Accident Management

Portland Mountain Rescue

Scott Branscum (He/Him) and Teresa Dalsager (She/Her)

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ICS 2025-26

Accident Management - ICS 2025-26

About us…

Scott

Climbing Experience

Mountaineering experience

PMR experience

Accident Management - ICS 2025-26

About us…

Teresa

Climbing Experience

Mountaineering experience

PMR experience

Accident Management - ICS 2025-26

DISCLAIMER

This is not a substitute for proper first aid training, nor does this prepare you to be a rescuer.

This session’s objective is to prepare you for real-life scenarios regardless of your training or rescue knowledge.

We strongly encourage you to seek further first aid training.

Accident Management - ICS 2025-26

Agenda

1. Before something happens
2. Something happened, now what?
1. Scene Safety 101
2. Stay put or leave?
3. Calling for help
4. What to do while you wait
5. Basic patient care
6. Psychological first aid concepts

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• Additional Resources & Local SAR you can volunteer for (PMR & beyond)

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Accident Management - ICS 2025-26

1. Before something happens…

Before the expedition

• Align on group goals
• Identify risk factors (including human)
• Consider your team’s rescue/first aid skill level when planning a trip
• Safely disclose medical conditions and emergency contacts
• Plan for special gear:
• 10 essentials
• Emergency shelter
• First aid kits
• Communication devices

The day of the expedition

• Green/Amber/Red
• Gear Check
• Define team roles
• Discuss where important things are
• Continuously monitor hazards and conditions

Accident Management - ICS 2025-26

Green Amber Red

A simple process to make sure everyone has the chance to weight in before heading out.

Accident Management - ICS 2025-26

2. Something happened�Now what?

💩 ➡️

Accident Management - ICS 2025-26

2.1 Scene Safety 101

The key question: To rescue or not to rescue

Accident Management - ICS 2025-26

2.1 Scene Safety 101

To rescue or not to rescue???

1. Is it safe for you/your group? For the patient?
2. Situational awareness
3. Be resourceful within your scope of practice
4. Focus on what you know - not the time to try something new
5. Liability considerations - Good Samaritan laws

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Accident Management - ICS 2025-26

Self-Rescue vs. Professional Rescue

Self-rescue uses only the people in your

party and the equipment you are carrying

You can ask nearby parties for help

Key consideration: Will self-rescue cause the patient’s condition to deteriorate more than a wait for professional rescuers?

Time, resource limitations

Help yourself while waiting for help:

• Leader to organize your party
• Move to safety

Accident Management - ICS 2025-26

2.2 Stay Put or Leave

Should I stay or should I go? Let’s talk about it.

Is it safe/possible to self evacuate?

• #1 Rule -> Don’t create more patients
• Almost always the faster option
• Is the mechanism of injury head/spinal injuries?

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Stay put once rescue is on the way (unless instructed otherwise)

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Accident Management - ICS 2025-26

Activating Search and Rescue

Initiate emergency: 911, PLB, radio, flare, etc.

• Calm, clear and concise report of emergency
• Location to best of knowledge
• Follow direction

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The Sheriff is responsible for all Search and Rescue and will determine what resources are needed based on your report.

Move only if your situation requires it while communicating your plan with SAR.

Accident Management - ICS 2025-26

2.3 Calling for Help

Expected timeline:

Accident happens

Accident Management - ICS 2025-26

Rescue Timeline

PMR often has Ready Teams on the mountain during climbing season to shorten response time

Is your team prepared to be self-sufficient for at least 5 hours?

WFA/WFR or higher medical training

Move away from hazards

Take care of the patient and yourself

Accident Management - ICS 2025-26

Rescue Timeline Continued

Total time of 9-13 hours until rescue concludes – can be much longer

Difficult location can delay even further

Bad weather can delay response and make it harder to keep your team safe

Accident Management - ICS 2025-26

2.3 Calling for Help

• When reporting a mountain accident to the sheriff, provide the precise location (GPS coordinates, trail name, or landmarks), the nature and severity of injuries, the time of the incident, and the number of people involved.
• Report weather conditions, terrain, current medical care being provided, and identifying information (clothing/gear colors) for rescuers. 

Accident Management - ICS 2025-26

Wilderness SOAP Notes

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• Subjective
• Objective
• Assessment
• Plan

Accident Management - ICS 2025-26

2.3 Calling for help

Verbal SOAP note for 911 comms

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Breakout session

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Accident Management - ICS 2025-26

2.4 While you wait…

• Create shelter for the subject and/or rescuers

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• Care for and monitor the patient

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• Make sure everyone is eating and hydrated

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• Provide emotional support to the patient and the other participants

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• Prepare for SAR arrival/possible helicopter evacuation

Accident Management - ICS 2025-26

2.4 While you wait

Shelter/unplanned bivy options & gear

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Accident Management - ICS 2025-26

2.4 While you wait

Prep for helicopter landing zone

• The National Guard will determine where to land
• Anchor personal gear – hats, etc.
• Don’t approach

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Accident Management - ICS 2025-26

2.5 Basic patient care

1. Basic First Aid Kit
2. Keep Warm & Dry (or cool/shaded in the summer)
3. Hypowrap and Vapor Barrier – Homework Discussion
4. Cold Injuries – Homework Discussion

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Accident Management - ICS 2025-26

2.5 Basic patient care

e. Be mindful of pain; find position of comfort

f. First aid certifications – resources in homework

g. Evac/short move i.e. to helicopter LZ (only if no suspected spinal injury OR immediate life threat)

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Psychological First Aid – continuously connecting – creating calm

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Accident Management - ICS 2025-26

2.6 Psychological First Aid Concepts

• The “Patient advocate” role – immediate emotional, practical support. A calming liaison to reduce long-term trauma
• Critical Incident Stress Management as a resource (CISM)

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Accident Management - ICS 2025-26

Psych First Aid for Patient

5 Principles of PFA Care

1. Safety

2. Calm

3. Connect

4. Self-Efficacy

5. Hope

*Language matters…know your audience

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Accident Management - ICS 2025-26

After Incident Debrief

• No judgments – learning opportunity
• Key takeaways – what we would do different next time
• CISM is a resource – always helpful

Accident Management - ICS 2025-26

3. Additional Resources

Local SAR teams VRT, OHSTAR, Crag Rats, Mountain Wave, Multnomah County SAR, Clackamas County SAR, Skamania County SAR, etc.

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Accident Management - ICS 2025-26

Who is PMR?

• Volunteer based
• Members receive no compensation
• Operates under the jurisdiction of the County Sheriff
• Registered 501c3 Non-Profit organization
• Receives no government assistance
• PMR does not charge for rescues
• Funded entirely from private donations

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Accident Management - ICS 2025-26