Wednesday, August 31, 2016

Training For Disaster (Part Three)

Preventative Search and Rescue (PSAR)

In this summer of 2016 I’ve been volunteering with the US Forest Service (USFS) as an Assistant Coordinator for Preventative Search and Rescue. I'm in a program of the USFS Recreation Office in Flagstaff, Arizona. The program is modeled after similar programs pioneered at Yellowstone National Park and Grand Canyon National Park. The program was piloted in 2015, so this is the first year of regular operation. It operates for 63 days, on weekends during the summer and fall seasons. The report on the pilot year of the PSAR operation is available here.

Our Flagstaff program is conducted in cooperation with the Friends of Northern Arizona Forests (FONAF), a 100% volunteer-based non-profit that works to preserve and protect the environment of the region. FONAF volunteers assist the Forest Service conduct PSAR duties plus. In addition FONAF conducts service projects such as trail building and other maintenance tasks throughout the Coconino National Forest. They are notable for building exclosures to fence out non-native elk from sensitive aspen tree groves until the trees grow to sufficient size and height to survive elk feeding on their tasty leaves and branches. In the winter FONAF also serves as the Forest Service’s representative for issuing wilderness back country travel permits. These permits are typically used most often by skiers and snow boarders that want to ski outside the boundary of the Arizona Snow Bowl.

So, what is Preventative Search and Rescue and ‘How does one prevent a search and rescue? The answer is more difficult than one might imagine. The answer goes well beyond simple preparedness for travel emergencies. To answer the elusive question I need offer a quick review of the long history of search and rescue.

The concept of preventative search and rescue (PSAR) is relatively new to modern government.
On the other hand, SAR has a long history dating back to biblical times. My observation from being a student of political science is that government is by its very nature reactionary, seldom proactive unless it wants to serve a member of the so-called 1%. PSAR has come into existence because of increased costs to government to save lives.

Look to history. In urban environments we’ve seen the evolution of fire and ambulance services. Citizens no longer run to the well with buckets to douse a burning building. The local barber no longer does tooth extractions and surgery. While still in existence in some rural areas, homeowners don’t pay a private subscription fee for firefighting companies to respond to emergencies because in the first world police, fire and ambulance services are seen as a core function of local government.

Nowadays, search and rescue units are no longer the exclusive operational domain of police and fire departments. Yes, they typically have training as Urban First Responders, but they are seldom involved in long-duration or remote/wilderness first responder operations. Frankly, government couldn’t afford to do so! The real cost to victims and government would bankrupt both. First of all, there are not enough deputies and EMS personnel available to be called out in mass to the wide variety of search and rescue incidents that occur. For example, a recent search I went on involved over 70 personnel from multiple counties and it lasted about two weeks.The diverted time of police and fire personnel from regular duties and cost of salaries for extended operations would be exorbitant. Imagine the cost of a just one 24-hour mission day for twelve personnel and related equipment and transportation. It would cost close to $10,000. Add in helicopter support costs and the cost could easily triple. As such, most SAR units are all volunteer teams except for the highest level of the SAR incident command structure.

Even at a wage of $25/hour the 18,434 hours donated by SAR volunteers in Coconino County in 2015 would otherwise cost the taxpayers $460,850. Given this potential expense of responding, just preventing one SAR incident can could save a lot of money, pain and suffering.

The role of search and rescue was once the sole purview of individuals, their families, and local villages. Historically, when a disaster of any size struck resources were thrown at the problem. When the crisis ended, response resources usually disappeared into the background. That all began to change in the 1950s when national coordination of SAR activities began. Then during the Korean and Vietnam Wars, medical advances such as MASH units, provided rapid deployment, extraction and wartime medical treatment for injuries that only years earlier were fatal conditions. By 1970 when the MAST (Military Assistance to Safety and Traffic) program was created, and Army and Air Force helicopters became available to rural communities. The programs great success led in 1971 to expansion of the program to mountain rescue operations. Intergovernmental cooperation then proliferated with mutual aid agreements and coordination among state and county SAR offices, the Coast Guard, Air Force, and county and private SAR groups.

Simultaneously, technical advances were occurring in climbing, rafting, camping, hiking, and skiing gear and techniques.

The improvement of SAR capabilities paralleled the growth in the outdoor recreation industry zand demand for use of open lands owned by all units of government. Visitation to national parks increased quickly after WWII. For example, the Grand Canyon has seen over 200 million visitors since 1950. Annual visitation is up 830% since 1950. Even the lesser known national monuments near me such as Wupatki National Monument outside Flagstaff, AZ has seen a 2,117% annual visitation increase in the same time period.  If you are interested in US forest visitation rate history from 1881 to the end of WWI, read this.

The Ten Essentials

Accustomed to urban living and parks visitors to parks, monuments and national forests, visitors frequently come for their outdoor experience way under prepared . Most peoples's eyes glaze over when they are asked if they have brought with them the "Ten Essentials" for their adventures:
  1. Navigation. Topographic map and assorted maps in a waterproof container plus a magnetic compass, optional altimeter or GPS receiver.
  2. Sun protection. Sunglasses, sunscreen for lips and skin, hat, clothing for sun protection.
  3. Insulation. Hat, gloves, jacket, extra clothing for coldest possible weather during current season.
  4. Illumination. Headlamp, flashlight, batteries.
  5. First-aid supplies, plus insect repellent.
  6. Fire. Butane lighter, or matches in waterproof container.
  7. Repair kit and tools. Knives, multi-tool, scissors, pliers, screwdriver, trowel/shovel, duct tape, and cable ties.
  8. Nutrition. Add extra food for one additional day (for emergency).
  9. Hydration. Add extra 2 liters of water for one additional day (for emergency).
  10. Emergency shelter. Tarp, bivouac sack, space blanket, plastic tube tent, jumbo trash bags, and insulated sleeping pad.
When visitors do know about the ten essentials, but often don't have them all with them that day, they often minimize their importance with questionable statements such as:
  • "Oh, it's OK, I am not going that far today."
  • "I've climbed peaks higher than this one with even less      preparation."
  • "Why? Isn't the trail well marked with signs everywhere?"
  • "I thought my buddy was bringing that gear."
  • "I know, but this is the only day I have left on my trip to do this."
Portable GPS Unit

In regards to some experienced hikers, they often approach their adventure with a false sense of security trusting their lives too readily to technological advanced gear such as cell/satellite phones, GPS units, 36-mile radios, PLBs and EPIRBs (personal locator beacons and emergency position indicating radio beacons), smart phone apps, and increased cellular coverage,

I applaud the technical progress made and I use a fair amount of tech myself, but basic survival skills may prove far more important, especially when all the batteries die or radio signals can't be found.

Ravines, canyons, mountains, steep slopes, avalanche areas, and severe weather may all conspire to make sure you don’t get where you want to go.  ~ Outdoor Adventure Education
In 2014 Grand Canyon National Park saw 324 SAR incidents and Yosemite National Park had 181. The Grand Canyon began its PSAR program in 1997."

A report, published by the Wilderness Medical Society, has a catchy title: "Dead Men Walking: Search and Rescue in U.S. National Parks." Its authors looked at the NPS' annual search-and-rescue reports from 1992 to 2007 and SAR statistics from all NPS units in 2005. Some key findings: From 1992 to 2007 there were 78,488 people involved in 65,439 SAR incidents. These included 2,659 fatalities, 24,288 injured or sick people, and 13,212 "saves," or saved lives." Source

San Francisco Peaks (Mt, Humphreys is on the left)

The Forests Service's Challenge

The Forest Service is trying to improve safety on its trails. The Flagstaff Branch began its pilot PSAR program in 2015. Program volunteers have two primary sets of responsibilities at the Mt. Humphreys Peak location because it is Coconino National Forest’s most used trail:

1. PSAR volunteers observe every hiker starting up the trail and:

   a. Try to determine every hiker’s physical ability, equipment and hydration preparedness.
   b. Provide mountain weather forecasts plus safety and self-rescue tips such as what to do
       during lightning and other foul weather conditions.
   c. Offer maps, direction, trail condition, and campsite information.
   d. Suggest alternative trails better suited to a person’s or group’s ability and preparedness.
   e. Encourage Leave No Trace behavior.

2. PSAR volunteers also hike the trail as roving rangers to continue providing supplemental information to hikers and render first aid to ill or injured hikers and their pets.

Approximately 6,000 people will hike some portion of the Humphreys Trail this summer. On our highest use day so far this summer we had over 635 hikers starting up the 4.9 mile trail. It ascends roughly 3,300 feet to the summit at 12,633 feet. In addition, we have had up to 70 dogs a day of all breeds accompanying hikers. All too frequently we witness dog-on-dog problems despite the requirement for dogs to always be on a leash.

A large majority of our hikers are visiting from the Phoenix metro area. Before they even begin their hike they are experiencing an altitude gain at the trailhead of nearly 8,000 feet. Thus, when attempting the summit climb, the altitude difference without acclimatizing can lead to difficulty breathing, headaches, early fatigue, dehydration, Altitude Mountain Sickness (AMS), and other more serious medical symptoms such as HAPE and HACE.

Immediate recognition of symptoms and prompt descent are the most life-saving interventions for HAPE and HACE, according to the WMS Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness. In dire cases supplemental oxygen and hyperbaric therapy can be beneficial. Medications such as acetazolamide and dexamethasone for HACE are temporizing measures while organizing descent. Nifedipine is a temporizing measure for HAPE while organizing descent. (Source)

Roving PSAR ranger volunteers carry a Forest Service radio when they are on the trail, as well as, a cell phone to call for more medical or SAR assistance when needed. In addition, I carry a separate County SAR Team radio for direct communication with the SAR Commander so that I might be able to expedite operations and advise early on as to the need for specialized personnel, equipment, or other rescue or recovery assistance.

Who Pays For All this?

To end this three part series, I want to address one of the biggest misconceptions most people have about the cost to victims of being rescued should SAR prevention messages prove inadequate. Some people do not seek SAR help in an emergency because they fear being billed for the cost of any rescue. In most states, including Arizona where I volunteer, the patient/victim is NOT billed for the cost of the rescue efforts. I hope that isn't surprising. Patients will likely be billed for any ambulance services, but that expense is often covered by personal health insurance policies. This newspaper story describes the situation well and the problems SAR teams face when they try to offer assistance, but that offer of care is rejected by the injured person.

Now that you've seen how expensive it can be too operate a SAR program, understand that some critics argue that we actually should charge for search and rescue. There are several reasons for not charging.

If the victim hesitates to call for help and WHEN (usually, not IF) the decision is made later to accept help (usually after sunset) several things can happen.
  1. Locating the victim may be more difficult and be complicated by temperature and visibility changes.
  2. Rescue may have to be delayed until another day when conditions are safer for access and extraction, and rescuers may need to bivouac overnight and care for the patient in more arduous conditions.
  3. The victim may increase the danger to other people's lives, including their own desperate friends, families and rescuers.
  4. By delaying a call for help the victim's condition will likely worsen requiring even more drastic measures to deliver medical care and affect a rescue. It's cheaper to carry someone down in a litter basket than to call out a helicopter for an emergency transport.
  5. The SAR team expenses and time requirements for rescuing usually go up after dark because of the greater need for more gear, fuel, and supplies.
There are numerous published examples of this problem. Here is but one. The position of the National Association For Search and Rescue is shown below the fold.

Please, if you cannot perform a self-rescue without major pain or further risk to yourself and others, seek professional help from a SAR group as soon as possible. Call 911 and/or send messengers to contact help. There are many volunteers itching to render assistance. 

Play hard, be safe!

Training For Disaster (Part One) (aka Life Is What Happens While Making Other Plans)

Training For Disaster (Part Two)


NASAR says: "The search for, or rescue of, someone in peril is among the most humanitarian of acts. It is recognized that, to the extent possible, individuals and communities have a moral obligation to aid those in danger, regardless of any legal obligation.
NASAR recognizes the ultimate decision to bill a survivor for SAR operations, or a victim’s family for attempts to save their family member’s life, is that of the local authority responsible for SAR. However, lifesaving action must take precedence and political, economic, jurisdictional or other such factors must remain secondary when dealing with lifesaving matters. Authorities with responsibility for SAR and SAR organizations can not allow cost reimbursement to delay response to any person in danger or distress.
A perceived or actual belief that the subject of a SAR mission will be billed for the lifesaving actions undertaken on their behalf must not delay or interfere with a timely call for help. Such delays can, at the minimum, cause further danger to the person in peril and, at the maximum, place their life in jeopardy. Delays can place SAR personnel in extreme danger and unnecessarily compound and extend the length of the SAR mission. Because of these factors, and to eliminate the fear of being unable to pay for having one’s life saved, SAR services should be rendered to persons in danger or distress without subsequent cost recovery from the person(s) assisted unless prior arrangements have been made.
The mission of SAR organizations is to save lives, not just the lives of those who can afford to pay the bill. As such, methods and means should be developed and used that diffuse the cost of humanitarian SAR operations among the many, allowing anyone to reasonably expect emergency aid without regard to their circumstances."

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