Should I start/stop CPR in my Wilderness Setting?

This question often comes from students on our courses*. We teach in and around Whistler, BC so even ‘average parents’ want to know if they should start/stop CPR. If you’re reading this you’re probably trekking into the kind of wilderness setting where it’s important to ask “should I start/stop CPR?” Read on…

Wilderness setting – what’s that?

It could be a true wilderness setting, it could be ‘post-big-disaster’, so for our start/stop CPR question, we’ll consider it a wilderness setting if:

• It takes longer than average to contact Emergency Medical Services
• Then, you expect it to take a long time for them to reach you
• You’re in a situation where the terrain is a concern
• You’re in an area where long-term exposure to weather/environment is a real concern

So when should I start CPR?

I’m assuming you actually know what to do? If not, take a training course before you hike too far from help. Then, I’m assuming there’s someone you think is in need of CPR?

Started? Good – If it’s not started within 10 minutes, then if they survive, brain-damage is certain. Now we can think about when or if you should stop. But first…

When shouldn’t I start CPR?

Now you understand immediate CPR is essential to their survival, here are exceptions to the rule. First, people you don’t want to approach. No, not the dirty drunk bloke outside the pub/bar – he’s probably just a hiker, these people:

• Decapitated
• Transected
• Decomposing

For more on these – see this post.

• Cold & stiff. Except that might not be a good reason not to do CPR – they could just be seriously hypothermic and could survive if you help. Use your judgement.

Next in a wilderness setting, will starting CPR endanger lives? (Avalanche? Rock-slides? Exposure?) If your planned actions put life in danger, don’t do them!

When should I stop CPR?

So you thought about ‘when I shouldn’t do CPR’ and still did it. Now decide when to stop CPR.

• You were successful in getting help; they found you and are ready to take over
• They revive
• You are physically exhausted – don’t put yourself at risk!

Now those are true in all situations. Here are extra considerations in a wilderness setting:

If you have been doing CPR for more than 30 minutes, consider stopping. They really should have been in the hands of more advanced medical care by now. Their small chance of surviving is becoming no chance, except:

• They have a better survival chance if they’ve been pulled from water or electrocuted
• Keep doing CPR anyway if they’re hypothermic
• Remember families want to know ‘everything was done to help’. Sometimes that’s your only reason to continue CPR.

So there you have it. When to start, when to stop and what to think about along the way. Now we hope you never use it!
*Tony has been teaching First Aid for the Red Cross for about 20 years, is an approved Canadian Red Cross Training Partner and has a blog here.