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It was going to be a long and strenuous hike in the North Shore Mountains. Trying to keep your pack light, you only brought a windbreaker, a light sweater, several energy bars, a litre of water and a small first aid kit. The nice and sunny morning you’ve enjoyed has turned into a cold and drizzly afternoon when your friend slips on a steep and wet section of the trail.

Tumbling down the rocks for about ten metres, your partner finally comes to a stop and lets out a bloodcurdling scream. As you carefully pick your way down the rocks, you can see that your friend is lying in a small puddle of water. His ankle is clearly deformed and blood is coming out of a cut just above his hiking shoe. He also says that he hit his back on a rock quite hard.

You pull your cell phone out only to discover that you don’t have reception. You are cold, tired and wet. There is about an hour of daylight left and you are still 45 minutes from the trailhead at a rapid pace. The slightest movement of your friend’s ankle is causing excruciating pain. It now dawns on you that dealing with the situation rests entirely on your shoulders. Are you ready?

Most first aid courses are developed for environments where first responders have rapid access to advanced medical care and equipment. In other words, they are designed for situations where paramedics can get to your location in a timely fashion. You don’t have to go very far for these crucial conditions become nothing more than wishful thinking.

Being far from help poses several questions that are not usually addressed in urban based first aid programs. In the scenario above for example, you are looking at a soft tissue injury and a broken ankle. Your friend is also cold and wet and you have limited means of keeping him warm. In all likelihood, it will be another few hours before you can get warm and dry. Is it possible that he might have hurt his spine in the fall? Should you move him out of the puddle? You have a small first aid kit for the bleeding but will you be able to improvise a leg splint with the equipment that you have with you? Should you leave your friend alone to go look for cell phone reception with little daylight left? Which is the biggest problem? Is it the broken ankle, the possibility of a spinal injury, the bleeding cut, the hypothermia or the fact that there will be significant delays before your friend receives proper treatment? What should you do first?

To answer these questions, we need to take a problem solving approach rather than the strict application of a procedure to manage a broken ankle. Simply calling for help and staying put is just not an option. To assess priorities, we need to know enough about physiology to understand the implications of delayed treatment and the role of hypothermia. We also need to be familiar with the principles of splinting and be crafty enough to improvise a treatment that properly immobilizes the ankle. Finally, we need to know more about the anatomy of the spine and the nature of spinal cord damage.

Of course, there isn’t a single, simple way to deal with these situations. A Wilderness First Aid course introduces you to the concepts and skills you need to help you make better decisions. In my fifteen years of teaching these programs the most common comment I have received from course participants is: “I had no idea how challenging things could get if my friends or I got hurt out there.”

This knowledge helps you better manage your risks by truly understanding the consequences of an injury and be a more responsible and self-reliant backcountry user.

To register for an upcoming session of Wilderness First Aid Training, please click here.

About A-J Maheu
Over his ten seasons spent as Patrol Training Coordinator, Avalanche Forecaster and Snowshoe Park Supervisor, A-J Maheu has been a tireless advocate for backcountry safety. Working alongside a team of highly-skilled and dedicated ski patrollers, the Montreal native considers the most defining moments of his life to be those spent traveling in the backcountry, all the while developing a deeper understanding our connection to the natural world. When not passing along his knowledge to others, you’ll find A-J skiing, climbing, cycling or sea kayaking.