Volume , Issue

Search and rescue (SAR) is a generic term which covers finding and providing aid to the lost, missing, stranded, ill or injured. It covers a range of responses including urban SAR (usually natural or man-made disasters), to wilderness and mountain rescue, to the Coastguard for ocean-based missions. In each area there are many subspecialties such as of K9 (dogs), horses, boats, drones, visual tracking, cave, swiftwater and avalanche rescue, as well as rope access and technical rescue for high-angle terrain. Given the broad number of areas there could be something of interest for any member of the WMS.

Being part of a search and rescue team is tremendously rewarding. It provides the ability to put into action the knowledge and skills you have learned, while working outdoors. It gives you motivation to train and keep fit. SAR provides a fun and exciting activity away from the office. It has been described by a past WMS president as “a vaccination against burn out” (Aaron Billin). The people that get involved in SAR are motivated, compassionate, highly skilled, and are generally the sort of folks that you want to be around. It is possibly the best team sport out there.

Medical skills are vital in a SAR team for the care of the ill or injured patient but there is much more than medical care involved in locating and rescuing someone from the wilderness. The commitment to hard work, to learning all aspects of SAR, to acting with humility as a member of a team are what will make you a great rescuer. Advanced medical skills are beneficial to the team as you can provide training and add to knowledge and skills the team already has. Your patient assessment and management skills are especially helpful, and being available in person or by radio or phone can improve efficiency and patient care. Medical providers need to be accepted by the team and understand the structure and levels of response before they can be effective in the supervisory role.

If you are unsure if SAR is your thing, groups may let you go and observe some training exercises. Most teams will not allow rescue participation unless you are a full member. You are not expected to be a SAR expert when you turn up. Be honest with yourself and the SAR team about your commitment and ability to participate in missions. A team may accept you and the limited time you can offer or they may not. Attending trainings and spending time in the field is important to develop the team’s trust in your ability and to facilitate effective communication during potentially stressful missions.

To be a member of a volunteer SAR team you do not need to be a rock star. Most teams will have requirements and these vary from group to group. To be a field team member you will need to have some competency in the outdoors. You should have reasonable fitness. Navigation skills and self-sufficiency in the wilderness are mandatory for most land SAR and mountain rescue teams, and this will need to be in adverse weather conditions as well as fair ones. If you lack skills, fitness or are less able, a team may have a non-field team role for you. You may seek out training opportunities outside of SAR to acquire skills you do not have if not offered by your SAR team.

All healthcare workers have something to contribute to search and rescue. Most SAR teams are made up of people from a variety of backgrounds. To be a field team member you need to meet your team’s requirements. As a healthcare worker you likely have some of these. Your training will be beneficial to the health of patients and team members in addition to team member education. As a wilderness medicine practitioner, your skills are especially useful for the “austere” environment of most SAR. While SAR teams generally carry appropriate equipment and rarely “improvise”, you should be familiar with the medical issues of prolonged evacuation, limited resources, and particular environmental hazards found in your region.

Here are some tips for getting involved in SAR:

  1. Research the SAR teams in your area. (an internet search will find them.) Most will have contact details and many have requirements listed. Many operate under local law enforcement or fire departments.
  2. Acquire the basic skills of map and compass navigation, knots, backcountry travel, and survival.
  3. Approach a prospective team with humility.
  4. Meet their requirements and become a functioning part of the team. You must get to know the individuals as well as the team culture. You might be stuck in the bush in horrible weather with your team.
  5. Show up and participate in group activities (training, meetings etc). Accept invitations for unofficial hikes and social events.
  6. Respect the team members’ skills and knowledge. Your teammates bring a variety of skills from a range of backgrounds. You are all there to accomplish the task of helping the person in need. Do what you are assigned, to the best of your ability, no matter how pointless you think it is.
  7. Do not expect to be the medical lead or have your knowledge used from the beginning. It may take a year or more before you become a full team member.
  8. Accept that SAR calls are not always exciting. Show up for ground searches, and volunteer for litter carries. You might be spending a few hours wandering (purposefully) across a field looking for a discarded granola bar wrapper.
  9. Get training in SAR related skills. Practice SAR skills in your spare time, e.g., when out hiking, do some tracking, (however, your kids might give up playing hide and go seek with you).
  10. Be honest if you are time poor. Most teams will be grateful for whatever knowledge and skills you have, and time you can give.

Medical Direction of SAR Teams

I would encourage interested WMS MD/DOs to consider providing medical direction to their local SAR as applicable and necessary for the jurisdiction. Medical direction should improve overall patient care and possibly patient outcomes. Medical direction also necessitates cooperation with other local EMS agencies, coordinating protocols, ensuring quality control and maintaining necessary licensure and certifications. These pointers are far from comprehensive and substantial clinical practice guidelines are in development by the WMS.

While it is not necessary to be a full SAR team member (or FAWM/DiMM), having good knowledge of the constraints of search and rescue missions is beneficial in being able to provide pragmatic advice to the team members in the field. Temper your expectations of what standard of care can be provided during a mission. Be cognizant that environmental hazards, operational requirements, and team safety may come before perfect (or ideal) patient care.

Ask the team/group what they want from you, e.g., teaching/training, lectures, phone support during missions etc. They might not know what they want or need, so join as a field member and see where you can help.

Back up your team. Especially if things don’t go well. Praise them when it does. Be aware of Psychological First Aid and normalize the discussion of stress injury within the team. Making mental health issues an acceptable topic of conversation is a significant way to build resilience.

The laws and regulations pertaining to medical direction and provision of care and medication varies state to state, country to country. It is beholden upon you to apprise yourself of the specific local requirements.

Have fun!

Acknowledgements: WMS SAR committee members Alison Sheets, Dale Chayes, Deb Haber, Maighdlin Anderson, and Scott Dreblow for their input and editing.

You Might Also Be Interested in

Under Pressure, Part II

George W. Rodway PhD, APRN6/4/2024

Some significant happenings in the early history of diving physiology and medicine – technological advances in underwater air delivery

Medicina de Montaña

Andrew Park, MD, DiMM5/29/2024

A Wilderness Medicine Fellow’s experience on South America’s tallest peak

Optimizing Hypoxic Conditions for Health and Longevity

Jason Cinti, DO, PGY-2 5/7/2024

What exactly is known about the role of exercise at altitude in terms of overall health?

Transmucosal Fentanyl No Longer Available for Wilderness Rescue

Aaron R. Billin, MD, MS, FAAFP, MFAWM5/3/2024

A consideration of alternative approaches for pain management in the field