You are the trip leader for a two-week high school snowshoe trip in the Adirondack mountains of New York state. It's day four. There was six inches of new snow on the forest road at the beginning of the trip. Last night it snowed three feet and it is still snowing hard. Looking closely at your map you realize that your original route crosses a few potential avalanche paths. After talking it over with your co-leader and considering the ever-increasing snowfall, you decide to reverse your route and head back. You have no satellite or cell phone reception during the storm.

After a day of struggling through the deepening snow, everyone is exhausted and wet from either sweat or snow when you reach your evening camp. You notice that two 16 year-old girls are particularly tired and shivering.

What are your concerns and what should you do? Click here to find out.

You are a trip leader on a five-day winter break backpacking trip in Linville Gorge, NC. It's day three of the trip when the gorge is hit unexpectedly with 14 hours of freezing rain. The rocks, trails, and trees are covered with an inch of ice; numerous trees have fallen, leaving the trails littered with trees and tree limbs, further increasing the difficulty of foot travel.

You are camped at the bottom of the gorge and scheduled to be picked up at 10 AM on the fifth day. To reach the pick-up at the scheduled time, you need to hike most, if not all, of the day.

What are your concerns and what should you do? Click here to find out.

A 35 year-old man hits a tree while skiing out of bounds. Bill is awake, alert, and reliable but fails your focused spine assessment due to cervical pain (8) and tenderness with no neurological deficit. Ski patrol is available to assist with transport via a Cascade toboggan and snow mobile. Estimated arrival to scene is 45 minutes and transport to an ambulance is expected to take another two hours with arrival at a local hospital in another hour. Total response and transport time to the hospital is estimated at roughly ± 4 hours. The outside temperature is 22º F and the patient has additional thermal layers in his pack. His remaining injuries are compatible with self-evacuation.

Geoff Jones, 52, is swept away in a medium sized soft snow avalanche while skiing in the backcountry. He travels approximately 400 feet and is recovered partially buried. He is awake, alert, and reliable with cervical spine pain and tenderness. He reports a tingling, electric-like pain in his right arm when his neck moves; he cannot distinguish between pinprick pain and light touch on his right hand; and, there is noticeable weakness on his right side when executing the motor exams on his hands. His remaining injuries are compatible with self-evacuation. There is no cell service and no one in the group is carrying bivy equipment with them or on their snowmobiles six miles away. Help is roughly twelve hours away. It's 3:30 pm in mid-January; sunset is within the next hour. The current air temperature is 21º F. Clouds are moving in, the wind is picking up, and it looks like it's going to snow.

Should you keep Geoff quiet and immobile and go for help or begin a self-evacuation? Click here for answers.

You are leading a week-long backpacking trip for a local high school. During the night a cold front with high winds passed through breaking tree limbs and blowing down trees. A six-inch limb split off an overhead tree and landed on a student tent, hitting one of the students a glancing blow on his head while in his sleeping bag.

When questioned, James said the storm had just woken him up when  something hit the tent, collapsed it, and hit him in the head through his sleeping bag. The commotion woke his tent mate and together they managed to push the branch off the tent. They came to get you because James said he had a headache and a big lump on his head. Other than the lump and a headache (3), James says he feels okay. He has no spine pain or mid-line spinal tenderness, normal motor and sensory exams on his hands and feet, and no tingling or electric shooting pain in his arms or legs. His skull feels intact beneath the swelling.

What is wrong with James and what should you do? Click here to find out.

You and two friends are riding an old mountain bike race course when you reach a gnarly downhill section. You elect to slide down the section with your bike and take photos. One of your friends manages to successfully ride down. Unfortunately Jack hits his front breaks too hard, flies over the handlebars landing on his head, neck, and shoulders, then slides with his bike another 50 feet to an open, dry wash at the bottom of the slope.

When you reach him, he is sitting up holding his side and having difficulty catching his breath. After a few minutes, he calms down and is able to breath as long as he doesn't try to take a deep breath and breathes with his diaphragm. Jack's helmet is intact and he is able to recall his entire fall. He says he landed hard on his handlebars and thinks he broke a rib low on his left side. Road rash covers most of his back where his jacket slid up during his slide and small pieces of gravel is embedded under portions of his skin; it looks nasty but Jack said it doesn't really hurt. Jack's pulse rate is 88 and regular; his respiratory rate is 22 and easy; he reports that his normal pulse rate is in the low 50s.
It's 3 pm, overcast and cool, about 50 degrees F; the sun sets about 7:30 pm. You have a small first aid kit, some water, food bars, but no additional clothing. Nighttime temperatures have been in the low 40s. You are roughly six miles from your vehicles over challenging terrain and another two hours to the nearest clinic. You have cell phone reception.

What is wrong with Jack and what should you do? Click here to find out.

You and your partner are planning a three day canoe trip with your five year-old son. He has been car camping multiple times over the past two years and enjoys sleeping in a tent and playing outside. He has also been in a canoe on a small lake near your home in northern Florida multiple times last summer and enjoyed it. You are considering taking the trip on 30 mile stretch of river with moving water and some Class I rapids. You and your wife are proficient expedition canoe paddlers with a number of 2-3 week trips in your resume and are comfortable paddling a loaded canoe in easy Class III whitewater.

What should you keep in mind as you prepare for the trip? Click here to find out. Click here to read a blog article about keeping children safe in the outdoors.