Reality Training: Snowmobile crash in the woods
Discuss your duty to extricate a patient from a remote location and what equipment is available to you
By Stephen Shoults
Incident Date: March 2, 2016
Department: Unknown. Paramedics responded to the incident near the town of L’Etape, 100 km (62 miles) north of Quebec City, Canada.
What happened: A group of snowmobile riders were on a trail when two snowmobiles collided, resulting in serious injury to a rider. An ambulance responded to the nearest road, approximately 3 km from the scene. At that time, the patient was reportedly unconscious. The patient’s brother was part of the group and reported that the paramedics refused to come from the ambulance to the scene.
After 45 minutes, the patient was reported to have stopped breathing and CPR was started by another snowmobiler. The patient was eventually transported to the ambulance by the other snowmobilers, but that was two hours after the injury and the patient did not survive.
Read the original CBC news article.
Discussion points: Remote locations, resources and duty to act vs. scene safety concerns
Ask yourself or discuss with your partner, company or squad the following questions:
- Do you have a duty to respond beyond the range of your ambulance?
- What safety concerns do you have for this snowmobile incident?
- When would you go to the patient and why might you stay at the ambulance?
- What resources do you have on the ambulance that could be used for remote patient extrication?
- What additional resources are available to you for remote patient access and which of those resources would you request on this call?
- How would you convey your decisions to the patient’s friends and family on scene?
Tips to remember
Before engaging in off-road rescue or other special operations, you should be properly trained and equipped for the specific type of rescue to be performed. Knowing your department expectations and limitations is also an important part of provider safety.
When packaging patients in remote locations, there are additional patient safety considerations, particularly in cold weather conditions. Thoroughly assess the patient on scene; once the patient is packaged, it will be difficult to assess anything other than general changes in condition.
Consider using a hypo-wrap to prevent or treat hypothermia. Lying motionless on a rescue basket or sled for an extended time can lead to reduced extremity circulation and an increased risk of frostbite. Footwear can also impede circulation; consider removing the patient’s boots and applying heat packs to the soles of the patient’s feet. Remember to check for changes in condition en route to the ambulance or landing zone.
While EMS protocols, training, resources and traditions vary by locale, our duty to respond during emergencies remains constant. In addition to being prepared for common emergencies, we should also foresee and pre-plan many of the low-frequency and high-risk calls that may likely occur in our area.
In the comments below, share some of your thoughts about this call, as well as the unique risks and special resources in your area.
About the author
Stephen Shoults is a full-time EMT in eastern Pennsylvania. He started his EMS career in 2008 as a volunteer firefighter/EMT in Alaska. He has experience in private EMS, hospital-based EMS and EMS via management service organization. Stephen is a certified EMS instructor and recently started his first business, a mobile CPR & EMS training service. He can be reached at: training@KeystoneCommunityRescue.com.