Evacuation Guidelines

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Evacuation Guidelines

• For the Wilderness First Responder

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Evacuation Guidelines

• Evacuation statistics are not kept

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Evacuation Guidelines

• Evacuation statistics are not kept
• Small injuries such as a blister on a foot can
  require evacuation.

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Evacuation Highlights

• A lot of the guidelines are geared toward the
  patients ability to ambulate.
• Foot injuries
• Hand injuries
• Frostbite on the feet
• Cramps

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Evacuation Highlights

• Some guidelines determine if the patients injury
  will worsen with time.
• Lightening
• Seizures disorders
• Burns
• Trauma

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Evacuation Highlights

• Some guidelines are geared toward a patients
  ability to eat and drink.
• Cramping
• Nausea
• Vomiting

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Evacuation Highlights

• Some guidelines determine if the patients injury
  is life threatening.
• Possible ectopic pregnancy
• Sepsis
• Skull fractures
• Heart attack
• Difficulty breathing

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Evacuation Plan

• Patient is first consideration
• Type of injury?
• Is the patient stable? (ABCDEs)
• Can they walk or assist with evacuation?
• Are they likely to become worse or more difficult
  to evacuate if evacuation is delayed?

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Evacuation Plan

• What equipment is necessary/available?
• Can EMS be contacted?
• How far to nearest help?
• Which route is fastest?
• Are there environmental limitations to immediate
  evacuation?

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Symptom Evacuate?

• 18 year old male in camp 3 hours from help
• Cramping left sided pain for 6 hours, worsening
• No temperature
• Minor guarding
• Patient can eat

• Evacuate?
• No shock, patient can eat, pain on left side,
  pain has been less than 24 hour, no blood is seen
  in stool, no fever
• Probably can watch

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Symptom Evacuate?

• 22 year old female with lower abdominal pain for
  2 hours
• Sexually active
• Sharp pain, guarding
• Retains appendix
• No fever
• Day 3 of a Grand Canyon river trip

• Risk of ectopic pregnancy.
• Need to evacuate

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Symptom Evacuate?

• 35 year old male
• Epigastric pain for 24 hours
• Unable to eat or drink well for 12 hours
• 12 hour backpack from help

• The patient cant eat, this is an indication for
  evacuation.
• Pain for 24 hours in another indication.
• Can his eating get better?

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Symptom Evacuate?

• 35 year old female epileptic has a grand mal
  seizure while on a rafting trip in Cataract
  Canyon. She is not injured. It has been 3 years
  since her last seizure.

• All that is probably necessary is to double her
  seizure medicine. She could be watched.

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Symptom Evacuate?

• 18 year old female experiences seizure like
  activity. She did not injure herself. No
  previous experience. She is at day 5 on an 18
  day trek still low in the Himalaya.

• New onset seizure activity warrants evacuation.

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Symptom Evacuate?

• A 16 year old male climbing is bit in the hand by
  a rattle snake.

• Evacuate

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Symptom Evacuate?

• 45 year old male climbing on Denali in Alaska
  develops sunned shortness of breath and other
  symptoms of HAPE.

• Evacuate to lower altitude immediately. It is
  conceivable that patient can continue with the
  trip. It depends upon how high he will need to
  hike.

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Symptom Evacuate?

• A 54 year old female receives a superficial and
  partial thickness burn over the palms of both
  hands while on day 3 of a 6 day river trip on
  the Salmon River.

• The patient has burns which may make using her
  hand difficult. Evacuation from this area is
  problematic.

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Symptom Evacuate?

• A 54 year old female receives a partial thickness
  burn over the palms of both hands, arms and face
  while on day 3 of a 6 day river trip on the
  Salmon River.

• The burns cover about 10 of the body, and now
  involve face. The patient needs to be evacuated.

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Symptom Evacuate?

• A 65 year old man is in the Wind River on a back
  pack trip when he experiences symptoms of what
  you think is a TIA?

• According to the guidelines he should be
  evacuated, how emergently depends upon his
  ability to walk, etc.

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Symptom Evacuate?

• A young 14 year old boy is bit by a black widow
  spider while hiking Kings Peak. (1 day from help)

• Venomous spider bites should be evacuated.

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Symptom Evacuate?

• A 60 year old man with no cardiac history and no
  risk factors had chest pain while on a fishing
  trip a 4 hour walk from help.

• The man must assumed to be having some cardiac
  problems and needs to be evacuated some way.

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Symptom Evacuate?

• A 21 year old male sustains a deep wound to the
  arm near the shoulder while camping on the John
  Muir trail in California. Bleeding is controlled.

• This man should be evacuated

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Symptom Evacuate?

• A 21 year old male while on a backpack, sustains
  a superficial wound to the ball of his right foot
  making it very painful for him to walk.

• This is a problematic wound. He probably needs
  to be evacuated simply because he can not walk.

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Questions?