Wilderness emergency assessment of the patient: Initial assessment

The primary survey of the wilderness emergency medicine patient needs to include an initial survey of the environment. The aspects to consider here are:

• Immediate hazards in the environment and what needs to be done to protect the rescuers and the victim
• Environmental support and mitigation: what can the environment offer by way of assistance in the care of the patient's primary survey needs and how can you use the environment to mitigate the risk against worsening of the patient's vital signs (eg thermoregulatory control)
• Long-term hazards that will create obstacles to the on-going care of the patient whilst awaiting evacuation
• Environmental management to support the patient during the waiting period whilst awaiting evacuation (shelter, warmth, food etc) (Consider the survival Maslow's hierarchy of needs)