Mountain Emergency Care: Dr. Naomi Gough's Methodology
In the breathtaking yet unforgiving landscape of New Zealand's alpine backcountry, emergencies can occur without warning. Dr. Naomi Gough, a recreational climber and medical doctor, shares her insights on how to respond to such situations effectively.
First aid practices in these remote and challenging environments require a unique approach. The unpredictable weather, the isolation, and the distinct risk profile all play significant roles. Common survivable injuries in a fall include head trauma, and Dr. Gough, following the DRSABCD (Danger, Response, Send for help, Airway, Breathing, CPR, Defibrillation) algorithm or any other first aid algorithm she is familiar with, prioritizes the patient's safety and wellbeing.
The New Zealand alpine backcountry presents a reduced risk of fevers, illness from extreme altitude, heat, or cold compared to many other alpine settings overseas. However, the isolation demands careful planning for evacuation and communication protocols. If someone has a suspected spinal injury, they should be repositioned flat on their back in a safe location, away from falling debris, and if possible, moved to an accessible evacuation point.
Advanced skills, a team approach, and specialized equipment are essential in alpine first aid. The use of gear such as avalanche transceivers and advanced splints may be necessary. The climbing kit itself can have multiple uses, from makeshift stretchers and tourniquets to thermal mats and visual aids for search and rescue.
In the event of a head injury, Dr. Gough emphasizes the importance of creating a shield for the eye and protecting the other from injury. For injuries like fractures or major arterial bleeds, the most likely opportunities to help in remote areas are early identification, calling for help, prevention of hypothermia, and managing less serious injuries.
Dr. Gough's approach to first aid care when someone is injured in a fall is adapted from the principles of the Joint Trauma System. Her priority following an accident is to avoid preventable death, not just for the injured person, but for the whole group at the accident scene and the incoming rescue party.
In remote areas, the most likely opportunities to help often lie in early identification, calling for help, prevention of hypothermia, and managing less serious injuries. Serious injuries such as major arterial bleeds or airway issues that require active management may be considered non-survivable due to limited resources.
Dr. Gough's advice is clear: be prepared, know your environment, and act quickly. The most responsible action is to prevent accidents, and in the event of an emergency, the right knowledge and quick action can make all the difference.
This article is kindly written by Dr. Naomi Gough, FAFPHM MBBS. A special thanks to Martin Vaclavu for the photo used in this article.
In the realm of health and wellness, Dr. Naomi Gough's expertise in alpine first aid extends to fitness-and-exercise activities like sports, where injuries can occur without warning. She employs therapies-and-treatments such as the DRSABCD algorithm and principles from the Joint Trauma System to respond effectively to medical-conditions like head trauma in such remote settings. From sports-analysis to wilderness medicine, Dr. Gough stresses the importance of preparedness, environmental understanding, and swift action to ensure safety and survival.
