Dealing with Emergencies

When walking in remote areas and the high hills, it is essential that at least one person in your party has some basic competence in First Aid.

The application of those skills in remote areas, and in wet, cold and/or windy weather is the challenge we face in dealing with emergencies in the British hills where any illness or injury is potentially more dangerous and difficult to deal with.

In this section we include only basic guidance on incident management. The intended audience for this is someone in the role of walk leader. First aid is best learned by attending a practical training course such as those offered (in the UK) by the Red Cross or St John's Ambulance Brigade.

Being Prepared

You should always take with you a very basic set of first aid equipment. Select items which are versatile and multi-purpose. For example, you should include : antiseptic creams, aspirin, tape, bandages, plastic bags, torch, light plastic gloves (to reduce transmission of infection).

Before setting out, it's also wise to find out if any of your companions are taking any medications and/or have any long standing illnesses such as diabetes or asthma. It's important that everyone understands what will be encountered during the day and is confident that this is within his/her abilities.

Incident Management

Even a relatively small incident can be exacerbated by other factors or trigger other events. As the leader of the group, you will need to make decisions about the most appropriate course of action. You will need to balance the range of risks for all concerned - sometimes a daunting task.

The first priority is to move everyone away from immediate danger. Next, you must assess the state of the injured person applying standard first aid practice.

Remember your ABCDE =
Airway, Breathing, Circulation, Deformaties, Emotions

Clearing a blocked airway is probably the most important life-saving action a first-aider can take. Most blocked airways can be cleared by following simple, basic manoeuvres. The three common techniques (tipping the head back, chin lift and jaw thrust) are best learnt on a practical training course such as those mentioned above.

Now step back and try to get an overview of the situation:

Location:

Is it dangerous?

How far from help, pick-up points, shelter?

Weather:

How is it?

How much daylight is left?

People:

What injuries do they have?

How strong/able are they?

What is their emotional state?

Equipment:

What do you have with you?

What can you improvise?

The key decisions at this stage are:

Can you move your injured companion?

If so, how far to a better location/home?

If not, does the party split up with someone going for assistance?

See Contacting the Emergency Services for more details.

Diagnosis

Unless you are medically qualified, aim to make only a broad diagnosis sufficient to allow you to decide what to do in your current situation.

For example, is the chest pain actually heart pain or something else? If it's heart pain, then evacuation becomes the priority.

The face and neck provide lots of information: skin colour for shock, pupil dilation for head injury, the neck has a pulse point, facial expression for pain,shock, breathlessness.

If someone is seriously ill or may deteriorate, you need to monitor (pulse, respiratory rate, how (s)he looks and - if head injury is suspected - pupil dilation, level of consciousness) regularly.

Record your findings on paper. If you are reporting the incident by messenger, then record in writing if possible: location, time, patient's condition, relevant recordings/times. Use layman's terms.

General First Aid Treatment

The aim is to attend to the basics:

• psychological state
• pain management
• warmth and comfort of patient
• provision of food and drink

Keep the patient informed, tell him/her your plans and offer other psychological support. Keep him/her as warm and as comfortable as possible.

It's not possible to over stress the importance of keeping the patient warm. Someone who is injured will get colder more quickly than usual.

Provide (warm) food and drink if possible but DO NOT give food and drink to patients with abdominal injury or nausea/vomiting, or to someone who is unconscious.

If it's likely that the patient will need surgery within 4 hours then, food should be avoided. Clearly, this may be difficult to judge - you need to try and balance the chances of this against the benefits food would provide.

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