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Evacuation Guidelines

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  • Please be aware that these are recommendations only.
  • They are based on best-practice and the most current available information.
  • Every first-aid scenario is dependent on responder training, patient presentation, environmental considerations and available resources- all of which should be taken into account and form part of your treatment and evacuation plan.

RAPID EVACUATION FOR ANY UNRESPONSIVE PATIENT

PRESENTATIONCONSIDER EVACUATIONCONSIDER RAPID EVACUATION
Unresponsive- CPRRAPIDRapid evacuation for all unresponsive patients (including deteriorating LOC) and unstable vital signs
Unresponsive- BreathingRAPIDRapid evacuation for all unresponsive patients (including deteriorating LOC) and unstable vital signs
Spinal InjuryAll patients with relevant MOIAll patients with relevant MOI and any signs and symptoms of spinal injury
ShockAll patients with injuries significant enough to cause uncontrolled shockDeteriorating patients, uncontrollable bleeding, airway problems and unstable vital signs
AbdominalSudden unexplained onset of severe pain or constant unexplained pain lasting more than 24 hrsBlood in urine, faeces or vomit; any acute abdo pain associated with women of childbearing age; any complications of pregnancy
AnaphylaxisAny abnormal reaction or first time exposure with systemic involvementAny patient who requires EpiPen administration
AsthmaAny persistent asthma event or where the trigger cannot be removedAny asthma event unresponsive to salbutamol and/or any patient with underlying comorbidities (eg: chest infection)
Chest PainAny patient complaining of cardiac chest painIf patient has no medication, has never experienced chest pain before or symptoms last more than 10 mins
ChokingAny patient requiring back blows/chest thrusts that doesn’t rapidly improve with clearing of the obstructionAny patient who becomes unresponsive
Diabetes- HYPOFor known diabetics, monitor resolved hypoglycaemia for 24hrs (provided patient does not have compounding issues- eg: trauma). Consider evac for relapse or first-time presentationsIf patient shows no signs of improvement, relapses, has altered level of consciousness (including persistent behavioural changes) or becomes unresponsive
Diabetes- HYPERAll T2/NIDDM patients experiencing hyperglycemia in a wilderness setting; monitor T1/IDDM regularly and consult/manage according to diabetes action planAltered level of consciousness, unresponsive
SeizuresFor known epileptics, monitor resolved seizures for 24hrs (provided patient does not have compounding issues- eg: trauma). Consider evacuation for relapsesSeizures related to head injury, trauma, unknown causes or lasting longer than 5 mins. Evacuation for ALL first-time seizures
StrokeRAPIDAny patient who ‘fails’ the F.A.S.T test
Bleeding- ExternalControlled bleeding with associated unstable vital signsAny patient requiring a tourniquet or haemostatic dressing
Bleeding- InternalAll patients with suspected internal bleedingImmediate evacuation for internal bleeding with compromised vital signs
BurnsPartial thickness burn greater than 10% of TBSA; Any full thickness burnMajor burns of the hand, face, feet or genitals; burns with inhalation injury; electrical burns; circumferential burns; burns to a medically ill patient
Blisters/ Minor Lacerations + WoundsRelated to patient comfort and logistical considerations- should be considered for any patient showing signs of localised infectionAny patient with signs of systemic infection
Head InjuryAll patients who have a relevant MOI, changes in LOC caused by a head injury (including concussion) should be assessed by a health professional; Acute onset of unexplained headacheAny persistent decreased LOC or deterioration
Limb + Joint InjuriesDirectly related to patient comfort and logistical considerations- should be considered for any patient with uncontrollable pain levels or persistent dislocationAny patient with signs of distal hypoperfusion
Penetrating InjuryAny patient with a penetrating injuryAny patient with signs of shock or breathing problems as a result of injury
Bites and StingsDirectly related to patient comfort and logistical considerations- should be considered for any patient with uncontrollable painAny patient with systemic effects, breathing or circulatory problems. Any patient who requires a Pressure Immobilisation Bandage
HypothermiaAny patient that doesn’t respond to rewarming interventionsPersistent moderate/ severe patients
HyperthermiaAny patients that don’t respond to cooling interventionsAltered LOC or seizing patients
HyponatraemiaAny patients that don’t respond to cooling interventionsAltered LOC or seizing patients
LightningRAPIDAnyone suspected of a lightning strike injury
DrowningRAPIDAnyone suspected of a drowning episode
Altitude EmergenciesDescent for all patients showing persistent signs of AMS lasting longer than 24 hoursRapid descent for all patients showing signs of advanced AMS (HAPE, HACE), breathing problems or decreased LOC
Diving EmergenciesRAPIDPain or breathing issues after diving, any altered LOC, any complications of rapid ascent
Avalanche EmergenciesRAPIDAny patient that has required rescue (self or bystander) following an avalanche emergency (possible unknown internal injuries)
Mental HealthPatients who show a deteriorating level of mental health where responder intervention does not improve situationAny patient at risk of harm to themselves or others; suicidal ideations; psychotic episodes