When Things Go Wrong

We all know the old adage about things going wrong. Ex-Ambulanceman Paul Yelland, gives us some advice on how we can be prepared should the worst happen.

“The international distress signal is six blasts of a noise or flashes of light in quick succession. This is followed by a minute pause and is then repeated.”

Having served fifteen years in the UK ambulance service, I have on many occasions had to deal with casualties found in remote locations. What I often find in these situations is that the casualty is shocked and in disbelief that the accident has happened to them.

The complacent attitude of “it won’t happen to me” is, in my mind dangerous. Lack of preparation and planning for an emergency whilst in the countryside not only endangers the individual, but it can also make the task of locating the casualty and their consequent rescue by the emergency services more difficult.

In airsoft, there are many options when it comes to the type of terrain we can choose to operate in. We could find ourselves in a forest, on moorland or in an urban setting. If skirmishing abroad, artic and arid landscapes can be added to the list. Airsoft events are generally well run with safety of the players a priority for event organisers, but unfortunately emergencies can still occur.

The following advice is just as relevant for when you are out walking with family and friends, for example on Dartmoor, as it is for when you are on a rural patrol somewhere in Wales.

So, some examples of common remote emergencies are:

  • Lower limb injuries
  • Falls from height resulting in multiple trauma
  • Chest pain
  • Asthma attack
  • Exposure
  • Stranded in flood water (on foot or in a vehicle)
  • Navigation issues (lost)

things-go-wrong-01When faced with an emergency in a remote setting, people tend to panic. The incident can catch them off guard and often happens at the worst possible time (in darkness, bad weather, in an area with poor mobile phone signal). By carrying out basic preparations prior to starting out, means the individual is prepared both physically and mentally for dealing with an incident. Some preparations to consider making include:

  • Fill out a route card/tell somebody where you are going
  • Check the weather forecast
  • Wear suitable clothing and footwear
  • Carry adequate water and food
  • Have a medical kit (including any prescribed medications for asthma, anaphylaxis, angina etc)
  • Take waterproof clothing
  • Pack spare warm dry clothing
  • Check your mobile phone battery is fully charged
  • Make sure your compass is accurate
  • Check any battery operated items such as torches and carry spare batteries

things-go-wrong-04Suggested items to carry

The weather, terrain, expected duration of the walk/event and time of day will dictate which Items of equipment that you may want to consider taking with you. I have kept the following list as basic as possible, and it is based on my own personal preference for when walking on the hills.

Backpack

This must be large enough and robust enough for the task in hand. I use a karrimor SF 35 litre backpack. I use a heavy duty black dustbin bag to line the main compartment and keep the contents of the pack dry. Emergency equipment such as medical kits should be easily accessible and should be packed last, so it is at the top of the pile of other equipment.

things-go-wrong-02My Kit list:

  • Waterproof jacket and trousers
  • Warm hat and gloves
  • Spare warm clothing (packed in plastic bag)
  • Medical kit
  • Food and water/flask with hot water
  • Stove
  • Mess tin and spoon
  • Map and compass
  • Mobile phone

Additional emergency kit could include:

  • Survival kit (carry in your pocket)
  • Space blanket/survival bag
  • Hi visibility tabard
  • Torch and spare batteries

Dealing with an Incident

The following is not official advice. It is my opinion based on experiences I have gained over the years. I would suggest to anyone who is visiting the wilderness, that they should attend a First Aid course to gain valuable lifesaving skills. Going on a decent survival course will further your ability to cope with rural emergencies. You really do not know when you might need to use these skills.

Safety

Do not endanger the safety of yourself or others by attempting a dangerous rescue. You are more use to the casualty alive and able to call for the emergency services, and guide in any rescue team coming to your assistance. It is difficult to stand back and watch a friend or loved one in trouble as it is only natural that we would want to help them, but jumping into a swollen river or attempting to climb down a fifty foot cliff without safety equipment is really only going to end in one way.

Call for Help?

Assuming that you can safely reach the casualty, and there is no further risk by staying where you both are, you must now decide whether to call for help or give first aid as a priority. If for example someone you are walking with falls over and breaks their ankle, you are naturally going to offer your assistance, find out what is wrong and make them as comfortable as possible. Then after finding out that they have a leg injury you would give some first aid and probably call 999 for help, assuming that there is phone reception. All pretty straight forwards so far….

Now, things start to become complicated. You are with your friend walking on the hills and they suddenly say that they do not feel well. They sit down on a rock, quickly keel over onto the ground and are now in cardiac arrest. There is nobody else around for miles. You get out your mobile phone, but find there is no phone reception. You know how to carry out CPR, but there is now only you. If you start CPR, who is going to go and call for help? The chances of CPR on its own getting the heart working again are very slim. Your friend needs advanced care with drugs and defibrillation – you have none of these. So, do you stay and carry out CPR, or do you leave your friend to run off and call for help? This is a realistic moral dilemma you may well face. This is a decision that only you can make at the time, but I know what I would do.

Identifying Your Location

things-go-wrong-05When making an emergency call it is really important to give as an accurate position to the operator as possible. If venturing out into the wilderness you should really be able to use a map and compass and be capable of working out six figure grid references. If you cannot do this, then practice. I work on the principle that you should be able to identify your current position on a map at all times. If no grid reference is available however, then the next best thing is to try and identify major land marks in relation to where you are. Just saying to the operator “we are on a hill” will not really be helpful on its own. Identify forests, peaks, rivers, aerial masts, distant buildings, roads and bridges to try and give the operator a rough idea where you are. If it is dark, look for distant artificial light sources such as red lights on top of towers and masts, street lighting from towns and villages or distant vehicle head lights and their direction of travel.

If you find yourself getting into difficulties and you do not have a mobile phone, or your phone has no signal, then you must rely on other methods to attract attention and signal your distress.

The international distress signal is six blasts of a noise or flashes of light in quick succession. This is followed by a minute pause and is then repeated. Continue this pattern until you receive a reply – three blasts of a noise or flashes of a light source in quick succession, repeated after one minute.

Waiting for rescue

Once you have called 999 for the Mountain Rescue, Coast Guard or Ambulance service etc, and you have given the operator your position, then stay where you are. There is nothing more frustrating than people calling 999, giving a location and then moving to somewhere else! Once you have made that 999 call and have given the location, as long as it remains safe to do so, stay put otherwise it will be harder for the emergency services to find you.

things-go-wrong-03Whilst waiting for rescue, make the casualty as comfortable as possible and continue to give them first aid as needed. It is really important to get the casualty and yourself out of the elements. Put up a shelter to protect yourselves from the wind, rain or snow. The danger now is hypothermia. Make sure the casualty is insulated from the ground and is kept warm by using extra clothing or a sleeping bag. Even in the summer time, it is surprising how much a casualty’s body temperature will drop when exposed to the elements and by lying directly on the ground for long periods. Put up a tent if you have one and everyone in your team should get inside it. If the casualty cannot be moved, then erect the tent outer over where they are laying. If no tent is available, then wrapping the casualty in a space blanket will be of some benefit, as will getting them to lie inside a survival bag. However, if there is any suspicion of the patient having sustained a spinal injury, then they should not be moved (unless they are in immediate danger). Any shelter or protection should be placed around them.

With the casualty and other team members warm and protected from the elements and the rescue services on their way, you need to make your position known them. Improvise with whatever equipment you have at your disposal. Making a noise such as with a whistle will attract attention at any time of day and night and also in poor visibility. If there is sunlight, then a heliograph is useful. One can be improvised by using any item that has a reflective shiny surface. Bright items of equipment can be laid out on the ground to attract attention, as can spare foil space blankets which will stand out against the natural coloured surroundings. At night, the methods of signalling are with noise and also sources of light. These could be torches, cyalumes or the flash of a camera. If using light sources to signal to rescue aircraft at night, then be aware to the risk of dazzling the pilot who will more than likely be using night vision equipment.

Helicopters

If a helicopter comes into land near your position, ensure any loose items are packed away, or held down securely. The force of the rotor wash can be very strong and will blow around anything not secured, such as space blankets and tarps. There is a serious risk of these loose items being thrown up into the rotor blades endangering the aircraft and its crew. Rotor wash also has a habit of throwing up loose debris from the ground. The effect is made worse in dusty dry conditions and in snow. So when a helicopter is coming into land near you, it is wise to turn away from the aircraft to avoid dust and debris blowing into your eyes. The casualty needs to be protected from this as well, so lean over them. One last thing – under no circumstances should you or anybody else in your team approach the helicopter whilst the rotor blades are moving. Keep a safe distance away. Once the aircraft has landed, a member of the aircrew will come over to meet you.

So to sum up, I hope you never need to use any of this advice but if you are well prepared and stay calm, the outcome is much more likely to be a positive one.