2. In a delayed help situation you have four options for getting help. 1.Stay where you are and radio, call or signal for help. 2.Send another group member, or in extreme situations, leave the patient alone to go for help yourself.

3. 3.Transport the patient to help. 4.. Care for the patient where you are until he or she has recovered enough to travel on his or her own.

4.  1. Is advanced medical care needed and, if so, what is the urgency of the care? Is it immediate or can it wait?  2. How likely is it that someone will come looking for the group and how likely is it that they will find the group?

5.  3. Is there a way to call from the scene for help or advice?  4. If phone or radio communication is not possible, is there a way to signal for help?  5. If there is no way to signal/call for help:  A. Is there a way to safely transport?  B. Is it possible to give care where I am until the patient can travel?  C. Is it safe to wait for help where we are?

6.  1. The patient’s condition (refer to SAMPLE).  2. Your location: GPS coordinates, prominent landmarks, How is your area marked, Mileage. ******ONLY IF YOU KNOW IT EXACTLY!!!

7.  Ultimately you must make the decision based on the info you have.  CPR will not sustain a person’s life indefinitely.  Survival chances are not good if there is a direct injury to the heart.  Lightening, drowning, and hypothermia give a better chance of survival.

8. 1.Chest Wounds: a. Go slow when evacuating any patient with a suspected fractured rib. b. Be sure to watch for difficulty in breathing. *Go fast and rapidly evacuate anyone who has a chest wound associated with difficulty breathing.

9.  2. Spinal Injuries  Go slow if the person is responsive and doesn’t act like they have a serious head injury.  Go fast if the person has indication of a severe head or brain injury. (Always carry them)

10.  3. Burns  Go slow if it is a minor, treatable burn.  Go fast if the patient has trouble breathing, has a full thickness burn, or other serious burns.

11. -Remember shock is when the brain and body cells don’t receive enough oxygenated blood. -It can occur from a great variety of illnesses or injuries.

12. -Care for the patient where you are until they reach a normal state. -If you cannot reach help in a few hours, then continue to monitor and give sips of water to conscious victims.

13. -Go fast if decreasing mental status or worsening vital signs. -Go slow if improving.

14. -you may be faced with a difficult decision about continuing CPR. -If direct injury odds are decreased. -Better chances with lightening, drowning and hypothermia.

15. -Go fast if you believe they have had any form of heart attack.

16. -use tourniquet only if you cannot control bleeding with pressure points or direct pressure. -if they gape more than ½ “ do not close in the field. Wait for a doctor. -Leave open large dirty wounds that expose bones, tendons or ligaments or animal bites.( it will need to drain) Go Fast.

17. --the patients degree of discomfort will determine need to evacuate. -first time dislocations should evacuate. (relocate if possible)

18. -go slow to evacuate any person with persistent abdominal discomfort -Go fast to evacuate any person with signs or symptoms of a serious abdominal problem.

19. -Ear-do not use force to remove things in ear. -if ear infection evacuate slowly. -Posterior nose bleeds evacuate rapidly. -tooth infections, evacuate rapidly.

20. -Keep victim physically and emotionally calm. -Wash and splint and keep at the level of the heart. -Send for help to come and get the victim.

21. Evacuation guidelines -If recover well. You may stay in field. -If severe, then go fast and use extreme gentleness.

22. -always evacuate fast even if they appear to be fine. -swelling can occur later that can cause serious complications.

23. -if occurs when people at high altitude don’t have enough oxygen in their blood because the barometric pressure is too low. (compared to what they are use to)

24. -this is the most common type. -It is also known as Acute Mountain Illness. -occurs around 6500-8000 feet. -if left untreated can become Hace,

25. -High Altitude Cerebral Edema -This is fluid in the brain tissue. - Can also lead to HAPE.

26. High Altitude Pulmonary Edema. _ This is fluid collecting in the air spaces of the lungs. _Eventually will cause death by suffication.

27. -headache Loss of appetite. Nausea, with or without vomitting. Insomnia Unusual weariness of vomitting Treatment -stop and wait for improvement before going on. -if illness persists then descend asap. -can give asprin

28. Symptoms- -loss of coordination, -Severe headache that is unrelieved -Bizarre changes in personality -possible seizure or coma. Treatment -Descend ASAP -provide O2 if available and trained to do so. -Keep patient warm and cool. -use portable hyperbaric chamber if available and trained to do so.

29. Signs -dry cough and shortness of breath. -shortness of breath becomes worse. -possible chest pain. -cough that becomes more productive but produces sputum and then reddish sputum. Treatment -descend asap by 1000-1500 feet. -give O2 if available and trained to do so. -Keep patient cool and warm. -Use a portable hyperbaric chamber if available and trained to use.