Wilderness on the Highway

by | Aug 2, 2021 | Wilderness Medicine Case Studies | AWLS

Because “Wilderness” is defined as a situation more than one hour from definitive medical care, you can certainly encounter a wilderness situation along the highway. Consider this case of a holiday drive home.

What’s Your First Responder Priority?

It’s 29 degrees outside and the wind keeps howling. Your grip tightens on the wheel.

You were able to take the day off and head home for holidays, but seven hours into the trip, lumbering snowflakes crowd the windshield. You would have just cut across Pennsylvania, but the turnpike was a mess of accidents when you left, so here you are on Interstate 90.

Up ahead you see flashers – one car alongside the road, a second car in the ditch with steam rising from the front. A man near the road is waving to you – flagging you down for help.

You decide to respond.

What is your first priority in responding to this accident?

A.  Use MARCH to quickly conduct a primary assessment.

B.  Take a brief history from the other responder.

C.  Look for other victims

D.  Ensure your personal safety

E.  Determine if 9-1-1 has already been called.

Correct Answer: D – ensure your personal safety. 



Personal safety is your primary concern in any accident response. In this case, safety begins with your selection of a spot to park your vehicle. If responding road-side, park as far off the road as possible with adequate distance (100ft) from the accident; avoid being crushed by a vehicle if there are subsequent collisions. The other answers are all important, but each in their due time. Scene safety and assessment is essential: go through systematically, every time.

  1. Am I safe?

I’m number one. Am I safe now, will I remain safe throughout response?


  1. What could have happened, to you?

Two is you. What does it look like happened? Mechanism of injury? Further threats such as animals?


  1. How can I protect myself?

Three is BSI. Body substance isolation and protection from the elements is essential to keep a responder active in the field.


  1. Are there more victims?

Four is more. Don’t fixate on the obvious: survey the area.


  1. Do they look dead or alive?

Five is alive. With multiple victims, this is the beginning of your field triage assessment.



Ingebretsen, Richard, and David Della-Giustina. Advanced Wilderness Life Support: Prevention – Diagnosis – Treatment – Evacuation. Boulder: 2013, Ed 8.1. Print.