Chapter 47. Rescue from remote places
Rescue teams require specialist training, equipment and physical conditioning for working in the remote or austere environments. Paramedics must be fully trained team members, otherwise they may become a liability, placing the other team members at risk. At other times, such as on expeditions, paramedics may have to work alone using their own resources.
Your medical skills are of value only if your physical fitness and specialist training are appropriate
Remote locations
• Mountain rescue
• Cave rescue
• Ski patrolling
• The Lifeboat service
• Search and rescue helicopters
• Remote industrial and agricultural sites
• Expeditions.
• Environmental injuries: hypo- and hyperthermia
• Dehydration
• Fatigue
• Any physical illness including myocardial infarction
• Near drowning
• Multisystem trauma resulting from falls
• Limb fractures and knee/ankle sprains
• Spinal fractures
• Skull fractures
• Burns.
Planning
A risk analysis and review of any previous audit or reports will help to identify the most common problem areas that a paramedic may face in a particular environment.
Find out:
• The precise location of the incident
• The type of incident and its cause
• Any potential or real hazards
• Access to the casualty with possible approach routes
• Number of casualties.
Much of the planning process used in the Major Incident Medical Management and Support (MIMMS) system of incident management is still applicable to remote rescue.
Mountain rescue
Mountain rescue in this country is undertaken by teams of volunteers, many of whom will possess advanced first-aid skills
• A doctor may or may not take part in the actual rescue work but will frequently provide advice to the team via radio
• Mountain rescue teams will usually provide or perform:
• Cervical, full-spinal and limb splintage
• Intravenous access
• Control of external haemorrhage
• Intravenous fluids
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