Wecome To RVs and OHVs

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Monday, March 8, 2021

Getting Emergency Medical Services (EMS) When You Need It When Camping or Boating

We are so very fortunate to have highly qualified Emergency Medical Services readily available to us most of the time.  However, the further you go off grid in your recreational pursuits, the harder it will be contact them and the longer it will take for them to get to you -- if they can even find you!  One of the most frustrating things I experience as a volunteer firefighter is not having good information about the nature of an incident and where it is.  Our designated coverage area includes many miles of highway, forest, river, and lots of campgrounds.  Fortunately modern cell phones with GPS can sometimes be used to locate a caller and hopefully they are near where help is needed.  I've even seen them used to track lost hikers and guide rescuers right to them!  But I have also seen situations where the GPS we got was far from the site of an accident along the highway.  Callers often have to go some distance to get a signal and not all pieces of electronic equipment are equally accurate.   If your pursuits take you into remote areas and many of our outdoor activities like hiking, camping, OHV riding, horseback riding do, it will be even harder for EMS personnel to reach you or even find you!  In some locations you will find it hard to even get a signal to make that most important 911 call.  It behooves you to know how to contact emergency medical services and how to help them find you!

As a volunteer firefighter and EMR (Emergency Medical Responder) I am acutely aware of the dangers lurking in outdoor recreational activities and the difficulty involved in getting emergency help when needed.  Too often our response is delayed by incomplete or inaccurate information about the situation -- or by how long it takes for someone to finally make the call.  Sometimes delays are unavoidable, e.g., the caller must travel some distance before they get cell service.  But sometimes people just wait too long before reaching out for help.  My advice, is always call sooner rather than later.  First responders would rather go on a dozen calls where they might not even be needed than have someone suffer or even die because they weren't called soon enough.   When participating in outdoor recreational pursuits, especially when going off road or off grid, plan ahead for how you will respond to an emergency if someone becomes sick or injured and needs medical attention.  Know where you will have to go to get cell phone service or obtain other assistance.  In some remote locations you may have to go to a ranger station to get help.  Sometime you can get cell service by going to the top of a hill or driving back closer to the nearest town.  Know where you have to go to get a signal so you don't waste critical time searching for one.  Seconds count in a life-threatening emergency!

Off shore boaters may be able to avail themselves of assistance from the Coast Guard, but sailors on inland waters may have to rely on park rangers and other local emergency response services.  Navigable lakes and rivers are often some distance from the bases from which emergency services operate and not all emergency service departments have boats to respond to marine emergencies.  Boaters often need to return to the dock or shore to meet emergency responders.

Campers, RVers, OHVers, boaters, and other outdoor enthusiasts often find themselves a long way from towns that have Emergency Medical Services.  Unfortunately, the kinds of activities we are often involved in increase the chances that we will need EMS.  Riding OHVs, working around campfires, maneuvering RVs and trailers, operating boats, rock climbing, and even just hiking can expose us to injuries we would not encounter at home.  At home it is pretty easy to dial "911" and get a quick response to get the help we need.  And then the time to reach the Emergency Room is usually pretty quick.  When we are out and about we may not have ready access to cell towers to even make the "911"call and once we do it will probably take some time for EMS resources to reach us, even if we give them good directions to our location.   Then it may take along time to transport the patient to an Emergency Room for treatment.  Thus it behooves us to make sure we know where to go to be able to make a call and how to help EMS find us.  Our rural fire department frequently makes use of Life Flight helicopters because we are 45-60 minutes away from any hospital.  In our area we have an insurance plane called FireMed that covers ambulance services and their premium service covers Life Flight.  You may want to obtain similar insurance in case you need efficient transport to the nearest medical facilities.

Today we all rely heavily on cell phones for basic communicationThe good news is that cell phones often have service in areas where there were never any land lines.  The bad news is that there aren't always cell towers near enough our outdoor activities to get service.Knowing where you have to go to get cell service just might mean the difference between life and death for an injured person.  Alternatives to cell phones might include CB and HAM radios that don't rely on cell towers.  Sometimes you can reach someone on the radio who has access to a telephone and can make that all important 911 call for you.  So, having and knowing how to use personal two-way radios could be a great advantage in an emergency.  CB channel 9 is the emergency channel but it is not as commonly monitored as it once was.  CB channel 13 is the unofficial RV channel.  However, the channel most commonly used by truckers is channel 19 and it has the best antenna efficiency so you might have better luck finding someone there.  You might be able to reach a trucker who is able to call 911 on his cell phone for you.  Be sure to give him the right information:  the nature of the emergency and the location, as correctly and concisely as possible.

Cell phone boosters are available that can extend the area of service for your cell phone, turning weak signals into usable signals.  Unfortunately they can't create a signal where there is none.  Cell phone boosters are kind of pricey, but you might find it worth the investment.  If you have anyone in your group that has any special medical conditions that might require fast emergency response, a cell phone booster might be a good investment.

Unfortunately, we face both higher chances of mishaps and slower EMS response times when we are camping or involved in other outdoor recreational pursuits.   Therefore we must be prepared so we can do our best to care for ill or injured companions and to expedite getting help for them when needed.  We can prepare ourselves to be able to care for sick or injured companions through basic and advanced first aid training, as frequently mentioned in this blog.  But we should also take steps to ensure we can expedite reaching EMS services and helping them to reach us.

There are a few things you can do to be better prepared if you do need to call EMS in a remote location.  First of all, I suggest you keep an eye on your cell phone reception as you approach your campground so you know where to go if you need to make an emergency call.  When boating, check your cell signal as you leave the dock.  Sometimes emergency calls can be made in fringe areas with weak signals, but just to be sure, know where you can get cell coverage when you need it.  Getting up on a hill top can sometimes help as it may get you above obstacles that would block the line-of-sight radio signals from the cell tower but if that isn't enough you should know how far back down the road you need to go to get cell service so you don't waste time searching for a signal, especially if you operate in waters.  Sometimes a cell phone booster in your vehicle and amplify cell signals in outlying areas.  Such systems typically cost several hundred dollars and will only work to boots weak signals, not get you a signal when there is none.  If you REALLY need remote access at all times you might consider a satellite phone, but those are still quite expensive to purchase and to operate.  Boaters may want to consider marine-band radios to expedite requests for emergency services, especially if you operate in waters under Coast Guard jurisdiction.    Land lubbers and boaters on inland waters may benefit from ham radios or even CB radios in some places.

Next, be prepared to provide accurate and concise directions so the 911 or other emergency response operator/dispatcher can tell the EMS team how to find you.   If you are in a developed campground, the name of the campground and your site identification should be sufficient to locate you.  However,  if you are in a dispersed camping area or out on a trail without clear landmarks to aid the EMS teams to find you, give the "911" operator the very best directions and distances you can.  You might be able to get geographic coordinates of your position from your cell phone or GPS and that would be helpful to emergency personnel trying to locate you.  If possible send someone down to an identifiable road or intersection to flag down the EMS vehicles and guide them to your location.  Be sure to give them a good description of your vehicle, tent, or other distinguishing characteristics of your camp site.  When boating always carry appropriate warning devices such as distress flags and flares.  Flares may be good for getting attention but are by nature, short lived.  Distress flags can be displayed throughout an emergency to alert other boaters to your need and guide  potential rescuers to you.

When you call "911" do your best to remain calm.  Think about what you need to tell them:  the nature of the injury or illness, when it happened or started, the age and gender of of the patient, and precise instructions for where you are and how to find you.  Also share any special circumstances, such as pre-existing conditions or physical disabilities your patient may have as that can have implications for responders.  You will probably we worried, frightened, excited, possibly somewhat flummoxed.  The hysterical reports 911 operators sometimes receive can be difficult to understand and can delay getting the response you need.   Try to be as calm and collected as possible so you can help them get you the help you need as quickly as possible.   Be prepared to listen to the instructions you are given by the 911 operator and carry them out exactly as given.  They are trained to provide proper directions for how you can best assist your patient until help arrives and help the EMS team get there as quickly as possible.  Be sure you understand the instructions you receive.  There is the story (fictional I hope!) about a hunter who calls 911 because his hunting buddy is was shot and he thought he was dead.  The 911 operator told him they should first make sure he was dead.  There was a short silence followed by a gun shot, then the hunter replied, Yes, I am sure he is dead!  I'm sure that wasn't what the 911 operator intended!  911 operators can often provide you with important, even life-saving, instructions.  Be prepared to do what you can until emergency services get there.

In some cases it may be beneficial to provide a signal to aid incoming responders.  In the day time that might consists of a brightly colored flag raised to where it can be easily seen from nearby access roads.  Or you might build a signal fire and load it up with green branches or leaves to create a column of smoke.  At night a large signal fire or flashing vehicle lights or flashlights can be helpful to responders who are trying to find you.  If you use a signal, be sure to let the "911" operator know what you are using so they can pass it along to the response team.  Just having someone stand where they can be seen from the road and jumping up and down and waving their arms can help rescuers find you.  Boaters will need to display distress flags or flares.  Aerial flares can be seen from a long distance but are fairly short lived.  Hand held flares can only be seen line of sight but usually burn for several minutes to help approaching responders to identify and locate you.  Displaying a proper distress flag throughout the duration of an emergency should be standard procedure.  Having someone keep an eye out for approaching responders and waving a bright colored flag (or shirt or jacket) to attract attention may be helpful.

Once you have called "911" stay with the patient at the location you gave the operator unless being there puts you and/or your patient in immediate danger.  If you must move, either notify the 911 operator, leave someone to tell EMS where you have gone, or keep your original location in sight.  It is usually best not to try to move an injured person before help arrives unless it is absolutely necessary.  Comply with all instructions you receive from the 911 operator to the best of your ability.

If you frequently visit places with little or no cell phone reception you might want to explore the options for boosting your cell signal.   Cell phone signal boosters are not cheap (several hundred dollars) but it still might be a good investment if you are often outside normal cell range.  If you or anyone in your regular group has been diagnosed with medical conditions that might make getting EMS help quickly a necessity, a cell phone booster may be well worth the cost.  Satellite phones are not dependent on cell towers and, since the transceivers for them are orbiting miles above the earth, they are usually not affected by mountains either.  Satellite phones are, however, still pretty darned expensive.  Phones start around $599 and can go up to thousands of dollars.  Plans start around $70 a month for 70 minutes of talk time.  You probably wouldn't want to use it for casual calls but it could be life saving to have those 70 minutes in a remote location.  Anyone with a high risk medical history or involved in high risk activities in remote locations should seriously consider getting a satellite phone for emergency use. If you have both high risk conditions and are involved in high risk activities you should probably consider a satellite phone as essential!

Another option for high risk situations is to carry a personal locator beacon.  A personal locator beacon, or PLB for short, is a personal electronic transmitting device that is designed to alert potential rescuers to a life-threatening situation in the air, on water or in remote areas.  They typically start a little north of  $200.  Higher priced units have more features.  All PLBs must be registered (free of charge) in the NOAA SARSAT (Search and Rescue Satellite Aided Tracking) database to become active.  Once triggered during an emergency, the unit sends an SOS that alerts rescue teams to your exact location and tells them it is an emergency, likely life-threatening, situation.  PLBs don't require a monthly subscription.  Since you only turn them on when you need to send an SOS the batteries last a long time, up to 5 years.  When batteries need to be replaced the unit must be returned to the manufacturer for replacement.  Batteries should also be replaced after a unit has been activated.  I have heard that most manufacturers will give you a new unit if you have to activate one for a life-saving rescue.  Boaters sometimes use an Emergency position indicating radio beacons (EPIRBs), but they are quite a bit bigger and more expensive than PLBs and are usually only found on larger boats used in off-shore cruises.

Of course another option is for you -- or someone in your group -- to get certified in Emergency Medical procedures.   Even if EMS can reach you fairly quickly, having proper training can be useful until they get there.  Being able to provide appropriate immediate assistance can significantly reduce suffering and minimize complications. Sometimes it is even life saving!  If EMS personnel are far distant or delayed it is even more important for you to have qualified help with you.  Throughout my off road career I have endeavored to maintain first aid and CPR certification and more recently have obtained certification as an Emergency Medical Responder (EMR).  An EMR is the first level of EMS and historically was called first responder.  If you are involved in any kind of outdoor activities where serious injuries may occur you should know how to recognize and treat life threatening bleeding and to be able to identify and splint broken bones.  Those skills could well be life saving!  EMR training does not require the hundred of hours you need to become an EMT or paramedic, but it does give you the skills you need to provide appropriate treatment until a higher level of medical support arrives and that will provide your patients a lot of comfort and may even be life saving.  I have never personally provided life saving treatment to a fellow off roader but I have splinted broken bones and prepared patients for transport and am thankful I have the training to recognize and respond to life threatening situations if necessary.

Get the help you need help when you need it!

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