When to Call — or Not Call — for Help During a Wilderness Emergency

Todd Mullenix

April 11, 2024

In wilderness or the backcountry, bad things can happen to even the most experienced of adventurers. Truth is, most illnesses and injuries on the trail can be managed by the adventurer, or with the assistance of someone possessing some training in wilderness medicine

Of course, some injuries and illnesses do pose a threat to life or limb, and in other cases, the person — who for our purposes we’ll call our “patient” — may not even survive without professional medical intervention. It’s those situations in the grey area that leave many outdoor adventurers wondering, Do we call for help or not? You maybe conflicted for several reasons: pride or overconfidence, embarrassment or reluctance to admit weakness, misjudging the severity of the situation, concerns over medical costs, or perhaps you lack an effective means to contact emergency services.

As the ancient adage suggests: “He who hesitates is lost,” and the objective of this post is to equip you with the knowledge and insight needed to arrive at the right decision faster. Here, you will learn when to call for help, the type of help to call for, and the various means of communication you can use to call for help.

Important! Before embarking on any wilderness or backcountry adventure, leave your itinerary with a trusted individual, along with instructions to contact emergency personnel in the event that you fail to return or call on the scheduled date of your return. If you need a visual on how important this is, watch the 2010 film 127 Hours, which vividly illustrates the torment suffered by Aron Ralston, the rock climber who was forced to amputate part of his own right arm after it was pinned between rocks in an isolated canyon in Utah.

Deciding When to Call for Help In The Wilderness

When you or someone in your group suffers a serious illness or injury, toss your emotions aside and focus on the following factors in deciding whether or not to call for help:

  • The severity of the illness or injury: Bad fractures, deep wounds, head or spinal injuries, severe allergic reactions, heart attacks or strokes require immediate professional medical intervention.
  • Available resources: These include your own knowledge and skills along with those of others in your group, available first-aid supplies and medicines on hand, and your ability to transport the patient. If you lack the resources to handle the situation, call for help.
  • Distance to medical assistance: In a remote wilderness area far from medical help, the decision to call for assistance should be sooner rather than later.
  • Accessibility to your location: Consider the difficulty emergency responders are likely to face reaching your location. Account for time of day, terrain, and weather conditions. Depending on the situation, determine if you would be better off sheltering in place or calling for a rescue.

Calling Sooner Rather Than Later

Keep in mind that you don’t necessarily have to call for a rescue or evacuation when you are facing a medical situation you feel ill prepared to handle on your own. You may simply need professional medical guidance, reassurance, or to let emergency medical personnel know where you are and that you may require assistance if the situation worsens. Most emergency medical systems prefer to be contacted sooner rather than when the situation has become a CodeRED emergency.

Exploring Available Means of Communication

Dealing with a medical emergency in remote wilderness settings is often hampered by communication limitations, including no cell phone signal. That requires a little pre-planning. So, before heading to a remote location, explore your communication options:

  • Cellular phone: Voice and text are ideal if you can get a signal. Texting is often more reliable than calling, so even if you can’t connect via voice to a local emergency system, you may be able to get a text out to someone.
  • Satellite phone: Satellite phones are expensive, but they allow you to make phone calls in remote areas where cell phone service is unavailable. Renting a satellite phone might offer an affordable option.
  • Radio: A two-meter amateur ham radio enables you to communicate via voice over emergency frequencies within about 100 miles. These radios are affordable, but you must be licensed to use them. Radios are becoming more commonly used by climbing teams but are limited to specific frequencies. Search and rescue systems could include a radio in a rescue cache to be accessed in times of need.
  • Satellite location beacon: Emergency satellite beacons, including Spot and In Reach devices support various methods of communicating a problem to emergency services.
  • Avalanche beacon: These devices are helpful for locating anyone in your party who gets buried in an avalanche. The device is tuned to receivers carried by other members of the party.
  • Sending a runner (preferably two) to call for help: If you don’t have a more modern means of communication but have members of your party not needed to care for or transport the patient, consider sending one or more people to a location where they may be able to contact emergency services. For example, you may be able to send a runner with a cell phone to an area that is within range of a cell tower.
  • Audio/visual signaling methods: When modern communication devices fail to meet your communication needs, try going old school with whistles, fire, SOS, mirrors, or other means of attracting attention. These signaling methods come in many forms but all have limited range. Most are implemented when a rescue has already been initiated.

You Make the Call

Imagine yourself hiking in a remote wilderness setting with two other backpackers when one of them tumbles 100 feet down a 45-degree slope. She is alert but has suffered a closed-head injury and cannot recall falling. She has visible deformities to both ankles and reports experiencing waves of dizziness.

Ponder the unknown factors in this scenario when deciding whether to deal with the situation yourself or call for assistance. After you make the decision, consider your available means of communication and the type of help you would request, if any.

Conducting a mental exercise such as this enables you to evaluate your preparedness for similar situations and envision your response. If you become overwhelmed just thinking about it, that might be a sign you would benefit from wilderness medicine training.

One of the primary benefits of attending a high-quality wilderness medicine course is the experience gained in participating in a systematic assessment system that determines patient status and makes transport decisions. A secondary benefit is the muscle memory gained through repetitive scenarios guided by an experienced instructor.

Hope for the Best, Prepare for the Worst

Whenever we head into the wilderness and engage in the outdoor activities we love, we knowingly increase our exposure to risk and danger. Our hope is that we make it through without suffering severe illness or injury, and that we can deal with any incidents without outside assistance. However, when circumstances arise that are beyond our capabilities and resources, we need to be ready, willing and able to bring in assistance. Hopefully, this post encourages and empowers you to increase your preparedness for obtaining any assistance you need to deal with unforeseen medical events.

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About the Author: Todd Mullenix is the Director of Wilderness Medicine Education at The National Center for Outdoor & Adventure Education in Wilmington, North Carolina.

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