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Backpacker Magazine – September 2011

Saving Lives: When to Evacuate, First-Aid Essentials

Learn to decide when to walk out and when to stay put with a variety of backcountry medical ailments.

by: Steve Howe

PAGE 1 2

When to Evacuate |First-Aid Essentials

Backcountry rescues can be hard, costly, and slow. But making the call to get outside help can prevent significant pain and discomfort—and possibly save a life. If a patient can walk out on his own, that’s almost always the best option. Use this chart to help guide your decision-making process.

Problem Always
evacuate?
Rush if... Relax if...
Altitude
Sickness
NO Evidence of cerebral or pulmonary edema is present (altered mental status, headache, dry cough, chest pain). Patient
recovers fully upon descent from altitude.
Anaphylaxis YES Continued exposure risk exists; respiratory problems persist. Reaction did not include respiratory distress.
Diabetes/
Hypoglycemia/ Hyperglycemia
NO Signs of hypoglycemia (reduced responsiveness, cool/clammy skin, rapid heart rate) do not improve with treatment; hyperglycemia develops due to incorrect insulin use. Patient recovers fully after ingesting glucose or adjusting insulin.
Dislocation NO Reduction efforts are
continuously unsuccessful; other joint or bone injuries exist.
Only involved digits; patient has dislocation history.
Flu-like
Infection
NO Body temperature hits 104°F; temperature of 102°F lasts longer than 72 hours; any reduction of responsiveness. Patient recovers with rest and hydration.
Fracture YES There’s an open or unstable fracture; femur, hip, or pelvis involvement; decreased circulation, sensation, or movement. Pain is minimal or manageable with available meds.
Head Injury YES Any reduction in responsiveness; signs of serious head injury exist (skull fracture, seizure, balance problems, vision changes lasting longer than one hour). Patient
responsiveness returns to
normal quickly.
Heat Illnesses NO Unable to reduce patient’s temperature; any reduction of responsiveness; patient relapses. No reduction
in responsiveness
Hypothermia NO Hypothermia reduces responsiveness or shivering stops due to cold; signs or symptoms of frostbite are present. Patient fully recovers;
no reduction in responsiveness.
Seizure Yes Incident was a patient’s first seizure; multiple seizures occur in quick succession; seizure cause is unknown. Patient’s seizures are being managed; history is on record.

PAGE 1 2

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READERS COMMENTS

Joe
Nov 11, 2011

Your Leatherman commercial will not close, it keeps coming back and blocking the screen, very annoying!

David Westfall, MD
Sep 23, 2011

Please note - listed maximum dose for ibuprofen is 3200 mg per day. Giving 800 mg every 4 hours exceeds the maximum dose. Just sayin'.

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