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How to Manage a Wilderness Emergency

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Cover image: This is not a practice test. The images here are from an ice climbing accident that occurred last winter at Louise Falls, one of the most popular ice climbs in Banff National Park. As Shauna's group descended from the climb due to too much icefall, a leader in a party above fell and broke some bones. Shauna's group initiated a rescue with Parks Canada, a highly specialized public service in the Canadian Rocky Mountain National Parks, to assist them. All images: Shauna Morey

Chances are if an injury occurs in the backcountry, you’ll be the first responder—getting emergency rescue and medical help is significantly harder in the backcountry. Cellular service diminishes in much of the backcountry, making technologies such as Spot and Inreach devices indispensible to the outdoor adventurer, allowing emergency communication via satellite. 

Although these devices come in handy, they are not a substitute to specialized first aid for the backcountry. While intensive, an 80-hour wilderness emergency response course offers a multitude of information to save or stabilize the injured until medical help can arrive, or even prevent a resource-dependent and expensive rescue.

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'Burrito wrapped' and ready for take off.

Not all accidents in the wilderness need an immediate rescue. Sometimes people can make it to the trailhead and local hospital with minimal assistance.

Still, it’s helpful to be prepared. While this blog post is by no means comprehensive (i.e.: get yourself to a wilderness emergency response course to be truly prepared), I’m offering tips and insight I’ve gained over my years as a professional guide for how to respond in the case of a bad bone fracture or other wilderness emergency.

A typical response to a fall like the one I witnessed would be to:

  • Assess the area for hazards to you, the patient and bystanders, and how you can assist.
  • Determine if the mechanism of injury necessitates spinal precautions.
  • Prepare to use universal precautions before helping a patient by putting on medical gloves, rainwear, and using a pocket mask to protect yourself from bodily fluids.
  • Check a patient’s airway, breathing, and circulation. Also check for deadly bleeding or medical bracelets/complications, and treat them.
  • Treat for shock: keep patient warm, take precautions to prevent other temperature related illnesses.
  • Position them in a manner that aids breathing and takes spinal precautions.
  • Continue taking a thorough patient history and see if you can clear them from spinal injury (as a fall over body height has a positive indication for potential spinal injury).
  • Clean, bandage and stabilize the patient’s broken bone. (Monitor pulse and capillary refill at the distal part of the limb before and after splinting. Examine and treat the fracture by cleaning, bandaging and splinting it in the position found while ensuring to prevent the joint above and below from moving. On longer trips where medical care is a long way off, repositioning of long bones may be indicated, especially if there is no distal pulse as it could enable circulation to save a limb).
  • After which continue to prepare for transport to emergency services, while continuing to take vitals. Vitals provide a good indication of a patient’s ongoing condition.
  • Stay with the patient until care arrives.
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Climber and nurse getting long-lined.

Note: To clear a patient from using spinal precautions, a patient would have to:

  • Be reliable: No altered level of consciousness, only one trauma, no other distracting injuries and no language barriers.
  • No spinal or mid-line pain.
  • No pain on spinal palpation.
  • No numbness, tingling, lack of strength, sensation or paralysis in any limb.
  • No spinal pain.

Sounds complicated? It is. Which is why nothing replaces training. A Wilderness First Responder (WFR) course will train you to be an aid to emergency services in the backcountry. Several popular companies offering this training include Rocky Mountain Adventure Medicine and Wild Med.

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High above the valley bottom climber is quickly helivaced to safety.

Apart from communication devices and first aid courses, a good first aid kit is indispensible. Wondering what to carry? One upshot of the WFR training is that the courses help you determine what is necessary to carry in your backpack in the backcountry, along with what type of information emergency services will need to aid in a rescue.

Shauna is a guide at Freeheelin' Adventures based in the Canadian Rockies near Banff National Park and specializes in guided hiking, backpacking, snowshoeing and Nordic ski instruction. Follow her on Facebook and Instagram or sign up for a tour today.



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