Out there, miles from the trailhead, things can go sideways fast. A sudden slip, a falling branch… and now someone’s hurt. That first hour? It’s absolutely vital. Knowing what to do, and in what order, can truly change everything. Forget panic; lets talk priorities.
Ensure the scene is safe
Before you even think about rushing in, stop. Take a breath. Look around. Is there anything that could hurt you? Loose rocks overhead? A steep, slippery bank? Maybe the accident involves wildlife or a downed power line if you’re near civilization. You cant help anyone if you become a victim too.
Make sure the area is stable before you approach the injured person. If its not safe, do what you can from a distance or try to make it safe first. Your safety is always number one. Only then can you focus on them.
Check responsiveness and breathing
Alright, scenes secure. Now, check on the injured person. Talk to them. “Hey, can you hear me? Open your eyes.” Give a gentle tap on their shoulder. No response? We need to see if they’re breathing.
Carefully tilt their head back and lift their chin to open the airway. Put your ear close to their mouth and nose. Look, listen, and feel for normal breathing for no more than 10 seconds.
- Look for chest rise and fall.
- Listen for air.
- Feel for breath on your cheek.
If they ain’t breathing normally, or are only gasping, you need to get help coming ASAP and start CPR if you’re trained. If they are breathing, lets move on to the next big problem.
Stop life threatening bleeding
Big bleeds are bad news. We’re talking blood thats spurting, or pooling quickly. This takes priority over almost everything else if they’re breathing. Your goal is to stop that blood from leaving their body.
Grab the cleanest cloth you have – a bandana, part of a shirt, anything. Wad it up and press it directly onto the wound. Press hard. Don’t be shy. If you have a first-aid kit, use sterile gauze pads.
- Apply direct, firm pressure.
- If possible, elevate the bleeding limb above the heart.
- If direct pressure isn’t cutting it on an arm or leg, and the bleeding is severe, a tourniquet might be needed. Place it high and tight on the limb, between the wound and the heart. Note the time you applied it. This is a last resort for really serious bleeding.
Little scrapes and minor cuts can wait. Focus on the big ones first.
Protect from elements and manage shock
Shock is a sneaky killer. It doesn’t just happen when someone’s scared; it’s a medical condition where the body isn’t getting enough blood flow. Anyone with a serious injury is at risk, even if its warm out.
What to do:
- Lay the person flat on their back, if injuries allow.
- Elevate their legs slightly (about 8-12 inches) unless you suspect a head, neck, spine, or serious leg injury.
- Keep them warm. This is super important. Use a sleeping bag, emergency blanket, spare jackets… whatever you got. Put something under them too, to stop cold seeping up from the ground.
- Don’t give them anything to eat or drink, even if they ask. It could cause problems later.
Signs of shock can include:
| Symptom | Description |
| —————— | —————————- |
| Skin | Pale, cool, clammy |
| Pulse | Rapid, weak |
| Breathing | Fast, shallow |
| Mental State | Anxious, restless, confused |
| Other | Nausea, thirst, dizziness |
Keeping them calm and reassured helps too.
Get help on the way
As soon as you’ve handled the immediate life threats – safety, breathing, catastrophic bleeding – you need to call for backup. The sooner rescuers know about your situation, the sooner they can get to you.
Use whatever you have:
- Cellphone (you might get lucky with a signal)
- Satellite phone or messenger (like a Garmin inReach or Spot)
- Personal Locator Beacon (PLB)
When you make contact, be clear and concise. Tell them:
- Who you are.
- Where you are. GPS coordinates are best. If not, landmarks, trail names, last known point.
- What happened. Nature of the accident.
- How many people are injured and involved.
- Condition of the injured person(s) – conscious? breathing? major injuries?
- Your plan (e.g., staying put, what signals you have).
If you can’t call out, prepare to send someone if safe, or make signals. Make yourselves visible from the air or ground if you’re waiting for rescue. Bright colors, a signal mirror, three fires or piles of rocks in a triangle… every little bit helps. That first hour sets the stage for everything that follows. Good, quick decisions matter more than you know.