By JANE SCHMIDT
VIOLA - We are four women in a car, with four well-loaded backpacks, all of us over 40 years old and filled with more excitement than we felt the night before Christmas when we were 12. We’re on our way to the North Shore of Lake Superior for a backpacking trip, and there ain’t no stopping us till we get there—except for potty breaks and lunch.
We’ve planned, trained, packed, unpacked, and packed again and finally we are ready: Superior Hiking Trail or bust!
Yesterday, I returned from my recertification as a Wilderness First Responder, a rigorous course designed to teach people how to respond to emergency situations in remote places. I’m sitting in the back seat behind the driver and my head is buzzing with thoughts of medical emergencies we may encounter. Somewhere between Viola and Solon Springs, I decide it’s best to share the information that’s overwhelming me, in hopes of increasing our chances of survival if anything goes wrong.
“In an emergency situation in the wilderness you need to remember three triangles,” I remark, as we get back in the car after our first stop for bathrooms and coffee.
1. Don’t just do something, stand there!
The first triangle refers to “scene size-up” and it’s all about stabilizing the scene. Instead of rushing in, stop and think. Is the scene safe? (Is there still a grizzly bear nearby, or lightning still flashing, or another tree about to fall?) How many people need care? Could the temperature be the reason the person is incoherent? How can I keep myself safe? Do I have gloves and a facemask, and are they needed? If so, put them on before proceeding.
We’re making great time as we approach Eau Claire. I’m not sure if anyone is even listening but I continue my lecture.
2. Find it, fix it, fast!
The second triangle is all about Primary Assessment. Do a quick check of the patient’s three critical body systems: circulatory, respiratory, and nervous. The purpose is to identify and correct an immediate life-threatening problem. Are they bleeding profusely? Is their airway blocked? Could they have a spinal injury?
We stop to eat, then go for a short walk to stretch our legs before getting back in the car. Before anyone starts to get sleepy from lunch, I move on to the last triangle: Secondary Assessment.
3. Treat and complete!
Now’s the time to gather relevant health history—all the basics, including the patient's name and age and what their chief complaint is—and make a routine check from head to toe. It’s also the time to start recording their vitals and to note patterns that may appear. You’re looking for and recording anything unusual and asking them more questions about their incident, when they last ate, when they last used the bathroom, whether they take medications, and so on. Are they alert? Do they have allergies? What events led up to their injury, illness, or accident? Now is the time to splint broken bones, ease a dislocation back into place, or package the patient for evacuation.
No one asks any questions and the car is quiet except for the beeps notifying someone of a message on their smartphone. The driver is focused, and I’m smartphone-less so I continue to play out different wilderness situations in my head: drowning, insulin shock, seizure, anaphylaxis, lightning strikes, dislocations, lacerations, and altitude sickness. I wear myself out and fall asleep.
Late afternoon, we arrive in Tofte, Minnesota, and check into our hotel, then spend time going through our gear and making final decisions about what to take on our hike and what to leave behind. After dinner, we all get some much-needed sleep before our adventure begins the following day.
I decide to take a bigger, more extensive medical kit than I ever have before. All the scenarios presented in my recent retraining make me anxious to be prepared for every possible emergency.
Five days later, after hiking 43.7 miles, with countless steps over roots and rocks and across rivers, carrying all the equipment we need to survive, we arrive safely back in civilization. Except for moleskin, a couple of Smooth Move tea bags, and a few Tylenol eight-hour tablets, my medical kit is untouched. As we drive home to Wisconsin, I drift off into a deep, calm, exhausted sleep.