Patient care techniques can have many different outcomes in regards to training, experience and applications used by the provider. In the wilderness environment this is seen during the transfer of care between, recreationalists to guides and guides to organized Search & Rescue. In other words, lay response to trained medical providers to highly trained emergency responders.

Regardless of the experience of the provider, the goal of patient care in the wilderness remains the same: Keep the patient warm, dry and comfortable while protecting from further injury and treating underlying injuries. The latter may be a tall order; managing injuries. Although, keeping a patient warm dry and comfortable and protecting from the environment is obtainable with the minimum training involved in a 16-hour Wilderness First Aid course, continued practice and a few common items you should already be carrying.

When serious injuries occur in the backcountry, supplies for appropriate patient packaging is often in low supply and high demand. At the Leadership Institute we have trained with and continue to modify techniques with common things you carry in the backcountry. These techniques when successfully implemented can and have provided more favorable outcomes for patients.

The equipment needed to provide care is a s follows:

  • 2 Backpacks – 30 Liter or larger, with waist belt and back padding
  • Light weight Guide Tarp or comparable – 8′ x 8′, Tent fly can be improvised for use
  • External Heat Source – 4 Heat Packs
  • Additional clothing for padding and insulation
  • Ground Insulation – Air mattress – optional on day trips
Common items you carry in the backcountry that can be used for environmental packaging in a wilderness environment. 2 backpacks, ultralight guide tarp and ultralight air mattress,

The goals of patient packaging are to provide insulation from the ground (backpacks), provide heat (heat packs), the ability to trap heat and provide a weather proof environment (tarp) while providing comfort (additional clothing and emotional support).

Alignment of backpacks and tarp with additional optional insulation

Additional features of this approach provide the option for the support of cervical spine and pelvic injuries.

Proper alignment of the waist belts allow for improvised support of the cervical spine and pelvic region.

The lightweight guide tarp is the one item most folks still need to add to their kit. While this works great as an improvised stretcher and patient protection it can also be used to bevy in the event of an unplanned night out. If you really get your skills together you can drop your tent all together in the summer and have a lightweight shelter. Thus this item become nearly indispensable to my kit on a daily basis.

Most serious injuries cause patients to thermoregulate improperly making it imperative to add an external heat source. While packaging the patient, add heat packs above the lowest layer of clothing to the armpits, chest and crotch. The tarp helps trap this life saving heat.

A lightweight guide tarp being used as a “Human Burrito” for environmental protection of the patient

While these techniques can be life saving they come with experience and training. Patients and providers can be exposed to significant risks while lifting and moving patients to achieve these outcomes. Be sure to have the proper training before implementing any of these techniques.

Be safe..and be well!