It is said that failing to plan is planning to fail, but in saying that, no good deed goes unpunished. However out of context, I am referring to bad luck. And bad luck is just bad luck. You cant control all the factors of every trip or outing. You cant even control internal or personal factors. You can do you best by getting a good sleep, eating well, keeping skills up and saying in shape. But sometimes the universe conspires against you. Disregarding the best laid plans and preparations what you do next will contribute to achieving the best possible outcomes. I am talking about disaster, injury, or possibility of death. Loosing the battle against the odds sets in motion a cascade of effects, panic or even counter panic, reactive actions or subjective thinking. I can clearly identify events of poor outcomes in my life where one stressor compounds itself with another and another until paralysis or outright acceptance has taken over. Sadly I have responded to these situations as a paramedic, a firefighter and as a guide. Ultimately hindsight is 20/20, but how do we stop the downward spiral when we find ourselves in the middle of these unthinkable events? What tools can we use to help us in these times where objective thinking may not be possible because our mind is overwhelmed or flooded with stress?
In the outdoor leadership world there are some things that are required as an industry standard to give leaders the tools to manage the unthinkable. Incident Command System, Avalanche Operations, Swift Water Rescue, First Aid and First Responder etc. In these courses we learn about how to give medical aid or how to anticipate hazard or to organize into teams with good leadership but what they don't give us an emotional and cognitive integration so that we can override the human factor of fear. There isn't much that can. For first responders, ER nurses etc. the ability to work under immense stress in the face of extreme consequences requires a practiced disconnection with the victim or patient and their outcomes. This is achieved through the "this isn't your emergency" mantra. Easier said than done. What all first responders have to fall back on are our personal process, group leadership models and SOG's (Standard Operating Guidelines). These tools help definitively. The last thing you want is the paramedic working on your loved one to be going off wrote memory without the option of calling a friend (leadership or medical control) or using reference applications.
Consider the system you have for any medical issue or emergency while in the back country. Assuming you carry a medical kit with you, it will likely be specialized for your activity, group and duration. But does it have some things that are standard? What else is standard, communications, survival kits, rehab, reference material? Below I am reviewing the various options, however these are only the kits and their contents, there is nothing about decision making or
Medical kits: They deserve a stand alone piece, However here are some things that save lives that you may consider standard. These life saving tools include things like Tourniquets, Epinephrine and CPR pocket masks, NPA/OPA's, Quick Clot etc. We are speaking of catastrophe after all. Another essential is a field manual with some sort of SOAP note or PCR, these are important because they give cues for reassessments of the problem initiate some sort of charting for trend evaluation etc . SOGs and field manuals are tools for standardizing your thought process and ensuring you have the information you need to make critical decisions.
Rehab: For river trips I like to have a hypothermia rehab kit. It holds two tarps a sleeping bag and a length of rope (at least 30 m of 7-9 mm rope) a stove, fast energy (gels or candy) and water bottle that can double as a hot water bottle. For lighter weight activities, hiking, ski touring etc. this gear will likely be spread out amongst the group. The equipment to make a hypo wrap as group gear should be considered. In an environment where there are limited options the ability to keep a victim warm and dry is life saving.
Communications: Even if you don't have a quality first aid kit you should be able to call for help if you are without the ability to self extricate. But which one is the best? In my understanding an inReach satellite communicator is your best bang for the buck considering subscription options, cost, network security etc. Talking to wardens and public safety specialist they recommend the inReach overall in respect to how they receive the information and how interactive they can be with the reporting party. Ultimately having the option to initiate a call for help and leave the device to do its thing while you manage the problem is ideal in low resource environments.
Additionally having the option for two way communication through text is a massive advantage for all sorts of reasons.
Satellite phones and radios offer the benefit of real time conversations. Sat phones are a great option for huts and sailing trips or extended expeditions. Both UHF radios and satellite phones can have connectivity issues. Satellite phones can experience huge connection delays and also lose reception randomly and radios need the proper repeaters and channels that, technically, permission or license to use is required. Also of consideration. satellite phones and communicators require a clear view of the sky and most notably the southern aspects. And the biggest benefit Spot, inReach or Zoleo can be left to send out the call for help un attended as it continually searches for its signal, eventually sending out the SOS (all of these systems are subject to network failure and dropped signals -be sure to confirm the delivery of the signal). Each one these tools will have a set of steps to turn them on, select the function required and destination contacts entered or selected. If your the only one in the party who knows how to do this it may be a problem. Most definitely a reference guide should be attached to the unit with a list of "if and when" contacts. In the case of the inReach that utilizes a phone for ease of two way communication consider adding information of how to unlock the attached phone and where to find the application. And finally, lets make sure that they are fully charged and that there are options for recharging them. My communications kits is separate and is stand alone. It contains two options for transmitting (radio and inReach-with phone), back up battery pack and user guides (laminated).
Bear spray and wild life deterrents: A consideration for most outings. Typically I keep these things in a common bag where anyone can access them. And honestly I DO practice deploying bear spray, bear bangers and flares. I'm sure I don't have to tell the reader to be careful here. I take no responsibility for readers who cant tell wind direction.
Repair kits: I believe they are worth a mention here. Managing disaster = disaster has struck. Disaster may have involved the thing you are traveling on, raft, canoe, bike, skis etc. This is where a small injury can be compounded by extended time exposed because you cannot continue on. A timely repair is legendary story.
Mechanical advantage: In the river world we practice using ropes to un-pin a boat, wright heavy raft or tension a line. Pin/wrap/4-3-2-1: these kits can be diverse relative to the type of the craft you are traveling in or how comfortable the operator is. The best advise here is make sure the the equipment is compatible. Practice with the set up so that your confident with it all Ensure that the friction device is capable of acting on the haul line and the pulleys work well with the haul line. Also that your break or progress capture is compatible with the pulley that is managing it.
Consider the anchor material you are using and if it’s appropriate for the options for anchors in the area. And finally, have an understanding of the material breaking strengths in the system and what it’s limitations or hazards will be.
This is an overview and by definition there are details left out. Each of these kits as mentioned, have specific standard items. They should all be considered group gear and in that, the group should know where they are kept and how they are labeled. Many successful leaders keep their world simplified with the basic concept that if they were to disappear someone could step into their shoes and complete current tasks. Although it is mentioned but possibly not emphasized enough, there is incredible value in using refence material. This includes medical field guides, instructions for using your communications (including passwords to unlock phones and emergency contact numbers), pre-determined evac sites and LZ's and also step by step guidelines/algorithms for emergent situations. Finally, the best policy is prevention. Identifying hazards and mitigating them before disaster strikes.