Outdoor Program Risk Management Case Study 1

Spring came early and warm temperatures precipitated an early run-off. Streams and rivers in the program area rose quickly. An instructor team with 10 college-age students were en route to their course end pick-up and were unexpectedly stopped by a flooded stream. The instructors were new to the course area and had no training in Swiftwater Rescue or high-water stream crossings; no emergency communication is available. After spending the night next to the swollen stream, they noticed that, although still quite high, the water level had fallen somewhat during the night and elected to attempt a crossing. During the attempt, one student was swept off her feet, into a fallen tree, and trapped under water against its branches. The rescue, although poorly conceived and extremely risky, was ultimately successful; however, the victim was recovered unresponsive with no pulse or respirations; and, her gear was lost. CPR was initiated and also successful; the patient recovered consciousness after 15 minutes with no memory of the event. One hour after the event she was warm, awake and alert with normal pulse and respiratory ratess, no spine pain or tenderness, and normal motor and sensor exams.

What were the administrative and site management errors, if any, that contributed to this incident? What are the patient's current and anticipated problems and what level of evacuation, if any, should be initiated? Click here to find out.

Don't know where to begin or what to do? Take our Effective Outdoor Program Design & Management workshop and one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course.

Looking for a reliable field reference for expedition medical problems? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available.