful to do.

I agree that carrying the litter is a major b!tch. This is why you need a lot of people to effectively conduct a rescue. As far as the kid being able to help with his evacuation with a broken femur... not very likely... while I would agree with that evaluation for someone who's just hypothermic, this kid's injuries kind of preclude that.

Wendy
CO EMT-B