Emergency First Aid – Hunker down for help, or move out?

Wait for help or move out?

Sometimes when injuries happen, it’s tempting to ‘stay & play’ – stabilize the injured person as much as possible before moving … then you get them to help and the doc says “What took you so long?”
Then again, you can ‘scoop & run’ – doing just life-saving procedures before getting the person to help quickly… only to hear “Why didn’t you deal with XYZ before moving them?”
If the professional crews find it challenging it times, what chance do we have as lay-people? This is what I was recently asked (I’ll paraphrase):
“On the trail one of my buddies had a heart attack about 6 miles from cell phone service. We sent one guy to run & call an ambulance as soon as he could and carried buddy out in a tarp. We argued about keeping him comfortable on the trail or carrying him out.
Did we do the right thing or should we have just stayed put?”

Strike the right balance     

As is often true, it’s all about balance; and your training, experience and judgment. Let’s lay out a few key points to help guide you. There’s no way we could cover every scenario in a blog post – that’s why training helps and the experience that comes with time. Still, there are pointers that will help you make the decision if you are ever in this situation.

Life over Limb

Go read The 3 P’s of First Aid. Got it? Preserve Life! If anyone’s life is at risk, then take action. If staying put means risk of exposure, wildlife, avalanche, forest fire… then move. Likewise making your buddy walk 6 miles while having a heart attack may put his life at risk from the strain (so either stay put or carry him out in a tarp).

Envision the Worst

What’s the worst that could happen if you stay put or move out? Could you deal with it?
Say you make Buddy hike out and this worsens his heart attack so that his heart stops. Can you do CPR? Or what if you keep him in the bush and your group gets hypothermia from the conditions? Got enough blankets or shelter with you? People often ask on courses ‘should I drive them to….?’ To which the answer is always – what if they collapse while you’re driving, what would you do? Plan ahead.

Reduce further injury or pain

Ok, so no lives are at risk and you’ve planned for the worst. The last thing to cover here is “Prevent Deterioration”. If your plan of action makes things worse, or if it causes undue pain to the injured person, re-think. Again you’ll need judgment: hiking out on a sprained ankle is uncomfortable; doing it on a broken leg is just asking for trouble.

Finally :

It was right to have moved him towards help faster and right to have carried him out. Staying put would have delayed necessary treatment, making him walk may have made things worse with unnecessary strain on his heart. Yes, he recovered.