Should You Take the Backcountry Incident Management Course?

Rich McAdams Rich McAdams
December 12, 2022

The short answer is yes, even if you think you are already well prepared to handle an unprecedented backcountry emergency.  Most of us have had Wilderness First Aid, and some of the older-version (Denver Group) WFA classes had a sprinkling of incident management activities built in.  But that was then and much has changed.

The Backcountry Incident Management School will facilitate our third year this coming summer, and based on observations made over the first two years there are significant disconnects between the good things we think we would do and the questionable things we actually do when confronted with an emergency.

To better illustrate the point, here is a backcountry scenario for your consideration:

Your hiking group comes across someone injured, or perhaps someone in your group takes a nasty slip and fall.  Step one is to size up the scene to ensure it is safe (are there risks of rockfall, avalanche, or lightning?).  If your location appears problematic you will probably want to move your “patient” as well as your group to a safer location.  Stop!!  Before the patient can be moved your First Aid person should perform an Initial Patient Assessment to check for spinal injuries, serious bleeding, and of course an adequate heartbeat.  This assessment is critical and must be done to prevent additional complications if prematurely attempting that move.

Once your first-aid person gives a “thumbs up” the patient can now be relocated.  For a responsive patient, one that may be able to assist, the relocation effort may be somewhat straight forward.  But with an unresponsive patient, or a patient with a more serious lower leg injury, you now have a challenge coordinating with your hiking team to invent a means to do the move.  This is where things can get very complicated, and much daylight is wasted debating multiple options, then a trial and error experimentation.

Ok, with the patient now in a safe location, and cared for by your excellent first-aid team, what do you do next?  Get Help in the obvious answer.  There are several ways to do that, and depending on local conditions, one may work better than the others.  Sometimes, much better.  Did you know that even if you have no bars on your smartphone you may still be able to contact 911?  Perhaps you already know that with minimal bars you may still be able to text 911, but did you know that if you add “enhancements” to your basic text you can freeze your phone for several minutes.

Regardless of whether you use your smartphone, or designate a team to hike out for help, those chartered to get that help need to know what to say and what to do.  When using a smartphone in the backcountry you may experience intermittent connectivity to 911, so when you are in contact it is important that what you communicate is meaningful and concise (FYI, you may have limited battery as well).  Alternatively, once your hike-out team has departed it is likely you will lose permanent contact with them, so they too need to have all the relevant information before they leave.

In this overly simplistic scenario, your patient is now stable, is being thoughtfully cared for, and your Get Help team is making good progress.  However, your patient can take a turn for the worse and the help you expect may not arrive for quite some time.  Now is a good time to consider a Bivy.  A bivy is the general term for activities intended to provide additional support to the patient as well as to your hikers.  This support can include setting up a shelter for the patient and the first-aid team (e.g., to protect them from rain, wind, or even harsh sun), and possibly starting a fire to heat water.  Why a fire and hot water you say?  Hot water can fill a variety of needs from helping the group stay hydrated, having hot water bottles available to warm a hypothermic individual, having “sterile” water to clean and treat a wound, offer an additional means to help the group remain warm, and (of course) gives team members something to do (keep ‘em busy) during this very worrisome event.

To make matters more complicated what if you find you need to spend the night?  What if some of your trip participants now start to experience issues?  What if you have more than one injured patient?  What do you do when some of your trip participants demand that they must leave and go home?  And finally, you may be the most experienced (only experienced) individual on the hike.  Does that mean you do it all?

At this point you are thinking, “There are a lot of moving pieces; the situation itself continues to evolve; how can it all be controlled?”  Obviously, someone needs to act as a focal point for the planning and communication; someone not immersed in all the minutia who can provide that element of oversight.  Usually, this role would be filled by the CMC Trip Leader, but it can be delegated to another depending on the experience and capabilities of the trip participants.  We call this focal point individual the Incident Manager.

So what resources are available, in the field, in real time, to provide guidance and direction?

In late 2021 the BIM School updated the CMC Incident Management & First Aid Cards and had this new set mailed to every active Denver Group trip leader (There are extras available at the CMC office).  These Incident Management cards provide the First Aid Team, the Get Help Team, the Bivy Team, and the Incident Manager with a step-by-step… what to do… and when… set of guidelines.  These IM Cards also serve as the field day textbook for the BIM School.

So, are you still confident and prepared to handle that unprecedented backcountry emergency?  Most of us probably admit, not really.  Each summer the BIM School facilitates a June, July, and August field day to review and practice all that was said above.  Enrollment tuition for this one-day class is minimal, the homework very do ‘able, and the equipment you are asked to collect is equipment you will want to add to your day pack anyway.

To Learn More:

The BIM School is now in the process of determining field day dates for 2023.  In addition, the BIM School website will soon go through a reconstruction effort to better accommodate the new CMC website.  Nevertheless, to provide a bit more info, the current (slightly outdated) website can still be accessed at:  Backcountry Incident Management School - CMCDenver.org

Should you have questions not yet answered you can email Rich.McAdams@hotmail.com.  Please include a reference to the BIM School in the subject line so you don’t look like spam.  😊


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