Let’s recap:

We’re miles from the nearest ambulance, 35-45 minutes from the arrival of the first response unit and a now rapidly swelling index finger from a snake bite.

The Coleman Brand Snakebite kit is a small package of provodine, a scalpel and a little sucker tube.  More or less useless unless we were hours from help.  We’re far, but not nearly THAT far.

One of the moms has the rangers on the phone and they’re en route, advising us not to take any action.  They’ve got a small BLS bag and arrive soon after we heard them running sirens on the mountain road.

The Rangers gather their patient’s basics and make a decent attempt to take a blood pressure when I suggest ever so gently that perhaps time is of the essence and an intercept with the responding ambulance would be a good idea.

“We can’t transport him.”

No, you can, you just can’t bill for it, or call your vehicle an ambulance.

“Oh, OK” was what came out of my mouth.

A patient update has been sent and when I realized the decision that had been made only one thing crossed my mind:

I wish Rogue was here to see this.

The helicopter was already circling, less than 10 minutes since the gentleman wandered into camp and at the rate the edema was intensifying even a ground intercept was going to be cutting it close.  The initial edema didn’t seem so bad, but now you can almost see it creeping slowly past the second knuckle with no sign of slowing down.

All my breathing coaching is helping a bit, but I was later informed of the reason his pulse rate increased:

He has no insurance.


The landing was fast, they didn’t wait for an LZ to be set up, just picked an empty campsite around the corner and did their thing.  One of the rangers drove off to check on them, code 3 of course, and came back moments later.

“Get him in here I’ll drive him over to the chopper.”

Chopper?  Really?  Oh well.  Suddenly we CAN transport, and I remind the patient to stay calm and let the nurse and medic know about any dizzyness, numbness, trouble breathing, the big stuff and away he went.  Another few moments later we hear the helicopter throttle up and tilt the rotors and away they went.

Now imagine he hears the helicopter and tells you there’s no way he’s going with them and asks you to drive him to the ambulance.

What would you do? You Make the Call.

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