EMERGENCIES AND INCIDENCES

Gorge forest

AS A LEADER OR A MEMBER OF A TRIP YOU WILL NEED TO KNOW WHAT TO DO WHEN A SITUATION ARISES, AND DETERMINE WHEN ITS AN EMERGENCY OR AN INCIDENT

• The trip leaders are in charge unless they are incapacitate

• Is the problem an incident or emergency – this will determine the response

• Look after yourself first, you cannot help others if you are incapacitated

• In any situation, always: STOP, THINK, OBSERVE, PLAN then DO

• The priorities of survival are: AIR, SHELTER, WATER, FOOD then Possessions.

• Only call for help on the instruction of your leader or if they are incapacitated, when you have fully thought through the problem

• Carry a few simple items which could help you deal with an incident or emergency

• Your mind is the most important part to control – panic will not help the situation

​Make some basic emergency plans in your mind at any change in situation during the trip. Be prepared.

Take care of your own safety and do not relegate this responsibility wholly to the leaders – you are most able to determine what you are comfortable with.

Emergencies differ from person to person. What may be regarded as an emergency to one person, may not to another. In addition, emergencies can be caused by a number of factors, but if we put some thought into them, we will discover that for a particular scenario to be truly regarded as an emergency, it needs to answer one specific question with ‘Yes’:

Will our / my situation continue to deteriorate so that significant loss will be caused unless action is taken right now?

Emergencies and ‘Incidents’ are not necessarily the same thing, but can be. An incident falls into the following definition:

Something unplanned for has occurred which has resulted in a loss, but the situation is now stable and even if we do nothing no further loss will occur even though there may still be actions we need to take to return the situation to normal.

If we categorise incidents and emergencies properly, we can then apply the correct action to them. Treating an incident as an emergency unnecessarily can place you and the group in further danger.

PREPARING BEFORE MY TRIP

Once you have decided on your trip, you should start to think about how you would handle incidents or emergencies. Detailed plans are the responsibility of those handling logistics, but it is your responsibility to do some basic research about where you are going, what you will be doing and how it may impact you personally. After all you are the best person in the world when it comes to knowing what you can cope with, and how you respond to problems. Have you told them you are afraid of spiders and are prone to panic attacks?? Decide for yourself that you will look after yourself first.

Everyone should have thought about what they will do in an incident or emergency. It is not expected that you plan in detail for every eventuality, but blindly putting your safety in the hands of another is never a good idea.

Simple possible scenarios you could think about include:

• The Hut we are staying in catches fire – how do I get out?

• If overseas: All my travel documents get lost.

• I know I will miss my flight home as we are running late.

• I break my glasses. (Can I cope without them?)

• You wake up from a nap and find your party has left without you and you are all alone. (Do you know which way they went and can you catch up?)

There are many more, but this is just to give you an idea as to what everyone should think about. Which of the above are emergencies and which are incidents?

Think about it…

MORE PRACTICAL THINGS I CAN DO BEFORE I GO

In the build-up to leaving on your trip – there are things you can do that are more practical which will not only prepare you for the trip, but set your mind at rest as it will know you are well prepared. The list could be endless, but a few examples of things you could do practically are:

• Do an outdoors first aid course

• Customise your personal first aid kit for the trip you are going on. What medications are allowed where you are going? What might you need specific to the area? (Anti malaria, Diarrhea medication, Sunblock, etc.)

• Prepare and double check any travel documentation is valid and up to date.

• Existing medical condition requiring immediate care must be shared, and where to find the relevant meds in your pack. (Heart medication, Asthma pumps, Bee sting EPI Pens, Insulin etc.) Have your personal particulars on your person somewhere. They speak for you when you're unable to.

• Read up about the area and research anything which may cause a problem.

• Start to get fit – walk as often as possible using the gear you plan to take with so that you can resolve any issues with gear before you leave.

• If you will be camping on your trip, and this is something new or infrequent for you, ‘camp’ on the lounge floor for a night or in the garden using the gear you are taking with. Make sure it all works and you know how to use it.

• Prepare a few simple items which could assist you to cope with things that may happen…

SOME SIMPLE THINGS… EMERGENCY KITS

Statistics show that the people best able to weather incidents or emergencies are those who have planned and prepared themselves beforehand.

It would be beneficial for every person in a group to carry some simple personal items which could assist. Again these will depend on where you are going. We are not talking a full emergency preparedness kit, jut some basic lightweight personal bits which could help you cope. All the following would weigh less than 1kg.

• 2 meters of 5mm nylon cord

• A couple of energy bars

• A few cable ties

• Duct tape – Wrap around trekking pole

• Map of the area you are going to

• Multi-tool. Just a small one is fine

• Personal first aid kit suited to your training & abilities

• Survival sheet/blanket

• Small sewing kit. Include a sail-makers needle and dental floss.

• Something to start a fire with

• Spare boot laces

• Torch

A pre-trip daily briefing must be held with the whole group: discuss routes, predicted weather forecasts, nature of terrain, safety, as a group - what to do in an emergency (environmental or medical), what to expect…

Whistle

LOOKING AFTER MYSELF ON THE TRIP

Again we reinforce the concept of not blindly just following your trip leaders or guides. Take some personal proactive steps to make sure you are prepared if anything does not go according to plan.

First of all do not be afraid to look after yourself and ask questions. Many people on trips think they will upset the leaders or guides if they interfere, but the opposite is true.

On arrival at the start of the trip

• Verify emergency information with the trip organisers

• Complete applicable rescue registers or intentions forms if they are available. Check escape routes with the organiser

• Carry your emergency, first aid and personal medication kit with you.

• Monitor the map during the day so you always know where you are on it. If things go wrong you want to already know where you are.

• Keep an eye on group members for signs of trouble if you suspect a problem

• Each day, spend a few minutes thinking about potential issues that could arise that day and what your response could be

• Act promptly and decisively in the event of an emergency

• Remember to look at the view from where you have come from every now again. If you have to retreat on your own, the path always looks different going the other direction – get used to what it looks like.

Be aware of wounds that do not seem normal. That red spot on a leg may be something more serious than just a mosquito bite. If you suspect a blister, stop for a while whilst you dress it. The five minutes it takes now, may save hours or days later on if it gets worse and infected. Perhaps you have developed stinking foot rot, or your period has come early and you do not have sanitary towels, or you have picked up an STD, or you have run out of hearing aid batteries. Communicate any problems, as the safety of the whole group is at stake if you are not performing at your best.

• Don’t be afraid to call for rescue should this be necessary

• Sign out rescue registers before leaving at the end of the trip (if available)

ACTION PLANS – WHAT DO I DO?

The number of different things that could happen on a trip are too many to count and probably will not happen anyway, but when they do we need to have a plan to deal with it. In any situation, we can follow some simple action plans to help guide us through the situation. The primary responsibility to deal with the problem is the leader or guide. But if they are the one affected, someone else may have to take over.

Everyone’s initial action plan in any incident or emergency should be:

This may only take seconds, but could take hours depending on the complexity of the situation.

• STOP – Stop doing what you are doing.

• THINK – Think about what is happening, and is what you were doing causing the problem

• OBSERVE – What is going on around you? Who is involved? What outside factors are influencing what is happening?

• PLAN – Decide on a plan of action that you feel will resolve the problem. Some things to think about:

• Determine the possible problems

• What will you do about them?

• Who should deal with them?

• How will you deal with them?

• What assistance is available?

• How do I contact them?

• DO – Get on with following your plan

Let’s look at a simple example:

You are stopped for a rest break near a stream in a remote area. You have just filled your water bottle from the stream and you hear a loud shout or scream. Immediately you should:

• Stop what you are doing – filling the bottle

• Think about what you heard – was it directed at you or someone else or everyone in general

• Observe what is going on around you – is someone looking at you trying to attract you attention as the water is polluted and they are trying to stop you filling your bottle; Has someone fallen into the river and is calling for help, Is someone in the group just messing about with other group members etc.

• Plan what to do next – Stop filling bottle and ask leader where to get clean water; Respond in a safe manner to assist the person who has fallen in the river; Ignore the group members messing around

• Do what you have planned – carry on filling bottle, Assist person who fell in; Ignore whoever shouted/screamed

This entire process could have taken 1 to 2 seconds, or maybe longer.

Essentially it should become an unconscious response to anything unusual around you. You must become spatially aware – that is aware of what is happening around you at all times and decide if you need to respond to it or not.

In your Thinking & Planning stages, we need to ensure our safety. We do not want to put ourselves in danger unnecessarily, so remember our Priorities are, in this order:

• Yourself (ME) – Am I safe? Can I approach the problem or help without getting into trouble myself? When personal safety is at stake, you should look after yourself first. Not only does this make you safer, but relieves this burden from your leader temporarily. If they see you are looking after yourself, they can concentrate on others. Also looking after yourself, means you are in fine shape to be able to help others as and when you can.

• Patient/Group (US) – Is the patient in any immediate additional danger? Can I mitigate the danger without putting myself in danger? Is the group in immediate danger? Will the group be in danger if they try to assist the patient? Will they be in danger if they stay where they are now doing nothing? Will they become in danger if they are left without immediate leadership? Once you are safe, you can then prioritise others in your group. They are family for the time being, and expect your assistance.

• Others (THEM) - Lastly you can then prioritise others in the vicinity. That is people not part of your group. Are there other people around who will be in danger because of what has happened to us or because of us?

• Possessions – Your gear is the least important unless there are specific items critical for survival. If the building is on fire and it’s freezing outside – you will need to take warm clothing with you when you evacuate, but forget the backpack. Even your money is not important right now. Never put your or anyone else’s life in jeopardy to save a piece of gear.

There is a second set of priorities which must be considered at the same time in any situation and these are the priorities of survival.

Humans need 4 things to survive and these are considered in this order:

• AIR – We need to breathe so access to air is the first priority. If you are under water, get out fast .

• SHELTER/WARMTH – Shelter from the sun’s heat; the cold hail falling, the wind blowing, rain etc.

• WATER – Humans in normal conditions can only survive up to 3 days without water – so once you have air and shelter, find a water source.

• FOOD – Humans can survive up to 40 days without food, so this is the least priority, but is something to think about and plan for.

CALLING FOR HELP

There will be times when whatever has happened is beyond the ability of the group to deal with alone and outside help is needed. This decision will be made by you as a leader, but in the event you are one of those involved and cannot make this decision, it is good for group members to know what to do.

Firstly the priorities must be dealt with. When sending for help there is always going to be some vital information the rescuers will need in order to make their own action plan. As a minimum you should be prepared to tell them (a student should be called upon to write all details down:

• What is your phone number if you are calling by phone

• What has happened

• Where has it happened (Where are you)

• When did it happen (take note of the time)

• Who is in charge

• Who is injured

• What first aid is available, been applied and qualifications of the first aiders

• How many are there in the party, ages and experience

• What is the terrain like where you are?

• What is the current and anticipated weather like?

• Is there a clearing for helicopters to land?

• How prepared are you to “Dig In” (Keep safe where you are)

• What is the groups plan?

When sending for help, inform the rescuers if it's your trip leader who's been injured. This might impact things quite severely. Also inform them of the state of the remainder of the group.

How you get this message out will depend on the situation, so again think about what options you have for communications even if you are not the group leader. Remember do not try to call for help unless your trip leaders / guides have given the go ahead or are incapacitated and cannot make that decision.

WHAT OPTIONS DO YOU HAVE FOR CALLING FOR HELP?

These will depend again on what plans were put in place beforehand and where you are, but they could include:

• Cell / Satellite phones

• Shouting / Whistles

• Sending a written message - Always write it as verbal gets mixed up

• Flares – hand or rocket

• Visibility

• Satellite phones

WHILE YOU ARE WAITING FOR HELP

We come back to the panic question – people with nothing to do in a stressful situation will tend to panic, so keep yourselves busy. It could take a long time for a rescue team to get to you, so you need to prepare to wait it out.

• Know where everyone is: pair people up in buddy pairs

• Get water, make a meal & eat

• Keep spirits up, be positive, reassure, and make sure everyone has something to do.

• Make yourselves big, easy to find.

• Continuously monitor your patient. Continuously monitor everyone else in the group

• Think about what important kit the person being evacuated is carrying that might be necessary for the rest of you (like half of the tent or the car keys to get home).

SELF-RESCUES

Of course not all incidents or emergencies require evacuation from the scene of everyone. Sometimes you can carry out a self-rescue to stabilise the situation, treat the problem and then carry on with the trip.

A person who has fallen into a river for example, could be rescued by the group, dried out and any minor injuries treated and then carry on as before, just more carefully.

This is why it is generally up to the leaders or guides to make the decision to call for help. They will have the training and experience to make this decision as to whether the group can cope on their own or not. Obviously if something has happened that prevents people from continuing the trip, and the group is not strong enough physically or mentally to evacuate on their own, they will need outside help.

A few points to keep in mind if self-rescuing:

• Sometimes larger parties (5+) can evacuate their own injured if they are strong enough and the injuries permit it

• Sometimes patients will only need to be moved short distances (e.g. away from rivers)

• Someone, usually the leader, needs to assign roles and tasks

• Watch group members for signs of fatigue, exhaustion, dehydration, hypothermia or excessive stress

WHAT IF I LOSE THE GROUP

We are going to look at this specific scenario as it is the one time that group members may end up alone with no one else to discuss problems with. Injuries etc. generally occur where there are others to help, but if you have become separated from the group you need to know what to do.

Quite simply, when you realise you are on your own and do not know where the group is:

• Stay put – if you do not know where you are or are going to, you will only get more lost by moving. Besides the leaders knew where you were last and will look there for you. You could also move out of the area being searched.

• Make yourself visible – always have some brightly coloured items with you. Clothing, rescue kit etc. Stay in the open if safe to do so. If you have to take refuge from bad weather for example, leave visible markers in a place they will be seen and direct rescuers to your position. If for some safety reason you have to leave the area, leave a highly visible marker and a note explaining what your intention are, so anyone looking for you will know what your plan is. Stick to your plan, do not change it as this will confuse the rescuers.

• Signal – Fire (ONLY if safe to do so), signal mirror, flares, whistle, shouting.

• Have any gear you have with you packed and ready to go, so when you are found you do not have to waste time packing up.

IN THE CASE OF A DEATH

No training on emergency procedures would be complete without dealing with deaths on a trip. The death of a group member is everyone’s worse nightmare but it does happen, even if the death was caused by natural causes. i.e. Heart attack.

• Treat as though alive until determined to be dead by a medical practitioner

• Do not move bodies except to protect them from further harm.

• Keep the group busy and distracted, out of sight of the body if possible. If an overnight wait will be needed before help arrives, consider taking actions to keep scavengers away from the body (strobe light, guard, etc). If it's a guard then try to use an older person with sufficient life experience to deal with the task.

• Contact nearest Police authority and inform of the death

• Remove children from sight of bodies

• Grim as it is, photograph the scene – especially any technical equipment setups

• Do not talk to the press. Only speak to rescue personnel and the police or embassy staff

• Arrange trauma counselling after the trip

Your trip leaders should be trained to deal with this eventuality, so follow their lead unless they are the person involved, in which case the above points will help you to deal with the situation.