EVACUATION GUIDELINES
- 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
| PRESENTATION | CONSIDER EVACUATION | CONSIDER RAPID EVACUATION |
|---|---|---|
| Unresponsive- CPR | RAPID | Rapid evacuation for all unresponsive patients (including deteriorating LOC) and unstable vital signs |
| Unresponsive- Breathing | RAPID | Rapid evacuation for all unresponsive patients (including deteriorating LOC) and unstable vital signs |
| Spinal Injury | All patients with relevant MOI | All patients with relevant MOI and any signs and symptoms of spinal injury |
| Shock | All patients with injuries significant enough to cause uncontrolled shock | Deteriorating patients, uncontrollable bleeding, airway problems and unstable vital signs |
| Abdominal | Sudden unexplained onset of severe pain or constant unexplained pain lasting more than 24 hrs | Blood in urine, faeces or vomit; any acute abdo pain associated with women of childbearing age; any complications of pregnancy |
| Anaphylaxis | Any abnormal reaction or first time exposure with systemic involvement | Any patient who requires EpiPen administration |
| Asthma | Any persistent asthma event or where the trigger cannot be removed | Any asthma event unresponsive to salbutamol and/or any patient with underlying comorbidities (eg: chest infection) |
| Chest Pain | Any patient complaining of cardiac chest pain | If patient has no medication, has never experienced chest pain before or symptoms last more than 10 mins |
| Choking | Any patient requiring back blows/chest thrusts that doesn’t rapidly improve with clearing of the obstruction | Any patient who becomes unresponsive |
| Diabetes- HYPO | For known diabetics, monitor resolved hypoglycaemia for 24hrs (provided patient does not have compounding issues- eg: trauma). Consider evac for relapse or first-time presentations | If patient shows no signs of improvement, relapses, has altered level of consciousness (including persistent behavioural changes) or becomes unresponsive |
| Diabetes- HYPER | All T2/NIDDM patients experiencing hyperglycemia in a wilderness setting; monitor T1/IDDM regularly and consult/manage according to diabetes action plan | Altered level of consciousness, unresponsive |
| Seizures | For known epileptics, monitor resolved seizures for 24hrs (provided patient does not have compounding issues- eg: trauma). Consider evacuation for relapses | Seizures related to head injury, trauma, unknown causes or lasting longer than 5 mins. Evacuation for ALL first-time seizures |
| Stroke | RAPID | Any patient who ‘fails’ the F.A.S.T test |
| Bleeding- External | Controlled bleeding with associated unstable vital signs | Any patient requiring a tourniquet or haemostatic dressing |
| Bleeding- Internal | All patients with suspected internal bleeding | Immediate evacuation for internal bleeding with compromised vital signs |
| Burns | Partial thickness burn greater than 10% of TBSA; Any full thickness burn | Major 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 + Wounds | Related to patient comfort and logistical considerations- should be considered for any patient showing signs of localised infection | Any patient with signs of systemic infection |
| Head Injury | All 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 headache | Any persistent decreased LOC or deterioration |
| Limb + Joint Injuries | Directly related to patient comfort and logistical considerations- should be considered for any patient with uncontrollable pain levels or persistent dislocation | Any patient with signs of distal hypoperfusion |
| Penetrating Injury | Any patient with a penetrating injury | Any patient with signs of shock or breathing problems as a result of injury |
| Bites and Stings | Directly related to patient comfort and logistical considerations- should be considered for any patient with uncontrollable pain | Any patient with systemic effects, breathing or circulatory problems. Any patient who requires a Pressure Immobilisation Bandage |
| Hypothermia | Any patient that doesn’t respond to rewarming interventions | Persistent moderate/ severe patients |
| Hyperthermia | Any patients that don’t respond to cooling interventions | Altered LOC or seizing patients |
| Hyponatraemia | Any patients that don’t respond to cooling interventions | Altered LOC or seizing patients |
| Lightning | RAPID | Anyone suspected of a lightning strike injury |
| Drowning | RAPID | Anyone suspected of a drowning episode |
| Altitude Emergencies | Descent for all patients showing persistent signs of AMS lasting longer than 24 hours | Rapid descent for all patients showing signs of advanced AMS (HAPE, HACE), breathing problems or decreased LOC |
| Diving Emergencies | RAPID | Pain or breathing issues after diving, any altered LOC, any complications of rapid ascent |
| Avalanche Emergencies | RAPID | Any patient that has required rescue (self or bystander) following an avalanche emergency (possible unknown internal injuries) |
| Mental Health | Patients who show a deteriorating level of mental health where responder intervention does not improve situation | Any patient at risk of harm to themselves or others; suicidal ideations; psychotic episodes |