What if the patient is in the woods, 1 mile from ambulance access and you don't have time to wait for the ambulance 4-wheeler.
Do you?
A. Borrow the patients buddies four wheeler and bring necessities.
B. Decide to see if the ambulance can make it, after all it hasn't rained today.
C. Make use of the 4x4 truck, again a buddies.
D. Use this opportunity to take a nature trail walk to the patient.
E. Break out some trail mix and joke while you wait on wilderness rescue to arrive.
The patient is located on/near a 4WD only road? Or is he actually in the middle of the woods with no vehicle access?
If he is near a 4WD road, as you options to use ATV or a Pickup suggested, then why the heck don't you have a 4WD Ambulance? Let's assume that you do not have an ambulance capable of this trip... are you gonna bring the pt. out via ATV? No. So unless it is your ATV and your agency uses ATVs in Rescue, then you have no business using an ATV that you are not familiar with; risk does not justify the benifit. Use the truck option, but insist that you or your partner drive. We have actually used pickups for transport of patients. For instance, after we extricated the pt. from a mine we had to get him 2 miles down a 4WD road that no ambulance or engine could traverse. So a Team Leader used his pickup to get the c-spined patient and the Medic down to the ambulance.
If the patient is in the middle of the woods, without vehicle access, then why would you even consider using an ATV or pickup? In fact, using an ATV on public land that not designated as an ATV Trail is often illegal, and unless you have permission from the Land Management Agency (A Federal MOU that many SAR Teams have with the USFS), you will get in serious trouble for this. You would, if anything, hike it in. That said, the pt. is, by our definition, on the boarder of being an Extended Reach Medical (Fire goes out in the woods) versus a SAR Call. If the patients exact location is known and the patient is less than a mile from the road/trailhead, then Fire may go in; Ambulance Crews may also, but usually do not. If the patient is more than an hour from the road/trailhead, than this is a SAR call... Fire may be sent in first (situation dependent) but SAR will be dispatched too. If it is a SAR Call, then command of the situation is no longer the hands of EMS or Fire... the first SAR Representative on scene is in charge and will tell you what to do, so you don't (by law) the choice; in our case that would usually be a Sheriff's Deputy, who will be on scene about the time you are… when the actual Team gets on scene, they will usually assume operational control…
So... Never A... B if you feel comfortable... C if it gets you closer to the pt... D if you are within 1 mile of the pt... E if you are more than a mile from the patient, the exact location of the pt. is unknown, or the terrain/weather makes your little hike a bad deal safety wise... AND NO MATTER WHAT... notify SAR early so that if they are indeed needed at some future point (manpower to carry he patient out, because the patients exact location is unknown, the patient turns out to be miles away from where he was supposed to be, or rope rescue/other is needed) they are already enroute...