It is the goal of the Forge Travel Study Program to prevent or decrease the likelihood of having an emergency by:
- Hiring qualified staff
- Providing thorough training in FORGE specific programming
- Maintaining a high staff to student ratio
- Following appropriate policies and procedures
- Using good judgement and common sense
Good preventative measures are still not a guarantee that an emergency situation will not occur. In the event of an emergency it is important to have a set of guidelines to help staff make decisions and take appropriate action. In each situation, the action taken will be determined through a combination of thorough data collecting, the team’s assessment, clear communication, and the use of sound judgement and common sense. Following is a set of guidelines that will help in the decision making process.
An emergency is considered to be any major accident, injury or incident that would require the evacuation of a student from the field or prompt action to reduce the risk to individuals or the group. This would include:
- A medical injury or illness serious enough that continuing on the trip would create a significant risk to the student or the group.
- A behavioral or personal problem that creates an unmanageable risk
- A logistical problem with equipment, supplies or itinerary that could affect the safety of the group
- A missing or lost student which creates a risk for the group and the absent student
Each situation will require a response from the instructor team appropriate to the emergency and all the variables involved. The basic plan of action for most emergencies would be:
- Stabilize the situation by preventing any further incidents and staying calm. Provide any necessary first aid to injured participants.
- Notify the School Director or on call supervisors
- Develop a more detailed plan of action and activate it when appropriate
- Document your actions and fill out appropriate forms
- Re-evaluate and make a new plan if conditions change
Incident Command – The first person on the scene of an incident or accident is in charge of the incident until a person with a higher level of training and/or authority arrives. At this time the responsibility of incident commander should be transferred to the person with more authority or training. First aid and patient care responsibilities should remain with the person with the highest level of first aid training (this may not be the incident commander). There should be a person on the scene designated as the second. This person should take over incident command in the event the primary person cannot continue their responsibility for any reason.
Communication Protocol—In the event of an emergency that requires the evacuation of someone from the field or necessitates the transfer of information to the Director or On-Call Supervisors, staff members in the field should:
- Use the cell phone (or other) to contact the Director. Try to reach them at FORGE first then try their home phones. An on-call schedule will be included in the trip packet information. (If a PLB is taken in the case of no cell service the appropriate procedure will be followed).
- If these people cannot be reached, leave a message on the Forge voice mail and on their home answering machines. Make sure to set a time that you will call back or if your phone will receive calls, when someone should call you.
- If the situation calls for immediate attention, call the most appropriate emergency service then continue to try Forge or activate PLB.
- Before placing a call, make sure you have written down all the important information which may include:
- Nature of the emergency
- Students or Staff involved and their current status
- SOAP note
- Location of the group
- Your cell phone number and your location in relation to the group
- Action that has taken place and a clear statement of what your needs are
Notification of Significant Other People—Anytime there is a serious incident or accident, evacuation, or lost student it is imperative that the Director is notified as soon as possible and given all pertinent information. It is his/her responsibility to notify the appropriate people and /or agencies. This may include but is not limited to:
- Parents or Legal Guardians
- The Police
- The media—Staff should refer all media contact to the Director to avoid any problems with student confidentiality. The Director will handle all media contact according to protocol.
Sending a runner—There may be times when the accompanying communication device does not work or may not be the appropriate choice in the particular emergency. In this case it may be necessary to send a runner to the nearest phone or emergency vehicle. It is always safer to send a group of three or four to run for help but this is seldom possible. One FORGE staff lead the runner team, and depending on the situation the team may decide to send one or more capable students with them. The staff team should choose the best route by reviewing the maps and evaluating the terrain, weather, time of day and abilities of the running party. It is imperative for the running party to take extra caution not to create another emergency. Runners need to remember to bring the following:
- Supplies that they will need to be comfortable and safe while they’re gone(food, water, warm clothes, maps, sleeping gear)
- Detailed incident information or SOAP note if the problem is medical.
- Written directions to pinpoint the location of the incident
- Emergency phone # list and some quarters
- Runners should have a travel plan so that the remaining staff knows approximately when they will return with help or receive a phone call.
Missing Student—There are many reasons that someone could be considered missing in the field. A student may be lost or have run away but it is also possible for a student to be hiding, or have just wandered out of sight and sound. At the point when you discover that someone is missing you should:
- Stay calm and interview staff and students to gain information, which would lead to the whereabouts of the missing person.
- What is the history leading up to the incident?
- Had the student been talking about running away?
- Was the student homesick?
- Had the student been in a fight or disagreement lately?
2. Perform a Hasty Search of the immediate area
- One staff should stay with the group to keep them calm and occupied
- The other two staff should take 10-15 minutes to search the immediate area calling out the students’ name or blowing the safety whistle.
- Listen for a response. If the student is still not found staff should start filling out the Missing Person Report Form and:
3. The staff team should have a conference to discuss possible scenarios. Factors to consider may include:
- Location and distance from the trailhead
- Time of day
- Current weather conditions
- Student’s behavioral history
- Type of terrain
- Recent mood the student was in
- What the student was wearing
- What gear was the person carrying
- What was the last spot that the student was sighted
Lost Student—If the team decides that the student is most likely lost or is hiding they should make plans to systematically expand the search. Staff should utilize the group and split up into search teams. Teams should coordinate how long they will search for, how far they should go, and when they should re-group. Proactively teach students Lost Protocol and use procedures. (See addendum with procedures and Lost Protocol cards).
- Hasty search of area
- Search to last seen point (instructor with 2-3 students – utilizing the strengths of the group). Calling and whistling. Checking possible alternate route, etc. Wait for response. Have planned regrouping time.
- Consider the well being and safety of the group. Leave responsible group at site to set up camp, continue to signal, keeping group warm, dry, calm and feeling productive.
- Search in continued direction of travel (instructor with 2-3 students – utilizing the strengths of the group). Calling and whistling. Checking possible alternate route, etc. Wait for response. Have planned regrouping time.
- If night falls, evaluate safety of continued search. Begin again at first light.
- If phone contact is possible contact the Director.
- Final search before calling in reinforcements: leave team at camp and send out self-contained team to next trail head searching the whole way.
- Cell phones add a connection to the outside that may not be an advantage. Continue to go through all search processes before making contact with a search organization.
If the student is still not found the staff team should contact the Director so that they can help coordinate with Search and Rescue. Staff should have the information from the Missing Persons Report Form available to give to appropriate persons. Staff should follow the communication protocol. At any time the student is found the staff team should meet with the student to:
- Make sure they are okay and provide any necessary first aid
- Process how the situation happened
- Contract on expected future behavior to avoid the situation happening again
- Make sure to call the Director and/or Search and Rescue to let them know that you’ve found the student and that the Director can help support next steps.
- Fill out the appropriate paper work ( Missing Persons Report Form)
Medical Emergency—In the event of a medical emergency due to injury or illness the staff will:
- Provide all necessary first aid to the level of their training
- Gather all pertinent information and write a thorough SOAP note
- Depending on the extent of the injury or illness and all the variables the staff will need to make a plan and be prepared to re-evaluate. Depending on the situation the staff may need to:
- Provide first aid and move on because there is no risk of further injury
- Provide first aid and wait and see if the condition improves. This may require changing the itinerary and calling FORGE
- Provide first aid and make plans to evacuate the student. Check the evacuation guidelines for the types of injuries that would require evacuation.
- Fill out an Incident/Accident/Near Miss Form
Evacuations— It is the policy of the FORGE Travel Study Program to perform our own evacuation only when the person can walk out without creating further injury or endangering the group. Any evacuation that requires someone to be carried out on a litter is the job of Search and Rescue or another Emergency Service. Staff may get some help with this decision by calling a Supervisor or Doctor but ultimately it is a judgement call for the staff in the field. Request a helicopter only when there is a definite threat to life or limb. Any time someone is evacuated from the field an Evacuation Report form must be filled out.
Walk out—If the person being evacuated can walk out the staff team will need to consider the following:
- Who to send to provide first aid, help carry gear and be supportive
- Writing a detailed SOAP note to send out with them. Remember to send the student information packet.
- Making sure that the walkers have all the necessary clothing and gear to stay safe including food, water, first aid supplies and shelter. Be careful sending gear that may be needed by the group.
- Contacting someone from FORGE so that there is a person to meet when you come out of the field.
- Making a plan of where and when the walkers will rejoin the group.
- Document your decisions and actions
Carry out—If you know that you are going to need assistance to transport the injured person:
- Call as soon as possible so that Search and Rescue can get started. Make sure you have all the necessary information ready.
- Your exact location.
- Incident information. What happened, where, and how?
- Patient information including injuries, care given and vital signs.
2. Continue good patient care, keep the patient comfortable, and make provisions for them to eat, drink, and go to the bathroom. Take a set of vital signs regularly.
3. Keep the rest of the group safe, in the information loop to the extent reasonable, and occupied with relevant activities.
4. Consider sending someone to meet the Rescue Team at the trailhead or a trail junction.
5. Assist the Rescue Team when they arrive. Send out all the appropriate paper work.
6. If at all possible have a staff stay with the student until another FORGE staff takes over.
7. Document all your decisions and actions
Helicopter—Do not take a helicopter evacuation lightly. Any time a helicopter flies in the backcountry the pilot and crew is taking a risk. Helicopters do not fly in bad weather and they need a good landing zone that may not be near your patient. At the time of contacting 911 inform the emergency personnel of the landing site location and condition as well as the proximity to the group and patient. If a helicopter is coming for the patient the staff will need to:
- Brief the students regarding expectations and safety procedures
- Choose, clear, and mark a landing zone—
- Choose an area that is at least 100ft in diameter and long enough for the helicopter to approach and take off at a 15-degree angle. Helicopter pilots like to be able to take off pointed down hill and against the wind, if possible.
- Clear all obstacles that could blow into the rotors.
- The site’s long axis should face into the wind.
- Hang a brightly colored wind sock in plain view
- Mark a firm, flat spot with something bright that won’t blow away
- Direct the pilot by having one person stand at the far end of the landing zone with their back to the wind and arms extended toward the landing area.
- Prepare the patient for air travel by dressing them warmly. Ear plugs, safety glasses, helmet and gloves are also appropriate if available.
- Be safe around the helicopter rotors by not approaching it until the pilot signals and keeping your head low. Never approach the helicopter from the rear.
- Keep camp and all other students 150 yards away from the landing zone.
- Remember that a pilot will make his own decisions of when and where to land safely depending what he sees at the time.
- Follow all the instructions of the pilot or crew.
- Accompany the student if possible.
- Document all your decisions and actions.
Natural Phenomenon or Disaster – FORGE staff should be aware of the possibility of storms, rock fall, lightning, river flooding, earthquakes, forest fires, and avalanches. Staff should be prepared to assess the dangers that these phenomenon present to the group and be able to make quick decisions and longer term plans on how to keep the group safe. Staff may need to make a cell phone call to gain more information or direction. The first priority is the safety of our students. Storms, rockfall, avalanches and lightning are all semi predictable events which staff can be prepared for. Earthquakes and forest fires are unpredictable and the staff will need to make action plans on how to deal with these situations when they arise. The general rule of thumb is to remove our students from harms way.
Fatality in the Field—In the event of a fatality in the field it is extremely important that the staff:
- Not disturb the accident scene or the body until the legal authorities show up and provide guidance and instruction
- Take care of the emotional, mental, and physical well being of all the members of the group.
- Keep communication with others factual and avoid offering opinions, judgements or speculations.
- Notify the Director as soon as possible
The Director is responsible for:
- Notifying next of kin and other appropriate people and filling out “Next of Kin”form
- Make arrangements to deal with the authorities and the media according to protocol.
- Setting up a debriefing to deal with the trauma of family and friends