Wilderness and Remote First Aid: Part 2/3

Knowing that we are going out into the wilderness on a regular basis it is prudent to be prepared in the event that something goes horribly wrong. Eleven of my most regular climbing crew attended a Wilderness and remote first aid course (3 days with an overnight) hosted by Adventure & safety atlantic. If you’re just joining the thread, read PART 1 HERE or PART 3 HERE.

Day 2:

Have you ever had a day so long and intense that it rivaled the rest of the year? Now imagine you paid to be there and are enthralled for every minute. A mentally and physically challenging day to say the least, this was the most intense day of the course. It involved a lot of scenarios, learning, and failure. How to deal with death became a very real concept for us. As you’ll see being out of range of a hospital makes death an all the more real possibility.

SOAP Notes

We started the day learning the importance of SOAP notes (Situation, Observation, Assessment, Plan) in a secondary survey. This was done for both conscious and unconscious victims where spinal is not suspected. I flailed around trying to remember all the steps for an unconscious person: Kick their foot & try to wake up, check for medic alert bracelet, check vitals (pulse, pressure), level of consciousness (Alert, respond to verbal, pain, unresponsive), find pain points over the body, check for blood, check inside mouth for broken teeth, pupil response, any belly bruising, then roll them up and onto a blanked to get them off the ground (heat loss). This controlled environment was a great place to learn but my eyebrows raise at the prospect of following those steps with a real scenario. Practice makes perfect, and this is something I will continue to work on for when I need it in real life.


While skipping along the wooded trail enjoying the lovely crisp fall air we came across Sarah sitting on a rock with a bloody nose having trouble breathing. She couldn’t articulate what was going wrong but eventually we figured out it was an asthma attack. After finding what we thought were the right drugs in her pack she began to calm down while we attempted a secondary survey. Somewhere between “What was your last meal?” and “Do you have any allergies?” she relapsed into another fit of panic and lost breath – too bad her puffer was empty.

Even while knowing this was a fake scenario, fear still crept in as I scanned my brain calmly yelling “WHAT DO I DO NOW?!” I really did not know what to do. Once she passed out her breathing returned to normal and we moved her up to the path onto a tarp for evacuation. Key take away here: Caffeine can help, and an epipen will stop an asthma attack if one is available.

Bloody nose

Peanut gallery

I was next on the docket for acting out a victim roll. Soup of the day was – anaphylactic shock after having eaten a peanut. For this scenario three of the four victims died. Turns out an epipen will only cover an attack for 15 minutes or so. WHO KNEW?! Again very scary for those who were trying to save their friends and watching them die helplessly. Except Mick who tried to perform a tracheostomy – unfortunately he was unsuccessful. You have to give Benadryl within 15 minutes of an epipen to be sure a relapse wont occur.

IMPORTANT NOTE: IF you ever find yourself having to do this make sure to write on the paperwork that you “assisted” in the epipen’s use, you cannot “administer” the drugs for “legal reasons”.

Final takeaway: if someone dies in the woods they are officially a crime scene. You cannot move their body and try to take them out (It also serves no purpose). You now must manage the group who has witnessed a death or lost a friend / family member this is more important.

Hunt Drunking

After lunch we went back to the woods to find another large group accident. This time a hunting accident. Matt was hanging from a tree, Mick had rope burn on his hands and an axe wound on his foot and was belligerent, Ben had a head and arm injury, Sarah had a punctured lung and was very quiet, and they were all HAMMERED. I missed most of the big events because we sat Ben down far away from his friends and tended to his injuries and keep him calm.

Key takeaway : A punctured lung will present bubbles from the wound rather than blood. Find something plastic and tape on three sides and most of the fourth over the wound. This allows for drainage on the exhale but pressurizes on the inhale. Also don’t try to haul Matt up a tree.

Hunting accident

Kitty Litter

After all of this we learned how to build a litter from two logs and a tarp Very quickly and easily. If left to my own devices it would have taken 3 hours and all the cordallette and draws in a 10 mile radius. This method takes 2 minutes and is super strong. On top of this we learnt the correct method for a hypothermic wrap. See below for instructions of the litter carry.

litter carryLitter cary

Boating Bonanza

The end of the night was a literal insanity. After cozying up by the campfire after a long day of lessons learned Billy busts in from the darkness screaming about a boat crash. His son “Noah” was lost and family badly injured. Eight of us ran to the scene and started to assess. We broke off into teams of two while Sarah and I managed information, the plan, and communication with what was our fake research headquarters. The first person we saw was Miles lying in the freezing river – for real i.e. “No Duff” – this became a real concern because he was legit cold we had to get him out of his wet cotton into a hypothermic wrap. Billy was screaming and running up and down the river and Bekah was screaming for her son but her feet had immersion foot so she could not walk.

Two people split off to tend to Bekah, two of us scoured the river only to find a child’s lifejacket with no child. This scenario ran for about 4 hours, and once we found out the base could not get help out until first light tomorrow we thought it would run all night. So we made a plan to get people back to camp and bunker down for the night. Miles began puking up parts of his lungs so he was going to die no matter what. Billy and Bekah couldn’t be near each other because they would fight immediately about the crash, all the while we were looking for a lost child. Eventually we realized that he wasn’t going to be found and our main concern had to be the two live patients – then the scenario got called off.

Hypothermia for real

The screams and tears, the fear and anger, the scatter and chaos all contributed to making this event such a realistic and heart wrenching event. Making decisions that result in lost life was hugely stressful but our ability to react and work as a team was amazingly powerful, and we began to realize that we had all these new tools to draw on in an emergency situation.

We went to bed around 12:30 that night in -3 degree weather expecting an early wakeup call the next morning with a new scenario. What happened next? Who knows?

Have you had to deal with any of these scenarios in real life? Have you gone through this training? Share your experience with us!

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