What to do in a First Aid Incident

By Bill Strachan, Instructor at Glenmore Lodge and a Member of WEMSI (Wilderness Emergency Medical Services Institute)

If you spend enough time in the hills around other people then there’s a fair chance that sooner or later you’ll be in the unenviable position of having to deal with a first aid type incident. A quick straw poll around my friends and colleagues revealed that between them they have dealt with a full range of issues: heart attack, seizures, broken femur, twisted ankle, asthma attack, hypoglycaemia, broken wrist, tumbling falls, dizzy spells and hypothermia to name a few. The good news is that this is from well over a hundred years experience and countless client days. Regardless of how slim the chances are it’s nice to be confident in your response to something when it happens.

It’s important to recognise that there are far too many variables for a particular incident to allow you to have the right response. Phone signal, location, severity of the situation, chances of it worsening, who you are with, what kit you have, what expertise there is in your group; all of these factors, and many more, will impact on what you do. It might even be in hind-sight you would do something different but take comfort in the knowledge that there’s usually more than one right course of action.

Once you’re sure that you’re not in any immediate danger then deciding how serious the incident is will greatly influence your plan.

Big sick or little sick?

A small question that you might find useful to help work out your options.

Big sick: something serious that can’t be fixed on site will need to be evacuated as soon as possible. This is a 999 call – Police – Mountain Rescue. As soon as this call is made then the world becomes a whole lot nicer. Once the burden is shared with a professional then a plan quickly develops as to the most appropriate course of action. The decision of staying put or an evacuation by helicopter, carry or both will be made for you and you’ll be given instructions about what to do in the mean time. A fractured wrist may fall into the “small sick” category if the injured person can be made comfortable enough for a walk back to transport to be driven to A&E, remembering that everything is situation dependant.

Some situations are black and white but others are a bit more grey, they can start manageable but can escalate into something more serious. An asthma attack may be resolved by use of an inhaler and perhaps the most appropriate course of action would be to amend your route to a shorter one. However, if there is no inhaler available, if it doesn’t resolve as expected or is different from the patients past experience then a helicopter evacuation would be gold standard. Remember if you’re unsure about what to do then call for help, a 999 call to MR doesn’t instantly call out the full cavalry.

Another possible decision to make could be “who to send to get phone signal and make the call”.

Do you go alone, do you send someone else, do they go alone or with someone?

Whatever choices are made, spending a few minutes thinking them through and even sharing them with the rest of the group will help make sure that nothing is missed. A waterproof pad and pencil are a useful part of a first aid kit, having things written down such as a grid reference, phone numbers in the group and timings can make for a clear and structured conversation with help and ultimately a quicker resolution.

It would be pretty hard to write a short article of this nature without preaching the benefits of a group shelter. As well as a refuge for lunch on a dreich day these are life saving bits of kit that get you and your party out of the elements if you’re having to stay in the same place for any period of time. A Blizzard bag or jacket, spare food and clothing, the skills to use them and knowledge from an appropriate outdoor based first aid course will all be worth their weight in gold if you ever need them.

Despite the best preparation for your days out there will be times when things don’t go to plan and unforeseen events happen, stay calm, do your best and learn from them.

Glenmore Lodge runs a series of First Aid and Safety courses throughout the year, delivering courses with the following partners:



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