So how do you get someone in this condition back to civilization? Let's assume is it summer time, thick forest with dense canopy, no cell coverage, 4+ hour hike out under normal conditions?
It’s hard, that’s why you should never hike! Always go by river :) But seriously, thanks for your question and here are a few thoughts: - This splint would be appropriate for someone with an unstable lower leg injury. It does a good job of immobilizing both the ankle and the knee, but as such, it’s pretty big and so it’s not the type of thing somebody can hop out with: they’ll need to be carried, transported in a vehicle or aircraft, floated in a boat, pulled on a sled, etc. - Even though this is a painful injury that will require medical attention and significant follow up, it’s usually not a medical emergency, but rather, it’s a logistical dilemma. We would only consider a lower leg injury to be a time-sensitive emergency if there was impaired circulation to the foot, if the bone was sticking out (open fracture), if there were signs of compartment syndrome, if there were other injuries going along with this that were affecting the person’s critical systems (circulatory, respiratory, or nervous), or if the environmental challenges could not be mitigated. So you would need to check circulation in the foot and all of the above, but again, often, these issues wouldn’t be present. In such a case (non-emergent evacuation), you still might need to get help in order to transport the person out, but this could take the form of calling friends, an outfitter, a transport service that you hire privately, and doing a slow and controlled evacuation while minimizing risk and making sure not to domino into other problems. If it was a medical emergency (impaired circulation to the foot, open fracture, etc.), then you would want to get the person to definitive medical care as quickly as possible, while of course still keeping in mind your safety and that of the rest of the group. This would usually involve contacting emergency services and/or if you have the ability and resources, carrying the person out on an emergent basis. Ultimately, there is no one right answer, but you would need to weigh the risks vs. the benefits of all of your options and then decide what to do for yourself. But you will for sure be able to make the best decision if you take the time to do a thorough assessment of the leg injury, the patient overall (looking for other injuries), available resources, and the environment and terrain. Also note, if this was a commercial trip (like a guided expedition) or field work for a job or research, the ‘industry standard’ in much of the world would be to carry two communication devices (sat phone, satellite messenger, emergency beacon, etc.) so that you can call out for support, even if no cell coverage. Also good to note: many of the newest cell phones have satellite SOS functionality and it seems like in the relatively near future, many cell phones will also have satellite messaging capabilities. Hope this helps and makes sense!
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Nice solid technique.
Thanks!
So how do you get someone in this condition back to civilization? Let's assume is it summer time, thick forest with dense canopy, no cell coverage, 4+ hour hike out under normal conditions?
It’s hard, that’s why you should never hike! Always go by river :)
But seriously, thanks for your question and here are a few thoughts:
- This splint would be appropriate for someone with an unstable lower leg injury. It does a good job of immobilizing both the ankle and the knee, but as such, it’s pretty big and so it’s not the type of thing somebody can hop out with: they’ll need to be carried, transported in a vehicle or aircraft, floated in a boat, pulled on a sled, etc.
- Even though this is a painful injury that will require medical attention and significant follow up, it’s usually not a medical emergency, but rather, it’s a logistical dilemma. We would only consider a lower leg injury to be a time-sensitive emergency if there was impaired circulation to the foot, if the bone was sticking out (open fracture), if there were signs of compartment syndrome, if there were other injuries going along with this that were affecting the person’s critical systems (circulatory, respiratory, or nervous), or if the environmental challenges could not be mitigated. So you would need to check circulation in the foot and all of the above, but again, often, these issues wouldn’t be present.
In such a case (non-emergent evacuation), you still might need to get help in order to transport the person out, but this could take the form of calling friends, an outfitter, a transport service that you hire privately, and doing a slow and controlled evacuation while minimizing risk and making sure not to domino into other problems.
If it was a medical emergency (impaired circulation to the foot, open fracture, etc.), then you would want to get the person to definitive medical care as quickly as possible, while of course still keeping in mind your safety and that of the rest of the group. This would usually involve contacting emergency services and/or if you have the ability and resources, carrying the person out on an emergent basis.
Ultimately, there is no one right answer, but you would need to weigh the risks vs. the benefits of all of your options and then decide what to do for yourself. But you will for sure be able to make the best decision if you take the time to do a thorough assessment of the leg injury, the patient overall (looking for other injuries), available resources, and the environment and terrain.
Also note, if this was a commercial trip (like a guided expedition) or field work for a job or research, the ‘industry standard’ in much of the world would be to carry two communication devices (sat phone, satellite messenger, emergency beacon, etc.) so that you can call out for support, even if no cell coverage. Also good to note: many of the newest cell phones have satellite SOS functionality and it seems like in the relatively near future, many cell phones will also have satellite messaging capabilities.
Hope this helps and makes sense!
@@borealriver Great explanation - thanks for take the time/effort to do this. I appreciate it.