If you are studying for your Field Level IV credentialing, this test is all you need to meet the educational objectives:
Learn the major life-safety and health hazards and risks for wilderness travel and wilderness search and rescue activities in the mid-Appalachian area. These include
subjective hazards, including lapses in judgment such as in risk assessment and not compensating from the mental effects of sleep deprivation and physical stress,
hazards from the area’s continental climate and changeable weather, including cold and heat exposure and lightning strikes,
hazards from the area’s terrain, including slips and falls, rockfall, and streams and lakes, 
hazards from pedestrian-vs-vehicle accidents, and from falling asleep at the wheel,
hazards from bees and wasps, ticks and poison ivy.
Learn enough about a personal GPS device or smartphone GPS app to be able to make sure the datum is set properly and determine WGS84 USNG/UTM location. Learn the concept of safety direction and when to use it.
Learn how to use the basic controls and functions of a team handheld radio, basic ASRC radio protocols, and enough of the phonetic alphabet and numerals to communicate standard field team status reports, including USNG/UTM location.
Learn how to serve as a member of a litter team, carrying a litter on non-technical terrain (non-technical evacs), following standard ASRC procedures for litter team positions including litter team positions including Litter Captain, Medic, and speaker, and standard calls, lifting and setting down a litter, dealing with vomiting, load straps, laddering, toenailing, litter bearer rotation, paving, turtling and lap pass. 
Learn the basics of the Incident Command System (ICS), as applicable to wilderness search and rescue as practiced by the ASRC. This may be learned via the FEMA free online course Introduction to the Incident Command System, ICS-100.B:  Field Level IV members should have a working knowledge of critical ICS concepts, terms and principles, and how they may be modified slightly for wilderness search and rescue. While the ICS-100.B course incorporates additional material that may be helpful during a disaster response, it is not expected of a Field Level IV member, and will not be part of performance standards or tests.Learn the essentials of SAR operation procedures and good behavior.

Subjective Hazards
Objective hazards are the environment itself, whereas subjective hazards are mental shortcomings in dealing with the environment. Examples include overestimating one’s physical or mental fitness, underestimating the hazards, and allowing goals (such as finishing the task so as to not look bad despite major hazards) to overcome good judgment.
Field team members may have to function while cold, sleep-deprived, dehydrated, or have poor nutrition with hypoglycemia. To help prevent injury from subjective hazards, SAR teams emphasize best practices such as:
Having knots and rigging, and other important decisions, double-checked by another member, and
Always practice these checks during training to develop good habits.
Subjective hazards have parallels in the search and rescue sayings “they say you have to go out there, they don’t say you have to come back” and “a dead rescuer never did anyone any good,” emphasizing the need for careful risk assessment and management.
Members, when assessing risk, must think about the effect an ill or injured field team member can have on the effectiveness of the team and the overall operation (not to mention the embarrassment attaching to the ill or injured member).
Climate and Weather Hazards
We have a continental climate in the mid-Appalachian area. In a continental climate, temperatures differ widely from summer to winter, from day to day, and sometimes temperatures drop very quickly particularly with cold fronts approaching from the west, often with increasing wind and precipitation, creating a major hypothermia risk. 
Hypothermia is a four-season danger, and frostbite . Several of the following sections detail how to use knowledge, clothing, other personal equipment and supplies and portable or improvised shelter to deal with the ever-present danger of hypothermia.
Heat illness is a constant danger from heat/humidity exposure with strenuous work in the mid-Appalachian summer, and is covered in a subsequent section. 
Lightning strikes during thunderstorms are a rare but potentially catastrophic hazard, and to some degree preventable; know to avoid exposed ridges and cliffs, wet ropes, and isolated trees, and to shelter in deep but not shallow caves. If unavoidably exposed to lightning risks, stand on insulating materials such as a coil of rope if possible, and to keep feet together to avoid a “step potential” voltage between the feet. People who deal with athletic events tend to use the “30/30 rule”: if the lapse between a lightning flash and the accompanying thunder is less than 30 seconds, that means the lightning is within 6 miles and the athletic event should be stopped and people should shelter inside until 30 minutes after the last rumble of lightning. Unlike for an athletic event, sheltering inside a building or vehicle may not be possible for a field team, but getting off an exposed ridge and avoiding single tall trees certainly may be possible, and well-advised. Thunderstorms may move fast, up to 70 miles per hour.
As the burgeoning use of smartphones and increasing cellphone-tower access have decreased the number of lost-person searches, there are also many smartphone apps that (when you have a signal) let you look at real-time radar weather maps to track storms that might be heading your way. As of 2018, the smartphone app Weatherbug uniquely offers access to a sub-app called Spark. Spark shows a map that plots, in real time, lightning strikes in your area. This is based on the WeatherBug lightning sensor network. However, the Weatherbug alert system will not proactively alert you when lightning strikes are close; you have to check the app to see this information. You can set this or other storm apps to provide audible severe weather alerts, which is probably appropriate for trips in the wilderness, whether recreational or as a search and rescue task. However, these weather alerts are not as specific to your location as the WeatherBug Spark sub-app. 
If you don’t have a cellphone app to consult, and if you are in deep forest without a view of the sky, there are other clues to an approaching storm. Thunder is nonspecific; in a quiet forest, you can hear thunder from far-away storms. A darkening of this sky, visible even thorough the forest canopy, might warn you that a cloud is passing overhead, but it could be just a sheep-like fair-weather cumulus cloud. More specific is a change in wind direction: the updraft of an approaching thunderstorm usually reverses the prevailing wind direction a few minutes before the storm arrives. In the forest, you can detect this by noting that you can suddenly see the pale undersides of some trees’ leaves. Trees gradually adjust their leaves’ direction so that, given the prevailing wind, the leaves are positioned to receive maximal sunlight. When the wind changes suddenly, there isn’t time for trees to adjust, and a sudden change in wind direction bends the leaves so their pale undersides are visible. A sudden drop in temperature usually soon follows, from the downdraft at the center of the storm bringing down cool air from high in the atmosphere.
In the winter, and often in spring and fall, our area is cold and wet and a great place to get hypothermia. Subsequent sections deal with using personal clothing, equipment and knowledge to prevent hypothermia.

Terrain and Vehicle Hazards
Falls down slopes, or simply tripping and falling over the edge of a cliff, are much more common causes of fatal or major-injury falls than falls while doing ropework on a cliff. For this reason, it is a best practice during vertical training and rescues to rope off a safety zone at the top of a drop, and have everyone in that area tied in securely. 
Falls from equipment failure are very rare, but improper rigging sometimes causes falls, hence, the standard best practice of having a second person check any knots or rigging. 
Rockfall is always a risk near cliffs, and though head injuries from falling rock (or carabiners or the like) are very rare, they can be devastating. Short falls while on a rope may also cause significant head injury. This, combined with the desire to serve as a good example to the outdoor public, leads to the best practice of wearing helmets whenever on or around a cliff. 
Drowning from falling in water with a pack on, or from crossing big or flooded streams, can be a significant risk to SAR team members. Best practices recommend not trying to cross a stream of any significant depth, or searching right along a steep edge of a lake, without flotation vests. Teams can call back and recommend a team with flotation vests be sent to complete such a task. However, sometimes it may be safer to cross a fairly-large stream without a flotation vest to escape a worse danger, and in a downpour most trails turn into small streams, so rigid rules about water and flotation vests don’t make sense. Unsnapping your pack’s sternum strap and hipbelt, and loosening the shoulder straps, are  a best practice, so as to be able to ditch your pack easily if you go underwater. Another best practice is facing upstream and placing your walking stick or trekking poles upstream, so that the force of the water flow tends to push the tip into the bottom of the stream.
Getting hit by a vehicle while walking along a rural road, especially at dusk or at night, is a major hazard for search and rescue team members. Having high-visibility colors and reflective material on clothing (including safety vests or Velcro type armbands) and packs are essential ways to manage this risk. Remember too that if you have dogs with your team, they tend to not be as aware of traffic hazards as humans and require extra attention.

Situational Awareness
Related to weather, terrain and fatigue, but also to other hazards, is situational awareness. You need to be conscious of the hazards around you and within you. The ones inside you are the hardest to monitor.
We who venture into the great outdoors for fun tend to be dismissive of those urban people whose lives move between climate-controlled houses, cars and offices, and pay little attention to the weather. But even if you have some outdoor experience, you too may not paying enough attention… not so much to the weather, or even the weather forecast, but to the interaction of fatigue, exhaustion of energy, dehydration or mild hypothermia. 
When we are out hunting, fishing, hiking, climbing or the like and the weather gets bad, we can (as we’ve always been told) to seek shelter. But for search and rescue tasks, sometimes you have to keep on going as finding or rescuing someone takes precedence. And in such situations, we have to carefully monitor our internal condition, and that of our teammates. 
When you’re out to walk the dog or take a short dayhike, be conscious of whether your body is getting just a bit chilled, a bit overheated, a bit dehydrated, or a bit energy-exhausted. It’s good practice for when this self-monitoring may become a matter of life or death.  
Fatigue Kills
The  says, I understand that I am subjecting myself to situations that may encompass a variety of natural and man-made disasters and/or events in which I may be subject to illness, injury or death. I understand that these situations may lack proper water, food, shelter, sanitation and medical care. I further understand events may expose me to death or disability caused by diseases, direct and indirect assault by humans and wild beasts, attacks by venomous creatures, exposure to environmental hazards (including but not limited to fires, high temperatures, flash floods, swift water, mud slides, landslides, rock slides, blizzards, ice storms, snowstorms, bitterly cold temperatures, tornadoes, high winds, lightning strikes, hazardous plant life), electrical shock, serious or deadly falls, hazardous terrain, and injury or death from a technical rescue system failure.
But in addition to this “lions, tigers and bears” clause, it goes on to say, I understand that all the modes of transportation available to me may pose a risk both at the event and transportation to and from the event.
Falling asleep while driving has likely killed more SAR team members than anything else. It caused the ASRC’s only line-of-duty death in over 40 years and hundreds and hundreds of SAR operations. Lisa Hannon, one of our Incident Commanders, was killed driving back from a search while sleep-deprived.
People say that driving while sleep-deprived is as dangerous as driving drunk, and the evidence supports this. Of all the hazards we expect the Field IV to learn about, this is the most deadly.
We don’t know precisely why, but sleep is essential for our health and safety; as Shakespeare wrote in Macbeth Act 2, Scene 2, Page 3: 
…the innocent sleep,
Sleep that knits up the ravell’d sleeve of care,
The death of each day’s life, sore labour’s bath,
Balm of hurt minds, great nature’s second course,
Chief nourisher in life’s feast, …
There is now evidence that lack of sleep makes you fat and makes your muscles weak. But the main problem is that lack of sleep makes you sleepy (duh), and falling asleep at the wheel will probably kill you. We drive all the time and discount the dangers, but you should learn as much as you can about this terrible danger: fatigue + driving.
For details on this topic by an ASRC member, read Bob Koester’s scholarly but readable monograph: Koester, R. J. (1997). Fatigue: sleep management during disasters and sustained operations. Charlottesville, VA, dbS Productions.
We will cover the most important points here.
Sleep and Fatigue Basics
We all need 4.5-5.5 hours of “core sleep” (deep, uninterrupted sleep) every 24 hours to keep functioning physically and mentally. However, to keep our emotions working properly, we need another three hours of sleep, though that can be in the form of scattered naps. 
Sleep is affected by humans’ circadian (circa = about, dian = day) rhythms. While these rhythms are slightly different for different people, and in different situations, they are remarkably similar in all humans. We all have an internal clock which is how many of us, at least some of the time, can start waking up five minutes before the alarm goes off. There are several distinct rhythms that are tied to this clock:
Sleep
Mental alertness
Temperature
Visual alertness
These rhythms repeat every 24 hours, though they can be stretched to 25-26 hours fairly easily, or compressed to 22-23 hours with more difficulty. Trying to adjust more than 1-2 hours gets these normally-synchronized rhythms out of sync: jet lag.
Many things affect these rhythms:
Bright daylight (though subdued indoor light does not)
Bright bluish light from staring into cellphone, tablet or computer screen
Certain drugs
Timed social contact
It is very hard to adjust to working a night shift, as even a little exposure to bright sunlight or blue screen light can reset your internal clock back to a daytime rhythm. 
Alertness and Temperature Rhythms
There are two separate alertness rhythms, mental and visual, and they are not tightly linked to the sleep/wake cycle and they work differently.
If you are sleep-deprived, the mental alertness rhythm becomes more pronounced: higher highs and lower lows. Minimum mental alertness is worst at 8 AM, which is why so many single-driver motor vehicle accidents occur right around 8 AM. No matter when you slept last, 8 AM is a very dangerous time to drive. Starting at 8 AM, mental alertness increases until a peak at 4-6 PM, and then drops sharply at 10 PM decreasing until the 8 AM minimum. 
If you need to do something that requires a burst of concentration, you can usually do it even around 8 AM. But vigilance tasks – monitoring a nuclear power plant, doing a long belay, or staying awake while driving – are very dependent on your mental alertness cycle.
If you miss a night’s sleep, your alertness will increase after 8 AM the next morning, but at 10 PM, your alertness will tank (a technical term meaning “decrease precipitously”).
Visual alertness, as with mental alertness, is lowest at about 8 AM, another reason to fear driving around 8 AM. Visual alertness peaks later though, at about 8 PM.
Temperature varies about 3.6°F (2° C) throughout the day. It peaks about 4-6 PM and hits a minimum at 4 AM; once it starts increasing at 4 AM it makes it much harder to fall asleep. Pulse and blood pressure track along with the temperature cycle. It’s normal to have a pulse of 50 or lower, and a blood pressure of 70/40, are normal at the 0400 temperature minimum.
Many different prescription medications may cause sleepiness, including narcotic (opioid) pain medications, as well as some psychiatric medications. Of over-the-counter medications, the main sleepiness-causers are the antihistamines. They are marketed as allergy remedies, and are in many common cold medications. Diphenhydramine (e.g., Benadryl) is particularly well-known for making people sleepy, and is sometimes used as a sleeping pill, but all other over-the-counter antihistamines, with one exception, are known to make at least most people sleepy. 
Some over-the-counter 24-hour antihistamines say they don’t cause sleepiness, but all of them except for fexofenadine (e.g., Allegra) can cause sleepiness. Some people can take loratadine (e.g., Claritin, Alavert) without sleepiness, but it makes most people at least somewhat sleepy. Cetirizine (e.g., Zyrtec, Xyzal) makes almost everyone sleepy.
Larks, Owls, and Sleep Gates
Some are morning people: “larks.” Some are not: “night-owls” or simply “owls.” Morning people reach their peak body temperature and alertness a couple of hours before night-owls. Morning people have a hard time sleeping when switching to a night shift, compared to night-0wls. Morning people are therefore more likely to be sleep-deprived when they have to work an overnight shift. A few people are extreme night-owls and adjust well to working overnight. Questionnaires are available online to assess yourself to figure out your degree of lark-ness or owl-ness.
Being able to switch to night shift is not only a function of night-owl-ness but also of age. At age 25, even night-owls’ ability to work overnight decreases, and this gets much worse by age 40-45.
Sleepiness, and the ability to fall asleep, are triggered by a change in signals from certain parts of the brain. Morning people have a sleep gate that normally opens from 9:30 PM to 11:30 PM, and another that opens in the mid-afternoon. Night-owls’ sleep gate opens at about midnight, and they have less of an afternoon sleep gate. Whether you’re a morning person or night-owl, though, you have a “forbidden zone” about 8 PM ± 40 minutes, making early evening the safest time to make a long drive.
Effects of Sleep Loss
Lack of sleep won’t kill you directly, but it certainly has lots of ill effects. Being conscious of these and working around them will make you more effective and less likely to make errors. Ill effects include:
Mood changes such as irritability (take a break to go do some breathing exercises or have a good cry)
Impaired vigilance, inattention (use caffeine to boost alertness, make up mental and physical exercises to keep up your alertness)
Impaired short-term memory (keep a small waterproof notebook in your pocket and write down everything; ask for instructions to be repeated at least twice and reply with a rephrase of the instructions to make sure you understood them)
Increased appetite (try to eat healthy; or just go with it and diet when you get home)
Problems with communications (take time to rehearse what you’re going to say on the radio)
Sleepiness (nap when you can)
Increased sexual drive (watch your behavior!)
Decreased performance (recognize your increasing mental and physical limitations)
Microsleep: “nodding off” or “zoning out” for a second or two, sometimes up to 15 seconds, (recognize for the major safety hazard it is)
After two days without sleep, you may see illusions or see or hear hallucinations or become paranoid. One note of relevance to SAR: working in Base, where your work is mostly mental, is actually more tiring than working in the field.
The typical sleep-deprived error is not so much doing something wrong, as simply forgetting to do something important. You can use your pocket waterproof notebook to make checklists, for instance, of things you need to do when you get back to Base. (“turn in radio and spare battery” “eat” “fill up CamelBak” “call home”) 
Assessing and Treating Sleepiness
It’s not all that hard to know that you are sleepy, but you may gradually get to a dangerous level of sleepiness without really recognizing it. You can even fall asleep, at least microsleep for a second or two, with your eyes open. If you find yourself dozing off while driving, stop and nap. One study showed that after 16 hours in a flight simulation trying to stay vigilant, your loss of reaction time is the same as someone with a blood alcohol  of 0.05%. Driving sleepy is as bad as driving drunk. Another good bit of advice is to not drive during open sleep gates such as 8 AM or mid-afternoon. 
There are many tests for sleepiness, but the only one that seems relevant for seeing if you’re OK to drive search and rescue is a variant of the Mean Sleep Latency Test. The basic idea is that the sleepier you are, the less time it takes to fall asleep. Before driving back from an operation, you simply lay down in a quiet area with your eyes closed for at least seven minutes; if after this you are awake, you are OK to drive. 
If you fail the Mean Sleep Latency Test, and since main cure for sleepiness is… wait for it… sleep, you get a nap. Koester (author of the monograph referenced above) recommends at least half an hour, and then you should be OK to drive. 
Regardless of whether you pass or fail your sleep latency test, you certainly may get sleepy later on during your drive. There are many things that are recommended to help keep you awake: driving with the windows open, especially in winter; listening to loud music; pinching yourself on the thigh or biting your own arm. Caffeine works, unless you’re tolerant to it, but when it wears off it causes rebound sleepiness. 
Some find that a really interesting podcast or audiobook helps them stay awake. But the best cure, is again… sleep. If you even suspect that you’re nodding off, pull over and take a nap.
All of the states in the ASRC’s region allow you to park at a highway rest area for up to two hours, as long as there is not a posted shorter time limit, which is long enough to get in a good nap. Remember to lock your car doors.
Ohio: up to 3 hours
Pennsylvania: up to 2 hours
Maryland: up to 3 hours
Delaware: up to 4 hours
West Virginia: unlimited but no overnight parking
Virginia: unlimited but no overnight parking
If you’re not traveling on a major highway, many Walmarts allow even overnight parking, and parking at a WalMart for an hour or two to catch a nap should not be a problem. 
If you really need to, just pull off on the side of the road, as far from travel lanes as possible, and nap for 15 minutes or so. If the police stop to see what is going on, just explain that you were so tired that you thought you were a threat to yourself and others due to fatigue. 
Sleeping and Napping Skills
Sleeping and napping are skills that can be improved with knowledge:. 
Avoid caffeine for 6 hours before trying to go to sleep
Don’t use nicotine at all; nicotine withdrawal tends to occur in the middle of core sleep, interfering with sleep
Alcohol before going to sleep makes it easier to fall asleep, but it results in poor quality sleep, and some mild withdrawal interferes with the last half of the night
If sleeping during the day to work overnight, or for a daytime nap to supplement core sleep:
Find a place that is safe, comfortable, dark, and quiet; a sleep mask over the eyes and earplugs may help
White noise or similar soothing noise may help you sleep; a fan provides white noise, as do smartphone apps such as White Noise, as does a handheld radio tuned to a frequency not in use with the squelch turned off
Don’t eat or read in bed, especially on a phone or tablet, even with a blue light filter turned on
Napping at any time will help improver your overall alertness. Nighttime/early morning, at the 8 AM alertness minimum, and in the mid-afternoon are the easiest times to fall asleep for a nap as your sleep gates are usually wide open then.
One-minute naps have been found to be useless; at least 10 minutes of real sleep is the minimum for a nap to help. The most effective short naps last for 20 minutes, though even longer naps can be more refreshing.
There is one problem with napping: “sleep inertia” or “sleep drunkenness.” For a short period after a nap – usually just a few minutes – you awake groggy and worse than if you’d taken no nap at all. If, however, you are awakened from short-wave sleep, also known as deep sleep, Stage 3 and 4 Sleep, or non-REM (rapid eye movement) sleep, which usually occurs between 4 and 5 AM, your sleep inertia is worse and longer. Recognize sleep inertia, and don’t start driving or doing other critical tasks until you’ve recovered from it. 
Napping is important for the health and safety of members, and for their effectiveness. There’s a military saying “Eat when you can, pee when you can, and sleep when you can, because it might be a long time until you get to do it again.” If you are tired and you have an opportunity to nap, take it! It’s not a lack of machismo, it’s a sign you really know what you’re doing. 
There is evidence that, even in those over age 60, exercise improves sleep. However, there are recommendations to avoid strenuous exercise for six hours before bedtime as it may interfere with going to sleep. As far as a remedy for tiredness and preventing microsleep, a military study showed that exercise does increase alertness in sleep-deprived aviators, but only for about 30 minutes, and that there may be a rebound effect of increased tiredness after the effect of exercise wears off. But for something to get you through half an hour until you can reach a safe place to nap, some sort of exercise is reasonable.
Hazards from Flora and Fauna
Just as altitude high enough to cause illness is not found in the mid-Appalachian region, poison oak, poodle-dog bush, scorpions, grizzly bears, moose, timber wolves, buffalo, wild boars and wolverines are simply not found in the mid-Appalachians. Knowing about them is important if you’re going to areas where they are found, but not for search and rescue in the mid-Appalachians. 
Black bear and snake attacks are a big concern, mostly among those who don’t know much about dangers of the great outdoors, like perhaps some of your friends or a parent, so we will look at these closely
These vastly overrated as dangers, and are far, far less likely than auto accidents, falls or anaphylaxis to beestings. From 1960 to 2017, in the US and Canada, there were a total of 54 deaths due to black bear attacks – and that included those feeding their “pet” black bears. For all the people hiking, hunting, fishing and working in the North American backcountry, that’s a very small risk, less than one a year throughout all of North America. Only one of these attacks was in the ASRC’s mid-Appalachian region, and that was someone in Ross Township, PA, just outside Pittsburgh. But the woman was killed, not outdoors, but while cleaning her “pet” bear’s cage.
As regards venomous snakebites: Ken Iserson, an emergency physician with the Mountain Rescue Association’s Southern Arizona Rescue Association, was puzzled as to why, if snakebites are such a problem in the area (and they are) SARA members never got bit, over at least a 30-year period. He published a latter with the observation about the lack of SAR snakebites in JAMA (Journal of the American Medical Association) in 1988 titled “Incidence of snakebite in wilderness rescue.” He once said he looked at the data for those treated in the local ED for rattlesnake bite and he reportedly said “They were all drunk. Or stupid. Or drunk and stupid.” 
This is a rhetorical exaggeration, but if you look at the list of fatal venomous snakebites on Wikipedia, about 1/3-1/2 of fatal snakebites were from things most reasonable people would consider are stupid. People who handle poisonous snakes as a religious ritual and refuse medical care when bitten. People who keep venomous snakes as pets. People who were trying to kill or otherwise handle a venomous snake. (A favorite example of “stupid and/or drunk” was the man who was bitten on the tongue while trying to kiss his pet rattlesnake.)  
Advice: don’t do any of these things.
Venomous snakebites do occur in the mid-Appalachian region on a regular but infrequent basis, from rattlesnakes or copperheads, and people out hiking sometimes get bitten on the ankle and people who get bitten sometimes die. A good estimate is that there are ~ 7500 venomous snakebites a year nationwide, and that about five people of these die. 
In the ASRC’s mid-Appalachian area, there were only two known fatal backcountry venomous snakebites since 1940. One was in Elk County, PA, in the north central part of the state, in 2015. The other one was in Bradford, PA, just north of Elk County. Before you start worrying about hiking in that very nice wild area, consider that the Bradford fatal snakebite was in 1941.
However, venomous snakebites can make people quite ill, and can cause significant local tissue damage, and so first aid for venomous snakebite will be covered in ASRC training, just not in Essentials for Search and Rescue. 

Mountain lions are so rare in the mid-Appalachians that they are almost never seen. Stinging nettles are common here, but an irritant rather than a serious problem, and giant hogweed, though spreading is still very rare. Black widow and brown recluse spiders are fairly common here, but bites are also very rare, and their toxicity is nowhere as bad as their reputation. 
These very rare, minor or nonexistent hazards are not part covered in Essentials for Search and Rescue, though they may be included in higher-level training.
Bee and wasp stings are common in the mid-Appalachian area, particularly in the late summer and fall. Those with a particular kind of allergy to beestings may get hives, which is a type of immediate hypersensitivity reaction (allergy): wheals like large mosquito bites. That can progress to full anaphylaxis: wheezing, shortness of breath, lightheadedness, swelling of the lips, tongue and throat, and sometimes airway obstruction leading to death. Most people who have anaphylaxis have a history of an immediate hypersensitivity reaction to a beesting in the past, but some people can get an “anaphylactoid reaction” from a first bee­sting. This is a vastly underrated danger, much more important than snakebite or bear attacks: both more common and deadlier. 
The treatment for all bee and wasp stings consists of first, gently scraping the skin with a credit card or knife blade held perpendicular (90° angle) to the skin to remove any possible embedded stingers without compressing any attached venom sacs. Second, an over-the-counter local anaesthetic preparation such as Sting-Eeze will decrease the local pain.
If a person suffers a beesting and immediately develops hives (wheals like large mosquito bites), that person is at risk for anaphylaxis. However, anaphylaxis may also occur without hives. Often the earliest sign of anaphylaxis is hoarseness; anyone getting hoarse after a beesting should be treated for anaphylaxis. Swelling of the lips, tongue and throat may also occur. 
The main treatment for anaphylaxis is an intramuscular (IM) injection (“shot”) of epinephrine (adrenaline). Anyone with a history of an immediate allergic reaction beestings, or any other substance, should have epinephrine in his or her pack. Autoinjectors are easy to use and effective. Those who are skilled with IM injections may carry vials of epinephrine and a syringe and needle to give the injection instead.
Epinephrine injections relieve the symptoms of anaphylaxis for about 15 minutes; repeated injections may be needed. At the same time as the first injection, it’s appropriate to give an oral dose of an over-the-counter longer-acting H2 antihistamine such as famotidine (Pepcid), ranitidine (Zantac), or cimetidine (Tagamet). H1 antihistamines such as diphenhydramine (Benadryl) or chlorpheramine (Chlor-Trimeton) also are effective, but have the disadvantage of making people sleepy, which can interfere with getting someone out of the backcountry, so the H2 antihistamines are better to carry for this purpose.
Ticks 

Blacklegged ticks (deer ticks, Ixodes scapularis) are common in the mid-Appalachian area and many are infected with Lyme Disease. As a result, Lyme Disease is now common here. There are other tickborne diseases, such as Rocky Mountain Spotted Fever, but they are much less common in this area.
You can help prevent tick bites by putting insect repellent on your skin. Thirty percent DEET works well; higher concentrations are a bit toxic, and lower ones don’t work as well. Better, use 20% picaridin, which works as well as DEET, is less slimy, likely less toxic, and doesn’t dissolve nylon and plastics. The Sawyer brand has been rated as longest-lasting by Consumer Reports. Clothing, especially socks, can be treated with permethrin, an insecticide that’s safe for mammals. Permethriin-treated socks decrease tick bites by about 75%. 
Checking for ticks and removing them after coming out of the field helps prevent Lyme Disease transmission. Small green plastic twist devices are best for removing ticks. 
The nymphal blacklegged ticks that are the main transmitters of Lyme Disease are so small they are almost invisible, so even with the best attempts at prevention, Lyme Disease still happens. Symptoms of acute Lyme Disease include a red plaque-like rash at the site of a tick bite (such a rash less than 2” in diameter is likely an allergic reaction, but if larger than 2” is treated as acute Lyme Disease), or target-like red patches. Sometimes, without a rash, people with acute Lyme Disease get fevers, chills, sweats, muscle aches and stiff neck, headaches without the sore throat or runny nose of most viral syndromes. Any member who gets these symptoms should consult a physician, either the Group’s medical director, a personal physician, or a physician at an urgent care or Emergency Department, as treatment requires a prescription antibiotic. The diagnosis of Lyme Disease is based on the above symptoms; blood tests are useless for diagnosing acute Lyme Disease. Lyme Disease, if untreated, can cause chronic joint, heart or brain problems. 
For more information on this topic see: 
Poison Ivy
Poison ivy is common in our area. There is no poison oak in the mid-Appalachian area, though it does occur in North Carolina. Poison sumac is very rare in the mid-Appalachians. mostly in swampy areas in northeast Ohio, eastern Pennsylvania, and a few rare scattered areas elsewhere. But poison ivy is everywhere in the mid-Appalachians: along trails, off trails, in fields, in backyards, along rural roadsides. All of these species are related and contain an oil called urushiol in their leaves and stems, even in winter when there are no leaves. 
For some reason, about 3/4 of humans and great apes—but not monkeys, cats, or dogs—quickly get violently allergic to urushiol. This is not like the immediate hypersensitivity that causes anaphylaxis to beestings, but delayed hypersensitivity that results in an intensely itchy, red and sometimes blistering skin rash that tends to last for up to six weeks.
It’s important to recognize poison ivy and avoid it if at all possible. Poison ivy can grow as ground cover, as a vine on a tree, or as a bush. Browsing images from an Internet search will help. It’s also helpful to use the mnemonic “leaves of three, let it be!” Also know that it’s actually leaflets of three; if you look at where the leaf joins the stalk, you can see that the three leaflets are part of one compound leaf. This makes it easy to distinguish poison ivy from the common climbing vine Virginia creeper (sometimes called woodbine), which occasionally has some leaflets of three when young, but almost always has leaflets of five. Poison ivy leaves also come off the stem alternately, as opposed to immature sprouts of the boxelder tree, which have leaflets of three that look very similar to the leaflets of poison ivy, but come off the stem opposite each other.
As with any hazardous material, the first step in dealing with urushiol exposure is decontamination. If you’re back in civilization, a long hot shower with lots of soap should get it off your skin. Washing your clothes in hot water should get the urushiol out of the clothing; for waterproof-breathable shells, softshell garments and down, special cleaners such as the Nikwax line and warm water should remove the urushiol.
In the field, though, decon is more problematic. Since urushiol is an oil, cold water probably does nothing to remove it. Cold-water backpacking soap along with cold water will probably help remove it. Alcohol-based gel hand cleaners such as Purell do a good job, as will alcohol. Alcohol-based hand cleaners are available in small plastic bottles as well as foil-wrapped wipes, and are also useful for cleaning off blood and many SAR team members carry some in their wilderness first aid kits. There are expensive cleaners designed for poison ivy that work very well, but the degreasing cleaners GoJo and Goop work just as well and are much cheaper. Those highly allergic to urushiol often keep a can of one of these degreasers in their vehicles for decontamination. 
Two brand names of poison ivy products are widely found in the US, and you might want to put one or more of these in your wilderness first aid kit: Tecnu and Zanfel. Both brand names apply to multiple products. Tecnu Original Outdoor Skin Cleanser, Tecnu Extreme Poison Ivy Scrub, Zanfel Poison Ivy, Oak & Sumac Wash are effective if much more expensive alternatives to GoJo or Goop. But once the urushiol is off your skin, these cleaners do nothing.
The “homeopathic” Tecnu Rash Relief Anti-itch Spray contains menthol that is an effective and non-sensitizing (unlikely to cause allergy) local anesthetic. However, a cream such as the original Gold Bond Medicated Rapid Relief Anti-Itch Cream, or the Rite Aid First Aid Anti-Itch generic, with both menthol and pramoxine, which is a also a non-sensitizing local anesthetic, are more effective additions to your wilderness first aid kit. However, anti-itch cream ingredients lidocaine, benzocaine  diphenhydramine (Benadryl), when applied to the skin, are famous for causing local allergic reactions; avoid them. For example, the widely-found Tecnu Calagel has diphenhydramine in it, and there is a version of Gold Bond with lidocaine in it, so avoid those. 
A field expedient is to use the flowering plant jewelweed (Impatiens capsensis): if you crush the stem and use it and its sap as a scrub brush, it works quite well to remove urushiol. Jewelweed grows in areas similar to poison ivy, but prefers somewhat moister soils.
If you get a mild case of the rash, you may use over-the-counter 1% hydrocortisone cream to gradually shorten the allergic reaction. Unless there is some reason to avoid them, taking the over-the-counter nonsedating antihistamine fexofenadine (Allegra) 180 mg twice a day (even though the usual dose for allergies is once a day) and then 50 mg of the over-the-counter sedating antihistamine diphenhydramine (Benadryl) at bedtime is recommended by dermatologists, and make a good addition to a first aid kit. The supposedly nonsedating antihistamines cetirizine (Zyrtec) and loratadine (Claritin, Alavert) make many people groggy and are not as good as fexofenadine for a wilderness first aid kit.
A severe rash requires a potent, prescription-only steroid cream, like hydrocortisone cream but much stronger. Or, if there is enough blistering to prevent the cream from soaking in, or the rash is over to large an area to reasonably treat with a cream, or on the face or genitalia where potent steroid creams should not be used, a two-week course of a prescription-only steroid such as dexamethasone is needed. 
For more information on this topic, see: 

Your pack is your wilderness life support system. The first rule of wilderness search and rescue is“Don’t get separated from your pack!” To work as a life support system, though, your pack has to have the right stuff. The ASRC provides a list of minimum equipment you have to have, but the more you know about outdoor gear the better you can select the contents of your pack, which may vary depending on the task you’ve been assigned, the weather, or other considerations such as the strengths and weaknesses of the members of your team.
Good outdoor gear can be expensive. But there are ways to get good gear cheaper. Membership in the outdoor coop REI gets you a rebate every year, regular special discounts, and REI also has regular sales. The online retailer  offers remaindered outdoor clothing, such as last years’ models, at steep discounts. 
Many manufacturers offer “pro deals” with significant discounts. ASRC members are generally eligible for such discounts, but signing up for them is handled by individual ASRC Groups, as it often requires submitting a list of members with personal information such as emails.
The Ten Essentials
The Ten Essentials first appeared in the newsletter of the Seattle climbing club The Mountaineers in the 1930s, then in updated form in successive editions of their definitive mountaineering text, Mountaineering: Freedom of the Hills, and in adaptations around the globe. The Ten Essentials are 1930s-era advice about what to take when hiking or mountaineering, but in one form or another are still the basis of much outdoor-skills teaching. As with any advice, they need to be taken with a grain of salt, but those getting into search and rescue should at least read through them as they consider their SAR pack contents. This version from the 8th edition  adds three more possible “essentials.” Our comments related to search and rescue are in italics.
The Ten Essentials, 1992Version
Navigation: Topographic map and assorted maps in waterproof container plus a magnetic compass, optional altimeter or GPS receiver. For SAR: printed map print and/or map on smartphone with spare battery, with task marked; GPS, or smartphone GPS app, and spare battery not optional. 
Sun Protection: Sunglasses, sunscreen for lips and skin, hat, clothing for sun protection.
Insulation: Hat, gloves, jacket, extra clothing for coldest possible weather during current season. 
Illumination: Headlamp, flashlight, batteries. LED bulb is preferred to extend battery life. For SAR: LED headlamp and spare batteries essential.
First-aid: first aid supplies, plus insect repellent.
Fire: Butane lighter, matches in waterproof container.
Repair kit and tools: Knives, multi-tool, scissors, pliers, screwdriver, trowel/shovel, duct tape, cable ties. A Swiss Army knife or multitool is the minimum for SAR, but the others may also come in handy. 
Nutrition: Add extra food for one additional day (for emergency). Dry food is preferred to save weight and usually needs water. For SAR: also need plenty of fast-energy snacks for during tasks.
Hydration: Add extra 2 liters of water for one additional day (for emergency).
Emergency Shelter: Tarp, bivouac sack, space blanket, plastic tube tent, jumbo trash bags, insulated sleeping pad. For SAR: ASRC requires 5 large plastic leaf bags, so you have extra to use on patients or unprepared team members.
Eleventh Essential: portable water purification and water bottles
Twelfth Essential: Ice axe for glacier or snowfield travel (if necessary)
 Thirteenth Essential: Signaling devices, such as a whistle, mobile phone, two-way radio, satellite phone, unbreakable signal mirror or flare, laser pointer. Minimum for a SAR pack is a whistle, almost every SAR team member brings a smartphone with a GPS app, and we tend to issue Group radios to anyone heading out on a task.
The 2017 Edition of Freedom offers a concise summary of the base 10 essentials:
To prevent emergencies and  respond positively should one occur:
1. Navigation
2. Headlamp
3. Sun protection
4. First aid
5. Knife
To safely spend a night – or more – outside:
6. Fire
7. Shelter
8. Extra food
9. Extra water
10. Extra clothes
The book goes on with a more detailed discussion, and we recommend the book to anyone interested in mountaineering. 
Personal Equipment and Supplies
Selecting which equipment goes in your pack is not a simple matter of checking off everything on a required equipment list (though the ASRC has a list of gear you have to have in your pack for your PTB pack gear checkoff), or making sure you have everything in the 10 or 13 essentials. For example, an ice axe and crampons are not something you often need in the mid-Appalachians, though it has happened on at least one search task. You need to select the gear your put in your pack, based on what’s appropriate for a particular task. This is especially true of food, water and spare clothing. But, taking too much gear will weigh you down and slow you down. 
When selecting what to take for any outdoor trip or SAR task, you should look at each bit of equipment and assess its usefulness-to-weight and usefulness-to-bulk ratios. You should judge each bit of gear in terms of how likely you will need it, and even if it’s unlikely you’ll need it, how important it might be in such an emergency.
There are certain minimums: you should never go out on a containment task driving a rural road without at least some minimal gear in your pack. Yes, even when driving containment you don’t get separated from your pack. What if you suddenly get a call on the radio that the subject is half a mile up the hill in the woods from your current location, and to head there right now to assist the team making the find?
The more survival-minded ASRC members insist that you should never go anywhere, even in a city, without two leaf bags in your pocket. One member even publicly posts a small Everyday Emergency Kit he keeps with him at all times: In The Picture of Dorian Gray, Oscar Wilde wrote “Experience is merely the name men gave to their mistakes,” and what you select for your pack for each task will be based on your experiences in past tasks. And if you haven’t been out on many search and rescue tasks, then pick the brains of those who have more experience; that is, take full advantage of their past mistakes. After a certain amount of “experience,” go through your SAR pack gear; consider taking out some things you’ve added: maybe some were an overreaction to one of those “experiences.” Consider leaving those things in your vehicle until you have a task that really needs them.
One ASRC member has, for decades, kept his list of disaster and search and rescue equipment online, updating it from time to time, and it might be instructive to scan through it: 
You don’t have to be like long-distance backpackers who cut the handles off their toothbrushes and cut the margins off their maps to save weight. Nonetheless, when deciding what gear to get, and what to put in your pack, look at each item and consider its usefulness-to-weight ratio, and its usefulness-to-bulk ratio.
If you are picking extra clothing to put in your pack, in case it gets cold or you have to bivouac, consider the warmth-to-weight and warmth-to-bulk ratio. A “duvet,” a warm down or similar jacket, is always appropriate on a cold-weather task. For a warm-weather task, a thin balaclava-style hood/hat provides considerable warmth for its size and weight. A thicker one is always a good thing to carry in winter. Even for warm-weather tasks, a winter facemask can act as a rebreathe flap and retain heat out of proportion to its size and weight. In any weather, a thin breathable nylon windshirt with hood weighs very little and packs small. Even in winter, adding a layer of nylon provides additional insulation, but you may need a larger-than-usual size if you want it to go over many layers of insulation. As with any upper-body insulation layer or shell layer, a full-length zipper makes getting it on and off easier, and allows for better ventilation.
Selecting an appropriate pack will prevent sore shoulders and a sore back.
One of the most important things to make carrying a pack all day comfortable is a good suspension, including a hip belt and a sternum strap. Trying on a pack for a while in the store is essential, because, as with feet and boots, what’s comfortable to one person is painful for another. People always argue about whether top-loading or zip-opening packs are better, and there is no clear winner, however, top-loading packs seem to have a wider range of load capacity.
A capacity of 1500-1800 cubic inches (25-30 liters) is about right for a SAR pack. A pack with compression straps to tighten when you’re not carrying much gear is a good idea. These straps also keep the gear in your pack from shifting and maybe causing you to become unbalanced and fall whilst climbing. 
Packs are water-resistant but never entirely waterproof. For hiking or doing SAR tasks in the rain, a separate rain cover or rain liner is a good idea. A plastic garbage bag inside your pack will work fine. A large drawstring liner of sil-nylon (very lightweight silicone-coated waterproof nylon) is more elegant and durable but also much more expensive.
Sometimes you get to a search and it’s a long way from home, and it lasts for more than one day, and you end up having to camp there. Sometimes there is a building to sleep in, but sometimes not. It’s wise to prepare for this by throwing some extra gear in your vehicle. Consider some extra clothing, food and water and a car-camping or backpacking sleeping bag and sleeping pad, and maybe even a small tent, is a good idea.
Food and Water
For your SAR pack, you need to pack appropriate amounts water and of appropriate types of food for while in the field. 
For short tasks, you can get by with supplies of almost any quick-energy food, but sometimes short tasks turn into long tasks, or might even turn into an overnight bivouac. To prepare for such happenstances, you need to have extra food in your pack. 
A standard tool for teaching short-term survival is to list basic needs and ask how long you can live without them:
Food: 			3 weeks
Water: 			3 days
Shelter in the cold: 	3 hours
Air: 			3 minutes
Will to survive:		?
While you can argue about the exact numbers, it is an effective teaching tool in emphasizing that, for short-term survival, shelter from cold is much more important than scavenging for food. 
However, we expect ASRC members not just to survive, but to keep performing at a high level while in the field. This requires not only quick-energy food to snack on during exertion, but also food for meal stops that provides sustained energy, and essential amounts of fat and protein that are needed for proper nutrition, especially when exerting yourself. If you’re just working in an office all day and not exercising much, 2000-2500 calories of food is adequate for a day, but military combat rations are 3,250 to 4,600 and 2,300 to 3,150 calories for men and women, respectively, varying based on body size and exertion levels. Figure 4000 calories a day and you’ll be close. 
Quick-energy food for when you need the energy to continue, or to combat cold stress, is very much a personal choice. Gorp (one part Virginia peanuts, one part raisins, and one part M&Ms, by number, according to the Intercollegiate Outing Club Association) is popular, cheap and good for this use. The raisins are high in glucose for quick energy, and the fat in the M&Ms and the fat and protein in the peanuts provide some sustained energy from the slowly-digested fat and protein to repair damage from exercise. Nuts keep well, and given their high content of protein and healthy fat, and ability to be eaten while moving with no preparation, are a popular SAR pack food. 
You also need to consider the weight of what you’re packing related to its caloric food value; for example, a can of tuna in olive oil weighs the same as a can of tuna in water but provides twice as many calories. Fat has many more calories per unit weight compared with sugar, starch and protein, and olive oil is one of the “good for you” fats. Freeze-dried entrées require reconstitution with water, usually hot water, but a field expedient is to add cold water and put the packet in an inner pocket while moving, and then wait for an hour or so for it to rehydrate. 
Often you’ll find yourself at Base and want something to eat. MREs (Meals, Ready-to-Eat) containing a heater are hard to beat for a hot meal with minimal preparation. Most SAR people keep a few MREs in their vehicle. However, they are heavy to carry in a SAR pack given their high water content, as opposed to drier foods that you can supplement with water or rehydrate with water.
A one-liter water bottle is standard hiking gear, and can be used to mix up Gatorade or similar electrolyte packets for hot weather. It’s also traditional to use the water bottle as a spool for several yards of duct tape. A water bladder in your pack, such as a CamelBak, can hold more water, and having a drinking tube dangling invitingly in front of you makes you more likely to drink; also, drinking small amounts frequently has less impact on your performance than less-frequent large drinks. The larger bladders carry up to 3 liters/quarts of water. For a half-day task on a pleasant winter day, a single liter of water will probably be adequate. For a half-day task on a hot and humid summer day, though, plan on carrying 2-3 liters/quarts. 
Hikers, especially backpackers, tend to rely on water purification pumps. For search and rescue, where the typical search task is half a day, and only sometimes a whole day or longer, a pump is a bit bulky and heavy for something you rarely use. If you’re on a large team going on a long task in a very remote area, a single pump for the team might make sense. But a small and light alternative is chlorine dioxide water purification tablets, which are a reasonable addition to anyone’s SAR pack. 
Personal Protective Equipment
Gloves and mittens are essential parts of your outdoor personal protective equipment (PPE).
Medical protective gloves are essential during rescues or first aid to protect your hands from blood and other body fluids. A fair number of people have severe and sometimes anaphylactic reactions to latex (natural rubber), but often you don’t know someone’s allergies before you start giving first aid. So, a plastic called nitrile has essentially replaced latex gloves for medical uses. You can usually obtain a few pair of nitrile gloves from people who work in the medical field or EMS at no cost. Not all nitrile gloves are created equal, and what one glove company considers medium may be nowhere near the size of another company’s, and some are much stretchier than others: try them on before putting in your pack. Packaging pairs of gloves in a small snack-size ziplock plastic bag will protect the gloves in your pack. 
Leather, leather-palm or similar ropework gloves are a standard part of SAR gear in warm weather. Hardware store gloves are fine, but if they don’t have a loop to attach to a carabiner or carabiner, use a knife to cut a hole in the wrist area so you can attach them when not using them. Or, if like True Grip gloves they have a nylon pull tab, you can use a pair of pliers to grasp a large finishing nail by the pointy end, heat the flat end of the nail in a gas stove or other flame, and then use the red-hot flat end to melt a hole in the nylon tab. Even on search tasks, carry your leather gloves: they are great protection as you’re trying to pull blackberry, multiflora rose or greenbriar brambles/sticker bushes/jagger bushes out of your way. 
For spring and fall, insulated gloves are essential. Given the increasing use of touchscreen smartphones in search and rescue, gloves that work with touchscreens are worth the extra cost. 
Since winters in the mid-Appalachians can go below zero Fahrenheit, mittens are essential. In very cold weather, even thick gloves will simply not keep your hands warm so you need mittens, as mittens have less surface area to lose heat. Some people like to wear thin liner gloves inside mittens, some like to wear thick touchscreen-capable gloves and put waterproof-breathable mitten shells over them.
Whatever insulating gloves and mittens you get, they should have palms and fingers that have leather or some similar material that will grip well on rope. 
A climbing helmet is an essential piece of equipment, and any helmet that meets UIAA standards is acceptable. The Petzl  seems to be popular and reasonably light and relatively inexpensive. 
Visibility enhancements are critical for SAR team members’ safety, especially at dusk or after nightfall.
Bright-color and reflective vests may be lifesaving, and are particularly important in hunting season. They are also useful when working near a large search Base where there are many vehicles driving around. When carrying a larger pack that might obscure the high-visibility vest, you can put the vest on the pack. 
Bright colors and reflective materials on packs and clothing are also good protection. Bright reflective armbands are light, so you can carry them all the time, only pulling them out when needed. If you have extras, you can share with spontaneous volunteers on your team. These can be lifesaving when you are walking back to Base along a rural roads at dusk or after dark.
Getting poked in the eye with a sharp stick is always a hazard when you’re bushwhacking or searching off-trail. With good visibility during the day, wearing safety glasses isn’t usually worth the hassle and decreased visibility, but at night, they may be a good idea. A pair of cheap lightweight safety glasses find their way into many SAR packs. Some older members are particularly fond of the kind with magnifiers at the bottom that make it easier to read a map, GPS or cellphone display in bad lighting. Wearing safety glasses during off-trail searching at night is certainly a best practice, but you need to use your judgment about the risks and benefits. If your safety glasses have major fogging from sweat or get covered in raindrops, the risk of not seeing a hole and breaking your leg may be worse than getting poked in the eye. In such a case it might be better to leave off the safety glasses and slow down, using your headlight to keep a close eye out for branches heading for that eye.
Too much sun exposure can cause painful sunburn, even sometimes second-degree burns with many small blisters: extremely painful and then severely itchy for a week. Too much sun can also, over the years, cause skin cancer. Clothing and hats with brims help prevent sunburn, as can today’s high-quality sunscreen, which are widely available. 
Sunscreen lotions or sprays can be effective. The Medical Letter (8/30/18) recommends a SPF of 15 or greater (they point out that a SPF of 100 is not that much better than an SPF of 15) and to cover both UVA and UVB, they recommend one of the following:
avobenzone + octinoxate
avobenzone + octocrylene 
avobenzone + ecamsule
zinc oxide
titanium dioxide
A small bottle of sunscreen in the top flap of a SAR pack, or in a hipbelt pouch, is a standard summertime addition to most people’s SAR packs. Brands that are water-resistant last longer and are available at many outdoor stores. Eyes can get sunburnt as well, and eyestrain from bright sun, especially on winter snow, means that sunglasses should be part of everyone’s SAR gear. 
Survival Gear
A bivouac shelter is probably the single most important piece survival gear in your pack. 
Leaf bags are part of the required equipment for Field Level IV. These are the heavy-duty disposable lawn and leaf bags you can get in any grocery store. Step into one and pull it up around your legs and lower torso. Pull one over your head and rip a small breathing hole for your face. Now you’re in a very cheap, disposable bivouac shelter that protects from windchill and rainchill. A number of past ASRC members say they are alive today because they learned to carry a couple of leaf bags with them even on short dayhikes.
The ASRC Training Standards specify a supply of five leaf bags. Why? As with anything designed by a committee, there are probably many different reasons. One is that you might be leading a team of firefighters or spontaneous volunteers who might not have raingear, get caught out in a rainstorm, and have some hypothermic people to deal with; if you just have people use them on their upper bodies, you’ve got enough to supply five other people. Another is that you can fill a couple of them with leaves and bark to create an improvised insulating pad under an injured team member or search subject.
If you want something more upscale than leaf bags, you might consider a European-style bothy bag. Both bags are basically lightweight waterproof tents (the lightest but most expensive are of sil-nylon) for a few people, usually 2 or 4 people, but larger ones are available. They’re designed for short-term shelter for a group when someone’s ill or injured, or the group is trapped by bad weather. Your heads are the tent poles, and your butts on little flaps at the bottom serve as the tent stakes, although you can also flip it over a group that’s standing. Body heat quickly warms the inside. They have small vents to keep the condensation down, at least a bit. If your team has to stop for lunch and it’s cold and rainy, one of these can provide some welcome warmth and shelter for the group.
European style bothy bags are sometimes called bivouac sacs, but in the USA we tend to use “bivouac sac” for what can also be called a sleeping-bag cover, even if you use it without a sleeping bag. You can certainly use two leaf bags as a sort of sleeping bag cover, but it doesn’t work all that well. You can also use an aluminized “space” blanket held together along the edges with duct tape, but that doesn’t work so well and crinkles VERY LOUDLY all night long. You can get aluminized plastic bags shaped like a sleeping bag for $10-20, and they work fairly well, but they don’t breathe so you tend to get wet from condensation during the night. A more expensive alternative at about $60 is the Adventure Medical Kits SOL Escape Bivvy which is as waterproof as Gore-Tex, but more breathable. It is reasonably sturdy and relatively light. You can get much fancier sleeping bag covers with hoods, poles to keep the top off your face, and mosquito netting and the like, and they work better, but these are heavier, bulkier and cost hundreds of dollars.

Personal First Aid Kit
Personal medications for existing medical conditions are essential, especially an epinephrine autoinjector and a H2 antagonist such as chewable famotidine (e.g., Pepcid Complete) and/or a chewable H1 antagonist such as diphenhydramine (e.g., Benadryl) if you have a history of anaphylactic reaction to beestings or other allergens.
Many like to carry common over-the-counter medications, such as:
Acetaminophen (generic Tylenol) for pain
Diphenhydramine (generic Benadryl) for itching at nighttime 
Fexofenadine (generic Allegra) for itching during the day
Famotidine (generic Pepcid) for acid indigestion, for immediate allergic reactions such as to beestings, or for hives some people get from the cold
Loperamide (generic Imodium-AD) for diarrhea. 
Naproxen (generic Aleve) for pain
Pramoxine-menthol cream (generic original GoldBond cream) for itching
Sting-Eeze for beesting pain
Most people carry minor injury supplies, such as Bandaids, and moleskin or 3M micropore tape or similar for blisters. Ampules of tincture of benzoin are popular to apply to skin before moleskin or Bandaids, to make them stick better, especially in wet conditions. 
A tick remover is a good idea; inexpensive small green plastic twisting devices such as the Otom Tick Twister are best.
Miscellaneous Gear
If you ask a random sampling of five ASRC members if a Swiss Army knife or multitool is essential to bring on any SAR task, you will probably get an emphatic “yes.” If you ask the same random sampling of five ASRC members which Swiss Army knife or multitool you should get you will probably get five equally emphatic but completely different answers.
A compass suitable for orienteering-type navigation is a standard part of any SAR team member’s gear. The kind with a rectangular clear plastic base and a fluid-filled needle housing that can be rotated is standard. Compasses that allow you to adjust the declination (difference between map north and magnetic north) cost more but most SAR team members advise that it’s worth the money. Compasses with sighting mirrors seem to get used as more as aircraft signaling devices than for sighting. If you plan to travel to the southern hemisphere and want to use your compass there, make sure that you get a model that works both in the northern and southern hemispheres, as the magnetic needle dips differently in the different hemispheres. You can use a military style lensatic compass for SAR navigation, but it needs to be the kind with a straightedge on one side. 
While experienced ASRC members will tell you that the most important tool for navigation is the ability to read a map and plot a route on it, there is no denying that a GPS unit excels at providing a precise location of your team. Almost any GPS unit or smartphone can provide your GPS location. There is a free app called USNG that’s available for iPhone and Android that does nothing but give you your location in USNG coordinates, which, if you have a map with USNG or UTM coordinates on it, is all you really need. GPS apps and units add features such as the ability to view maps on them (maps of varying quality), to track your course and show it on the map, to put waypoints on the map, and to export tracks and waypoints. While dedicated GPS units by companies such as Garmin have been popular, GPS apps such as BackCountry Navigator and Gaia, which can display high-quality topographic maps onscreen, are becoming more popular. For popular Garmin devices and smartphone apps such as Gaia, it’s possible to download search task maps to the unit or app. You can then track your team’s position and add waypoints for clues or other important landmarks, and download these once you get back to Base. 
Handheld lights just don’t cut it when you need both hands free, for instance to clamber over rocks or fallen trees. There is no reason to get a headlamp with an incandescent bulb, get one with an LED bulb. Those who use headlamps all the time on a regular basis, such as cavers, prefer more expensive lamps with many features and rechargeable batteries. If you only plan to use a headlight occasionally, a model that uses disposable AAA cells is best; disposable lithium cells cost about the same as alkaline cells in terms of headlamp life per dollar, but have a longer shelf life and perform better in the cold. Such an entry-level headlamp (e.g., a Petzl Zipka) costs about $30. 
Clothing
When picking clothes to wear on a task, and picking extra clothes to put in your pack or keep in your vehicle, you need to select appropriate clothing for the potentially rapidly-changing weather conditions found in our area. The following information will help you choose good clothing. As an anonymous Norwegian once said, “There is no such thing as bad weather, there’s only the wrong clothing.” Hint: cheat by checking the weather forecast for the next couple of days.
Another thing to consider when deciding which clothing to put in your pack, and how much clothing: hurry up and wait. If you’re in a small group on an outdoor recreation trip, you can keep going to keep warm. But in search and rescue, you often get told to wait for further instructions. And you don’t want to take the time to set up a bivouac, as you might have to start moving again at any minute. So pack a bit more extra clothing than you would for a dayhike.
Use the layer principle for clothing: multiple layers instead of a single thick coat. The advantages include flexibility for changing temperature and exertion levels, and trapping air that serves as weightless insulation. Full-zip midlayers and shells also make it easier to adjust to changing conditions, for example when coming up onto a wind-exposed ridge just as the sun goes behind a cloud. Or, even when the weather or terrain don’t change, since search and rescue, just like the military, has a lot of “hurry up and wait”: when you’re hurrying you get hot and sweaty and when you’re waiting you then quickly get cold. Given we perspire all the time (“insensible perspiration”) and sweat when we exert ourselves, breathability is important for staying dry. Not only is this important for helping keep your insulating layers dry and more effective at insulating, it makes you feel more comfortable. 
Baselayer is designed to be worn all the time, best if thin and highly-wicking, and a zip-neck will aid in ventilation when adjusting for changing conditions. Wool, Capilene or equivalent and silk are popular. Avoid cotton, except for cotton treated with Dri-Release, which works as well as Capilene as far as wicking, rapid drying and not holding much moisture against the skin.
Insulation layers (midlayers) include knit wool, which ventilates very well and keeps you drier during exertion. Polyester fleece breathes less, but still fairly well, and down or artificial-fiber batting vests don’t breathe much at all. 
A shell garment is an outer garment that is wind-resistant, and can be both tops (jackets and parkas) and bottoms (windpants, rainpants). A windbreaker or windshirt is generally thin, light and wind-resistant, but not water-resistant. Softshell garments tend to be soft and wicking on the inside, stretchy, and variably wind- and water-resistant. Waterproof raingear is seldom used as a shell garment for outdoor pursuits due to the problem of condensing perspiration inside. Most outdoor raingear is made of a waterproof-breathable material such as Gore-Tex. 
When picking pants, don’t forget that you’ll want some rainpants as well as thick, warm pants for winter, and thin, tough pants for summer (tough to resist when you have to force your way through a thorn thicket of blackberry or multiflora rose.
Duvet is a British term for a down or similar batting-filled vest or jacket. In cold weather, experienced people keep a duvet in their packs to pull out as soon as they stop and before they chill, or for use in an emergency. 
You should know about common outdoor clothing materials and their advantages and disadvantages, with particular focus on their performance in cold, wet conditions. Reference: 
Polyester (e.g., Capilene) is commonly used for baselayers and for midlayer fleece, is lightweight, dries quickly and retains much of its warmth when wet.
Wool (often merino wool, which is expensive but soft and comfortable against the skin) is good for baselayers and midlayers. It is not as light as polyester, nor does it dry as quickly, but ventilates better, is more stretchy, and it will take about twice as long to smell bad compared to polyester. Wool is still the go-to material for socks, because unlike cotton or artificial fibers, it does not mat down under your feet, and continues to provide padding underfoot to prevent sore feet. Experienced outdoorspeople tend to wear wool socks even in the summer. Wool does retain a lot more water than polyester fleece, but it’s easy to squeeze out the water, or in the case of socks, spin around your head to get out the water.
Down provides the lightest warmth, and is very compressible. However, it becomes essentially useless when wet, and even so-called “waterproof down” loses most of its insulating properties when wet. It also takes a long time to dry. Most down garments and sleeping bags have outer fabric that is waterproof-breathable which does help somewhat. Unlike artificial fibers, down is a natural product and varies considerably in quality, which corresponds with loft = warmth per unit weight, compressibility, and ability to re-expand after being tightly stuffed. Connoisseurs of down clothing recommend high-end suppliers of down gear such as Feathered Friends or Western Mountaineering.
“Artificial down” (e.g., Primaloft) batting is heavier than down, not as compressible as down, doesn’t last as long as down, but retains much of its warmth when wet. 
“Cotton kills!” is a traditional mantra of survival instructors. Hard-woven cotton is tough, which is important in summer bushwhacking (off-trail travel), due to immature forests and open areas filled with thorn-bearing blackberry, multiflora rose and greenbriar (variously referred to as brambles, sticker bushes, or jagger bushes). Cotton may be appropriate for hot, humid conditions, provided conditions don’t change, or you have backup clothing if a cold front comes through. Cotton wicks well, meaning that it sucks sweat off your skin well, which is a good thing for a baselayer. Treated polyester, silk, wool and Dri-Release fabrics also wick well, but unlike cotton, they don’t hold onto much water, they transport it out away from your skin to evaporate, which means they also dry quickly. Cotton holds lots of water next to your skin, and thus loses all its value as insulation once it gets wet. Cotton clothing such as blue jeans or cotton flannel shirts will soak up a massive amount of water, even if only a small portion is exposed to rain, and become very heavy. The cotton holds the water against your skin, sticking to and abrading your skin, and feeling cold, clammy and generally yucky. Cotton, other than Dri-Release cotton, is never appropriate for cold-wet conditions, even for underpants. Polyester briefs and boxers are available from multiple manufacturers.
Nylon material is used in shell garments, either as the outer layer of waterproof-breathable garments, or by itself for a lightweight windshell, often with a durable water-resistant treatment (DWR) without sacrificing breathability. Nylon can be treated to make it waterproof (and also not breathable at all), and then used for tents or bivouac shelters. Sil-nylon is the current lightest and thinnest, but also most expensive, type of waterproof nylon for such shelters; Sil-nylon is short for silicone-treated nylon. 
Softshell materials are widely used in outdoor gear, and for good reason. Unlike hardshells (waterproof-breathable shell garments) soft­shells generally are somewhat stretchy. They have an inside that feels soft due to a wicking layer of polyester or wool baselayer-type fiber, and an outside that feels hard, usually from nylon fibers. Compared to hardshells, softshells are not as windproof or waterproof, but much more breathable. For active (=sweaty) activity in mixed conditions with small amounts of rain or even fairly heavy snow, they often keep you drier than a hardshell, even a hardshell with pit zips. Softshell pants are particularly prized by wilderness enthusiasts. Softshells vary widely in terms of stretch vs wind/water resistance; there is a trade-off, and those that are stretchier are less wind/water resistant and vice versa. Some are thick, and fuzzy enough on the inside, that they provide significant insulation; others are thinner and don’t provide any significant insulation.
Waterproof-breathable shells, also known as hardshells, generally have a nylon outer shell and an inner layer of expanded polytetrafluoroethylene (Teflon) or similar. That inner layer has microscopic holes that pass water vapor, as from sweat, but are impermeable to liquid water. These garments excel at keeping water out, but despite manufacturers’ efforts ever since the introduction of the first Gore-Tex parkas back in 1970, still have far less breathability than softshells or nylon windshells. And, when the outside of one of these materials is coated with water, they don’t breathe water vapor at all. Thus, high-end hardshells designed for strenuous activity in the rain include pit zips (armpit zippers) or other ventilation devices to cut down on condensation inside them. 
One exception to the “no-cotton rule” for outdoor clothing, at least in cold-wet conditions, is cotton treated with a patented process called Dri-Release. This process partially coats cotton (or other fibers) with Teflon. As a result, these materials absorb very little water. SAR teams find these materials attractive for uniform T-shirts, as they look and feel like cotton, take a silkscreen logo well, retain their warmth when wet, wick well, and are fast-drying. Such team T-shirts serve well as a baselayer top.
Consider spending extra for clothing that is easy to adjust for changing conditions. Zipping and unzipping layers, pulling up or pulling off a hood, or hat or gloves or facemask, can make a big difference in your temperature. Parkas with big exterior pockets are great for storing hat, gloves and facemask. A full-zip fleece or sweater allows you to ventilate better, and get it on and off easier, than a quarter-zip one that you have to pull over year head. For that matter, a half-zip instead of a quarter-zip will allow you to ventilate better. Fleeces or baselayers with sleeves that you can push above your elbows help you adjust to changing conditions. Parka pit zips do a lot to help adjust your temperature.
Being closely conscious of changes in your body temperature, and adjusting your clothing for them, are a best practice. Changing your clothing for every change in the wind isn’t necessary, but you should routinely make adjustments that don’t slow you down. When your body temperature is just right, that gives you more leeway to get hotter or colder if something bad happens.
For more information on this topic, see: 
Feet
One of the major medical problems that impact performance in military boot camps, and with “tenderfoot” new outdoor enthusiasts, is blisters. 
The military, under the direction of Dr. Murray Hamlet, has researched the problem in detail, and designed new “Hamlet Socks” that help prevent blisters. Originally they considered thick socks with a thin liner sock, as was the tradition for some hikers and climbers, but abandoned this after they found that a single-layer sock, if designed properly, works as well to prevent blisters. 
Hamlet socks are made of wool, but as Murray Hamlet confided, the military was unable to afford the fine merino wool that would make them better. They have a plush pad of terry-knit wool, similar to the terry-cloth of a bath towel, but with the terry loops on the outside of the sock; having them on the outside seems counterintuitive but worked significantly better than with them on the inside. 
For a commercial equivalent, softer and more comfortable but made from more expensive merino wool, Hamlet recommended SmartWool or similar socks, but turned inside out so the plush terry pad is on the outside (he said they sold better with the plush on the inside even though not as good for preventing blisters), or better, wool trekking socks long made by Jacob Rohner of Switzerland, which have somewhat harder terry plush on the outside. Darn Tough Hike/Trek cushioned boot socks, if inside out, come close to the original Hamlet boot socks, as the plush terry twists are more tightly twisted and harder than SmartWool socks’ softer terry twists.
One problem with socks with terry loops on the outside is that they are even better than regularly-worn socks (which are pretty good themselves) at picking up lots of burs, burrs, hitchhikers, whatever you call those Velcro-like seeds that like to stick to fuzzy clothes. The solution is to wear a pair of gaiters over your socks; gaiters are things you wrap around your bootlaces and at least part of your lower legs. Not only do they keep prickly things from sticking to your socks, they keep water, dirt and pebbles from getting between your boot and sock. As with Swiss Army knives and Leatherman tools, there seems to be a competition amongst members of both sexes to get the tallest, heaviest and manliest-looking gaiters, with Outdoor Research Crocodile Gaiters being particularly popular among ASRC members. However, even a small, lightweight pair work pretty well. 
Boots are important for wilderness search and rescue. Quality is important, fit is very important, and weight is also important: it’s said that a pound on your foot is like ten pounds on your back. 
Wilderness search and rescue is not like a through hike on the Appalachian Trail, where some recommend soft neoprene toe shoes, or like Grandma Gatewood who used cheap tennis shoes to hike the entire Appalachian Trail (three times, the last time at age 75). For search and rescue, you are often off trails, and you can’t watch your footing while carrying a litter. You need more ankle protection from rocks and ankle support to prevent sprains. For summer tasks lightweight non-leather trail-running shoes may work, as long as they are high tops, but they don’t provide as much ankle protection against rock bruises as a thicker leather boot. Some hiking boots are not waterproof, and breathe better, but waterproof boots are recommended for search and rescue. 
Hiking boots generally come with a fairly high-quality removable OEM (“original equipment manufacturer”) insole. Many experts, however, recommend using a more expensive after-market insole, such as SuperFeet insoles, sold by REI and other outdoor stores. These high-end insoles are expensive, but are significantly better than OEM insoles at preventing sore feet. There are versions for high and low insteps, so it’s important to get the right one to fit your foot. There are also low-volume (thin) ones that are a one-for-one replacement for most OEM insoles. The high-volume (thick) insoles, however, are best bought and fitted at the same time as getting a new set of boots, so that the boot fits well with the thicker insole. Especially for “weekend warrior” type SAR personnel, sore feet can limit members’ time in the field. Having wool socks and after-market insoles can allow them to stay in the field longer.
One trick for preventing and treating sore feet is to simply elevate the feet. During a rest stop or when waiting, propping your feet up for even a few minutes. It may look silly, but it may help you stay in the field longer. And after you have done it once or twice your feet will feel so much better that you won’t care if you look silly. Dipping feet in cold water for a few minutes will help, too. 
Another way for preventing both toe blisters and sore toes is to, at the beginning of a long downhill bit, tighten your bootlaces to prevent your toes from sliding too far forward in your boot and jamming up against the toe of the boot.
 
Hypothermia = low (hypo-) temperature (‑therm-) condition (-ia). It’s also known as Killer of the Unprepared. Hypothermia is when the body gets chilled – not just the skin and muscles, but deep inside.
Heat Balance: Your body produces heat continuously; your heat production must be balanced by an equal heat loss to keep your body tempe­rature from going up or down. You must keep your body temperature within a narrow range for vital chemical processes to work. Use clothing and knowl­edge to keep your body core near 99°F=37°C, even in hypothermia weather.
You lose heat from your body several ways:
Cold Temperature: radiation (like heat radi­ating from a hot stove) and conduction (like sitting on a cold rock).
Windchill: convection, as body-warmed air blows away.
Wetchill: you lose heat when you are wet. By con­duction into and through the cold water in your clothes, and by evaporation. (Like alcohol on your arm cools by evapo­rating.)
Hypothermia is a particular problem at tempera­tures around freezing (32°F=0°C) with wind and rain: cold temperature, windchill, and wetchill combined. This is called hypothermia weath­er, because so many under­estimate it. Even in the summer, sudden storms with the combination of wind and rain may cause hypother­mia at temperatures as warm as 60°F=16°C.
In bad weather, clothing is your life-support system.
Waterproof raingear protects you (somewhat) from wetchill. But even in truly waterproof raingear you will get wet. We all perspire, and clothes get wet from condensation, even in “waterproof-breathable” parkas. 
Most clothing, when it’s wet, conducts heat like water. How many times faster does water conduct heat than dry air? 240x! Therefore your clothes must be warm when wet!
And, as nice as down parkas may be (even so-called “waterproof” down), they are flat and cold when wet. Cotton clothes (such as blue jeans and flannel shirts) are even worse; they are essentially useless as insulation when wet. Only wool and some synthetics (Capilene, other fleece) retain some warmth when wet.
So, when going out, remember the Three W’s.
Waterproof Clothing
Warm-when-Wet Clothing
Windproof Clothing
Always carry two large plastic leaf bags. These are light, cheap, and pro­vide quick protection against wind and rain. Just stick them in your pocket or pack.
If someone in your team is getting hypothermic, or worse if you are all getting hypothermic, take action immediately. Let Base know if you can reach them. Quickly try to get to a sheltered location. Check with team members to find extra bits of clothing to put on the hypothermic team members. Get the hypothermic people into shelter, with leaf bags if nothing better is available. Make sure you insulate under hypothermic people as well. Get food and water into hypothermic people, even if they don’t feel hungry: food is fuel for the warming fire in the center of our bodies, and digesting it makes you warmer.
Graphics courtesy of Gene Fear

Frostnip, also known as superficial frostbite or first-degree frostbite, is freezing of the superficial tissues, but sparing the deeper tissues. This is seldom a problem in your rescue patients, but may be a problem in team members involved in winter operations.
Frostnip commonly affects your and your teammates’ fingers, toes, ear lobes, and noses. You can recognize it by a sudden blanching of the nose, ear, or fingertip. Although the part is pale or yellowish, it is still soft to the touch, not hard and “woody” as in deep frostbite. Numbness is not a useful symptom for diagnosing frostnip. A frostnipped area may feel numb, but cold skin gets numb well before it becomes frostnipped.
The wind-chill temperature does not represent a good index of hypothermia danger. However, it is a good index of the danger of frostnip and frostbite. Face masks and goggles or sunglasses are a necessity for windy deep-winter search and rescue operations. If you don’t have face masks in bitterly cold weather, or when the wind is very strong, it is a good idea for team members to check each other’s faces regularly for the blanching that is the first sign of frostnip, and to stop and rewarm immediately.
Treatment of frostnip is simple: rewarming by a warm hand over the nose or ear, or by placing a frostnipped finger in the mouth, in an armpit, or in a warm pocket. On rewarming, the affected part tends to turn red, painful, and possibly slightly swollen, but no permanent damage results. Providing a warm armpit for a someone’s frostnipped toes is supposedly a mark of true friendship.
Deep frostbite is different from frostnip: the deep tissues are also frozen.
In deep frostbite, the subcutaneous tissues are frozen solid, and the affected part feels hard, like a piece of wood or frozen meat.
Freezing causes great tissue damage, but the effects are postponed until the part is re~warmed. Once the frozen parts are rewarmed, the damage becomes evident, with excruciating pain and blistering.
Trauma to frozen tissue may push sharp ice crystals into cells, rupturing them. Napoleon’s battle surgeon, Baron Larrey, suggested rubbing the affected parts in snow to increase circulation. We now know this will cause much more damage than it cures.
It is said “you can walk on frostbitten feet, but you can’t walk on rewarmed feet.” True, but walking on frostbitten feet is a really bad idea unless it’s the only way to save your life.
Unless circulation is impaired, for instance by too-tight boots, or from dehydration or hypothermia or exhaustion, the human body is highly resistant to freezing. Note that wearing two pair of socks with a pair of boots fitted for one pair of socks is a common cause of frostbite (“two-sock frostbite”), even appearing in the military medical literature.
Even a vigorous, healthy person may get frostbite if it is very cold and the wind is very strong across an unprotected nose or ear. It is also possible to get frostbite by touching a bare hand to a piece of supercooled metal, or by spilling sub-freezing stove fuel on a hand. (Gasoline and alcohol are still liquid at temperatures below the freezing point of water.)
A secondary phase of damage occurs after rewarming. The frozen and thawed tissues become inflamed, with damage to the inner lining of blood vessels, which leads to small clots. Blood vessels also leak, causing swelling, and go into spasm, cutting off blood supply to the tissues. This all causes more damage and loss of tissue.
A major goal of management is to prevent this additional damage after rewarming.
The proper definitive treatment, in the hospital or in the field, is rapid rewarming in hot water, 99-102° F (37-39°C). If you don’t have a thermometer, dip your elbow in the water; if the water feels hot but you can keep your elbow in, it’s probably about right. 
However, don’t rewarm until there is no danger of re-freezing. Refreezing causes severe damage.
Frostbitten limbs are numb, so don’t cook them in too-hot water, or burn them by rewarming in front of a fire.
There is some evidence that non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin, Nuprin, Advil) or naproxen (Aleve) or aspirin, if given early, will help prevent some of the additional tissue loss after rewarming. Ibuprofen is preferred but only based on shaky evidence, and any of the three is better than none of them. The sooner the person takes a NSAID the better.

Dehydration is a common problem on SAR tasks, even in the winter, when you lose lots of water by your airways humidifying the dry air you breathe in, and then lose that water when you breathe out. In the winter, a “rebreathe flap” across your mouth and nose, either a scarf or a commercial neoprene/fleece face mask, can decrease this water loss and also decrease the heat loss from evaporation from your airways.
But dehydration is much more common in hot weather.
Signs and symptoms of dehydration include thirst, but thirst does not always occur when you’re dehydrated. Instead, you may develop lightheadedness, weakness, tunnel vision, or headache. Producing no urine, or small amounts of dark urine, is also a sign of dehydration. Lack of urine or dark urine is probably the most reliable way to tell you’re dehydrated. 
Dehydration can make members so weak they cannot continue with the task, or in extreme cases they may not be able stand without losing consciousness. With advanced dehydration comes nausea, and this may overwhelm any feelings of thirst Even mild dehydration decreases aerobic and muscular performance, and recent evidence shows that, although it doesn’t decrease reaction time, it does decrease mental performance. 
Prevention involves having enough water to drink. That means taking enough with you, especially in hot weather. A single liter/quart water bottle is not nearly enough for a long task on a hot day. Water bladders (e.g, CamelBak) can hold multiple liters of water, and the ease with which you can drink from them encourages sipping, and likely improves your physical and mental performance. 
When appropriate, monitor yourself and your teammates for dehydration. Team leaders will sometimes even schedule pee stops, and ask about the amount and color of your urine. 
Treatment of dehydration seems simple: drink more water. However, dehydration from sweating involves loss of water and salt. If you don’t have enough salt to hold the water in you, any water you drink will pass right through and you’ll stay dehydrated. This is important particularly at the beginning of hot weather when people aren’t acclimatized to the heat. One part of heat acclimatization is that your sweat glands switch to producing less-salty sweat. It takes about two weeks of moderate exercise in the heat to acclimatize. So, especially if you’re not acclimatized to the heat, you need to increase your salt intake. Salty snacks will help, and you can carry some fast-food salt packets in a plastic bag to add to your food. Salt tablets are not a good idea because they can really mess up your stomach. 
Heat exhaustion is basically just very bad dehydration, bad enough that you almost pass out. There’s no real dividing line between dehydration and heat exhaustion. 
When you get dehydrated, your body temperature will rise a bit, so a person with heat exhaustion may be a bit on the warm side if you feel the skin or use a thermometer. However, the skin should still be at least a bit damp. 
The treatment is rest in a shady area, if needed, and salt and water repletion. 
Heat Stroke is qualitatively different from dehydration and heat exhaustion. In a hot environment, heatstroke may come from heat exposure in someone who is taking a medication that interferes with heat regulation, without much exertion. It can also come from aerobically-fit people who, in a hot environment, can create heat faster than they can get rid of it (“exertional heatstroke”). The person’s core body temperature rises so high that it starts damaging vital organs. Heatstroke can cause lifelong medical problems or death.
There’s no way to tell in the field if there is liver or kidney damage, but damage to the brain is easy to spot. If a people are in the right setting for heatstroke, their skin is very hot and maybe dry (maybe not dry in exertional heatstroke), and they are confused or comatose, you should assume that they have heatstroke and treat them for it.
Treatment for heatstroke is fairly simple: reduce the person’s temperature to near-normal. Cold or even cool water on clothing is the best technique for in the field; fanning to increase evaporation will help. 
Immersion in cold water works, but there may be risk of drowning. And some say that icy water on the skin causes the blood vessels to constrict by reflex, and that evaporation, at least if it’s not too humid out, cools faster. 
But make sure not to over-cool, people with heatstroke can’t regulate their own temperature, so if you tool too much, hypothermia is also a risk. If you have a thermometer, cool to 104°F (40 °C) as a good target, try not to get below this. 

To provide accurate, clear, and effective reports over a radio during a SAR operation, you need to take time to organize, and maybe even rehearse under your breath, a succinct message before you speak on the radio and to use basic ASRC radio standard operating procedures. 
The current  (available in the ASRC Archive) has the standard ASRC prowords and phonetic alphabet. You don’t need to memorize everything there to meet the requirements for Field Level IV, but you should keep a copy of this crib sheet or an equivalent in your SAR pack. 
For Field Level IV, the expectation is that you can use the or equivalent rather than having the entire phonetic alphabet memorized. 
Essential prowords you need to know: 
This Is
Over
Go Ahead
Roger
Affirmative
Negative
Clear
Clear the Net
Secure the Net
Status One
Status Two
Status Three 
To speak over the radio, you should practice so that you can confidently and reliably do the following:
Push the push-to-talk button
Pause for a second (some radios miss anything in the first second after pushing the push-to-talk); taking a deep breath will do
Speak in a normal tone: loud voice levels cause over-modulation and distorts your voice so it’s hard to understand
Speak slowly and distinctly
Use the basic prowords above and remember that in search and rescue, you always say “you, this is me,” not “me to you”
You must also remember, if speaking for a long time, to release the push-to-talk occasionally, to make sure your message is being received and understood. This also leaves room for priority messages to break in. “How copy so far?” is often used right before such a pause.
You should learn basic handheld radio operation for the radios you’re most likely to use, practicing until you can do them confidently and reliably:
Off/on switch
Volume adjustment
Push to talk
Channel selector
Squelch if set by a knob and not by a menu
Attaching and detaching an antenna
Replacing a battery, and if appropriate
Toggling on and off the keyboard/channel select lock
Any other buttons you might accidentally hit that might cause a problem with the radio, and how to fix the problem

There are different ways to specify your position, for example, latitude and longitude, or bearing and distance off a VOR aerial navigation beacon. However, the system used almost exclusively for wilderness search and rescue is the Universal Transverse Mercator (UTM) or the similar but newer United States National Grid (USNG).  There is a free USNG (U.S. National Grid) app, which we strongly recommend you obtain and put on your smartphone.
A USNG coordinate consists of three parts:
A Grid Zone Designation specifies one of sixty vertical slices that cover the globe. A search in the mid-Appalachian area will be in UTM Zone 17S, 17T, 18S, or 18T, but for a particular lost-person search, the entire search area will be in only one of the zones, so we don’t usually report or record the zone.
A 100,000-meter Square Identification; for regional areas. Again, we will not need to use this for lost person searches, so we don’t usually report the square.
A Grid Coordinate, which we do report and record. 
The UTM system is exactly the same but without the 100,000-meter Square Identification.
Numeric USNG/UTM grid coordinates may be to an arbitrary precision, but it’s standard to report your position to a 10 meter precision, using four digits. That number is a certain number of meters east of your Zone 17S, 17T, 18S, or 18T western zone boundary, and a certain number of meters north of that zone’s southern border. The standard mnemonic for this it “read right, up.” Others say “read from left to right, then from bottom to top.” 
For example, if you were standing at the Newcomb Hall Post Office at the University of Virginia, which is the ASRC’s official mailing address, the USNG app and see “17S QC 1880 1269.” You would ignore the “17S QC” as it would be the same for everyone in your vicinity, and report your position over the radio like this: “Base, this is team Bravo. Our location is, figures, WUN, AIT, AIT, ZE RO, [pause] WUN, TOO, SIX, NIN er. How copy, over?” 
The map on the next page has UTM grids on it. Note that grids on maps give one more digit than we and the USNG app use; you strip off the last digit of both the easting and the northing (other terms for the “read right, up” principle), and then give the remaininglast four digits If you were reading your position off a map instead of a GPS, and you were at the top of Robertson Mountain, you would report your position as “We are at the top of Robertson Mountain, which is, figures, TREE, WUN, FIFE, WON, [pause] SEV en, TOO, FOW er, WUN. How copy, over?” 
For training and search tasks, Base or a Field Team Leader may give you a compass safety direction, such as northeast. If you get separated from your team, and you go this direction, you will come to a feature, such as a road or stream, that will allow you to get back to civilization. It’s a good idea to look at the map yourself and pick a safety direction, if possible, before heading out on the task.

Communications: the ICS says that you should only use plain English and position titles or last names. Per the ICS, don’t use non-ICS abbreviations or 10-codes or the like. For the ASRC, we do use standard radio prowords in the  including Status 1, Status 2, and Status 3 but everything else is in plain English. 
Task Assignment Form (TAF): this is a form, somewhat similar to the ICS Assignment Form (ICS 204), that the ASRC’s Yorke Brown and Keith Conover, with input from other ASRC members, originated in the early 1970s. The TAF is used in variants nationwide for assigning tasks to search Field Teams; TAFs are covered in detail for Field Level III; Field Level IV need to know that a TAF is a wilderness search and rescue add-on to the ICS, is commonly used, and that the Field Team Leader is responsible for carrying out the task specified on the TAF. 
For purposes of ASRC Field IV (Trainee) testing, we do not expect you to memorize the names for the various supervisory positions (Officer, Chief, Director, Supervisor, Leader) nor the differences between Branches, Groups, or Divisions. Or the various units that may be parts of a Section, Branch, Group or Division. Or the definitions or standard sizes of Strike Teams or Task Forces, as in wilderness search and rescue it is a best practice to hand-craft variable-size Field Teams for specific tasks. However, you may need to memorize these long enough to pass the NIMS/ICS classes required of emergency responders by the Federal government, and as you progress in your SAR training, these ICS terms will become more important.  

You must learn how your Group alerting process works, and how you are expected to respond when alerted.
You must learn safety best practices, including 
Double-checking knots and rigging by a separate person.
Wearing a helmet and gloves when appropriate, 
Carrying some semblance of the Ten Essentials and the ASRC required gear list, given the task and the weather and the terrain.
You must learn best practices for conduct during a search and rescue operation, including 
How to sign in and out of the mission and it is so important; i.e., you don’t want to be in trouble because people are out searching for you when you’re really on your way home; it has happened, many times.
What a staging area is (where you rest, eat, drink, and mostly wait for an assignment), the common problem of having to wait patiently for a field task, and why it’s important not to bother incident staff.
The chain of command and why it important to observe it, although with the option to refuse an unsafe task at any po.
Accountability including Personnel Accountability Report or PAR (“we have PAR” meaning that everyone on our team is here or otherwise accounted for).
You must, despite the stress of SAR operations and the egos involved, know how to conduct yourself appropriately, and how to manage difficult interpersonal relations, including
Conduct when approached by the press: give general information on what it’s like be involved in SAR, but refer all specific questions about the operations up the chain of command or to the Public Information Officer (PIO).
Observe communications security by turning down your radio when near people other than your team, and turning volume way down if you hear Secure the Net.
Understand how interpersonal/interagency conflicts may be as dangerous to the mission as incompetence, and the importance of trying to defuse them.
Understand the importance to avoid even the appearance of publicly criticizing other persons or organizations involved in the mission; if you must do so, do so privately one-on-one with your superior in the command chain or in a secure debriefing; as your mother used to say, “if you can’t say anything nice about someone, don’t say anything at all.”
Understand the importance of avoiding even the appearance of freelancing/self-deploying: responding to a situation without the approval of the Agency Having Jurisdiction/Responsible Agent, or responding to the field or deviating from your assigned task without coordinating with Base. Freelancing/self-deploying can be by individuals, field teams, or SAR organizations. 

The following is copied verbatim, from , 10/14 version, with permission. It covers non-technical evacuations: how to carry a litter.
Well, no, it’s not really, it’s pretty hard work, but learning how to carry a litter isn’t very hard. 
The first rule is to not get hurt. The easiest way to get hurt is to pick up the litter wrong and mess up your back. 
You have probably heard all the hype about “lift with your legs, not your back.” But it’s all true. Bending over a litter and then lifting is a great way to give yourself pain and misery for a week or so. Or maybe the rest of your life. 

With a litter, though, it’s hard to get close enough to lift with your legs. There are a couple of tricks. 
The first trick works like this.
 1 Face the litter
 2 Squat down on one knee. Keep the other knee up. (Some obsessive-compulsive people insist that everyone get down on the same knee. Ignore them)
 3 Put both hands on the litter rail. Lean away from the litter. This keeps your back reasonably straight and upright.
Here’s the second trick. When it’s time to lift the litter and you hear  say “  ” don’t lift. Right. Don’t lift. 
Instead, pull out. Pull directly away from the litter bearer across from you. The litter will lift slowly and smoothly. (Slowly and smoothly is good for preventing bad things. Like back strains. Like dropping the litter.) I know it seems like magic, and maybe it is, but try it, you’ll like it. 
Now for a joke. (Bear with me, it’ll be relevant in a bit. Well, a little bit relevant.) Goes like this:

Once I saw this guy on a bridge about to jump. I said, “Don’t do it!” 
He said, “Nobody loves me.” I said, “God loves you. Do you believe in God?”
He said, “Yes.” I said, “Are you a Christian or a Jew?” 
He said, “A Christian.” I said, “Me, too! Protestant or Catholic?” 
He said, “Protestant.” I said, “Me, too! What franchise?” 
He said, “Baptist.” I said, “Me, too! Northern Baptist or Southern Baptist?” 
He said, “Northern Baptist.” I said, “Me, too! Northern Conservative Baptist or Northern Liberal Baptist?”
He said, “Northern Conservative Baptist.” I said, “Me, too! Northern Conservative Baptist Great Lakes Region, or Northern Conservative Baptist Eastern Region?” 
He said, “Northern Conservative Baptist Great Lakes Region.” I said, “Me, too!”
I said, “Northern Conservative Baptist Great Lakes Region Council of 1879, or Northern Conservative Baptist Great Lakes Region Council of 1912?” 
He said, “Northern Conservative Baptist Great Lakes Region Council of 1912.” 
I said, “Die, heretic!” And I pushed him over.

Now, about calls for lifting the litter. 
Some insist that the One True Call is “” Or maybe “” And then there are the Trinitarians who insist on “” Personally, I think that fewer words are better, especially if you’re doing something that will likely leave you short of breath. And, in the early days of the Appalachian Search and Rescue Conference, “” is what we chose as the standard. 
So do it this way. Or get pushed off the bridge. 
The most important thing for  is not what words he or she uses, but that little . During that pause  quickly scans all the litter bearers to assure they are ready. Yes, if you’re a litter bearer and you hear “” and you’re not ready, a little enlightened self-interest suggests you say “” or “” or something similar. I suppose “” is more official-sounding. But is simply being official-sounding enough to establish a new standard? You’re standing right next to the person, so there aren’t likely to be problems communicating. No, there needs to be no One True Call for this. 
Even if the litter bearers are expected to respond if unready, still, it’s  job to make sure everyone’s really ready.
It is important to have one person on the litter, and only one person, who communicates with the Rope Team:

, gets to be ? Options include:
 • Whoever is senior in grade (this means the highest ranking person, e.g., a Field Team Leader outranks a Field Team Member, and whoever has been a FTL longer is senior within the grade of FTL)
 • Whoever wins a vote
 • Whoever is tallest
 • Whoever is shortest
 • Whoever has the coolest helmet or hat
 • Whoever really, really wants to be  
 • Whoever wins the fight
Long ago (circa 1974), the ASRC debated these sorts of things and finally decided it’s your position on the litter. It’s easy to remember: whoever is in the driver’s seat gets to be  Again: the litter bearer in the front left gets to be . I suppose there might be a bit of jostling to see who ends up in the “driver’s seat” but really, everyone’s supposed to be able to do the job. And, if you’re switching off litter bearers (which is a really, really good idea; see below) then everyone eventually gets to be . 
If you suddenly decide to move the litter backwards for some reason, then a litter bearer who was in the back may suddenly become . 
(And yes, if you go to the UK, then the person in the front right is  Now stop it and get back to reading.)
Putting down the litter is almost the reverse of picking it up. The standard call is “”
Again, you lean out and keep your head up and your butt down as you lower the litter. When training people to pick up and put down a litter, it is customary for the instructor to walk around the litter and litter bearers as they are practicing. Sometimes, to prevent back injury, urgent intervention is appropriate. If the instructor sees a litter bearer who is leaning over – as shown by the bearer’s buttocks protruding from the line of litter bearers – verbal remonstrances are inadequate, and the instructor is expected to rapidly and forcefully place his or her boot on the lower back and top of the offending litter bearer’s buttocks and forcefully push it in line. This is just as much a safety measure as a means of negative reinforcement. And, yes, this is where we get the phrase “kick butt.” Actually, I don’t know anyone who does this, as kicking someone in the butt, even in a good cause, is probably a crime. But threatening to do so is pretty common. 
However, there is one major difference between raising and lowering the litter. It’s possible to put the litter down on a punji stick (sharpened sticks left sticking up as a booby trap). Or a shrub someone has cut off with a machete to clear a helicopter Landing Zone (LZ) which is functionally the same. Back when we used to use real Stokes litters, which were also known as Navy Wire Basket Litters, this was a big deal. These original litters had a steel frame with chicken wire in it. Punji sticks left by well-meaning but incompetent machete-wielding landing-zone clearers (or trail maintainers) were a real hazard. You’re supposed to cut off right at the ground, and leave it cut flat, not diagonally-pointed.
Now with plastic Stokes litters, this is much less of a concern. However, putting the litter down on a sharp pointy rock can still crack a plastic Stokes, not to mention flexing the Stokes and hurting the patient. 
So that  allows everyone, prior to setting down the litter, to check underneath for any impediments, for example, wasp nests, mines, or small furry animals.
It’s also very embarrassing when all of the litter bearers let go at the same time, and the litter then slides down the mountain like an out-of-control Olympic Luge sled. Unlike the wire-basket Stokes, which has lots of friction, the newer plastic Stokes are pretty slippery and this is not just theoretical.
There are some simple solutions. Leaving a couple of people holding onto the litter (usually those on the downhill end) will work. However, this may not be favored by the people on the downhill end of the litter. In forested areas, a simple solution is to have a short (~20’ = 6 m) belay line attached to the head of the litter. (Even if you have a 200’ rope attached to the litter for a semi-tech evac, such a separate short belay line may be handy.) Tie a figure 8 loop with a carabiner about 5’ away from the litter. Whip it around a tree and clip it back into the litter and you’re secure. 
There may be times when the Medic tells you that it’s important to keep the litter in a slightly head-down position (perhaps blood loss, dehydration, or hypothermia), or perhaps a slightly head-up positions (perhaps a head injury, or a breathing problem). In such cases some of the litter bearers will just have to suck it up and hold the litter in the appropriate position during a stop.
Shit happens. To litter patients. So does piss. We will discuss management of defecation and urination more in the later section on Patient Packaging.
Vomit also happens in litter patients. And despite the fact that litters are obviously design to carry people on their backs, vomiting when you are on your back is bad. Especially if you have immobilized the neck so the patient cannot turn his or her head. This is a good argument against immobilizing the neck unless absolutely needed. It’s also an argument for not packaging people on their backs, but using the on-the-side coma position, discussed more in the section on Patient Packaging. 
If you see a litter patient on his or her back vomiting, yell “” and rotate the litter away from . Why away from the litter captain? We just need a standard way to do this so litter bearers are not fighting each other to turn the litter different ways. 
Sometimes when I see this in litter practice, I see litter bearers tilting the litter to about a 45° angle. Not enough. When someone is immobilized and vomiting, you need to turn the litter a bit more than 90° to actually prevent aspiration (vomit going into the lungs). Ideal is to turn the litter entirely upside down so the patient is facedown. So if you are doing litter practice, you hear “” and people just turn the litter a little bit, tell them that what they’re doing is a waste of time and that they just killed the patient, and show them how to do it the right way. Tell them I told you to do it.
Speaking of stops: yes, the Medic may need a stop for some medical reason, or you may need to stop to change the litter rigging, or the patient may need to pee. But except for such mandatory stops, the litter should never stop moving; for a rescue team to accomplish this takes study and practice, which is why this essay is so long. 
…

Knowing how to rotate litter bearers the right way can really speed up a nontechnical evac (carryout). And, unlike the bit about calls for lifting the litter, there is only One True Way to rotate litter bearers. The ASRC developed this in the early 1970s, but then as there’s only one way that works best, this has probably evolved independently other places. 
Here are some issues with litter bearer rotation:
 • The litter should not stop. 
 • Litter bearers should alternate using their right and left arms.
 • Litter bearers should be in pairs roughly matched by height.
 • Litter bearers should be ready to rotate in to carrying the litter whenever  indicates a need for rotation by calling “” (the grunt indicates that you really need to come off the litter right now). 
 • Relief litter bearers should not have to fight their way past the litter.
We had tried having the extra litter bearers behind the litter. This didn’t work so well. Say you and your partner come up behind the litter and then grab hold, and then all the litter bearers shift up a bit, and the pair in the front peel off to either side. Then they have to wait for the litter bearers and all of the relief bearers to pass them before getting back on the trail at the end. And, when you’re behind the litter and there is a call of “” (leaving out the grunts from now on), you have to rush up to the litter. And it’s hard to take over on the litter while you’re also walking fast to catch, and trying to watch your feet so you don’t stumble.
So it’s better to have the relief bearers in front of the litter. That way, when you and your partner are at the end of column of relief bearers, and you hear that strained “” from behind, you can step off the trail on either side. You set your feet so you’re stable. Then, as the litter passes, you grab hold of the tail end of the litter, and quickly move out into the trail. 
Say you’re at the back left of the litter. Once you and your partner have hold of the litter, you call “” to let the entire litter team know that it’s about time to shift forwards. 
You then tap the hand of the litter bearer in front of you on the litter, the old back left litter bearer. This is a signal for the litter bearer in front of you to shift forward one position. 
If you’re at the back left of the litter and you hear “” and feel a tap on your hand, you shift forwards to the middle position. Since the foot is the lightest part of the litter and we tend to go head-first, fairness requires that you move forward fairly far, so you’re not right at the tail of the litter, and take your fair share of the load. As you do this, you use your free hand to tap the hand of the litter bearer in front of you.  
If you’re the middle left litter bearer and you feel a tap on your hand, you move forwards to the front, tapping the hand of the left front litter bearer.
If you’re  on the front left, once you feel a tap on your hand, you can let go of the litter, smile, and speed ahead of the litter, switching to the right side so next time you rotate onto the litter you’ll be using your right hand.
Everything is the same on the right side, except you don’t call “” or “”
Tapping the hand is the official way, but I’ve also seen people tapping on the shoulder; works OK unless the person has a big pack on and you can’t reach the shoulder, which is why tapping the hand is the standard, but whatever works. 
Note that there are two parallel messages here... the “” call from the back, and the tapping of hands or shoulders. It’s a bit redundant, but that’s not bad. And, you can think of that “” call as a heads-up that you should start shifting forward on the litter as soon as you feel that hand-tap. 
And, the front litter bearers peel off of the litter, cross sides, and start ahead, moving fast. There often is a long line of potential litter bearers ahead of the litter, and the litter bearers who just peeled off the litter are supposed to head to the front of the line. (The closer you get to the roadhead, the longer the line seems to get.) Now, you might think that asking the people who were just on the litter and likely exhausted to basically do a quick-march to the front of the line is a bit much. 
Once upon a time, my wife and I took our toddler daughter on a hike, doing the Ferncliff Trail at Ohiopyle State Park, a short circuit hike. Usually, she rode in a Kelty toddler pack on my back, maybe walking a little bit at a time. As we started out, with her on foot rather than in the pack, we pointed out the store with the big picture of an ice cream cone on it. “See that? We’ll go there once we’re done with the hike.” “OK!” And of course, a bit more than halfway through: “Daddy, I’m tired. Pick me up.” “Well, Laurel, you remember that store with the big ice cream cone on it?” “Yeah?” “Well, we’re hiking in a big circle, so that means the ice cream store is just ahead there.” I pointed to the trail ahead. And Laurel started ahead fast enough we had trouble keeping up with her. Finished her first full dayhike without further chivvying or complaint. Motivation is key.
Same thing with peeling off of the litter and heading to the head of the line: whoever’s at the front of that line of potential litter bearers is the last to take over carrying the litter again. Motivation is key. 
One observation: if you have a bunch of litter bearers who don’t know anything about this system (very common), then it’s worth doing a one-minute explanation before setting out with the litter. This will likely save time in the long run. 

 down a nice, wide flat trail is all well and good. For the five feet of it you will do over your entire SAR career. 
But often there are obstacles, narrow trails, trails that go straight up or down, or no trails at all. And there are time-tested techniques for dealing with these problems. And you need to learn these techniques. Or you will flail, waste time, and get litter bearers hurt. Not to mention looking like an idiot.
This is not rocket science. Once you understand the rationale, and practice it a few times, you’ll have it down. 
Laddering
 down a nice, wide trail. But it’s right after an ice storm, and you will be tootling right along, when your come to a four-foot diameter downed tree across the trail. Everything grinds to a halt. 
No, it doesn’t. Because you already know how to rotate litter bearers, and you have a couple of litter bearers who’ve gone on ahead, and are on the other side of the log, eagerly awaiting their turn to lengthen their arms by carrying the litter. 
Basically, this is just a brief interruption in litter bearer rotation. You stop, and then plant your feet solidly. You think to yourself “At this point, I am going to move the litter. I am not going to move my feet. I am not going to move my feet.” Actually, if you’re new to this, maybe you should say it out loud.
Once everyone has their feet planted well, you shift the litter forwards as far as you can without anyone letting go of it. If you can, you set the head down on the downed tree. Once you’ve got the litter where you want it, calls “”
Then, the back two litter bearers peel off, and work their way around to just above the head of the litter, and find secure footing, and then bend down and each grab the top of the litter with one hand. 
The new litter bearer to the front left of the litter will receive the litter and become the new . He or she grabs hold of the litter, and then does a quick visual check of the litter bearer across from him or her. As long as the other litter bearer looks ready, the new calls “” 
Then, without anyone moving their feet – again, without anyone moving their feet – the litter bearers shift the litter forwards a couple of feet. The back litter bearers peel off, and just like rotating litter bearers, they hop over the log, and head around to the front of the line, ready to take the litter when it’s their turn.
You repeat this simple process over and over until you’re past the obstacle. For a single downed tree, this only has to be repeated three times. But, if you’ve got a bunch of downed trees right together, you may do it quite a few more times.
You can use laddering for any obstacle, including rocks, and you can use it to get up or down short, steep slopes, in which case we call it…
Toenailing
 is derived from carpentry. Toenailing, also known as skew-nailing, is when you are nailing an upright 2x4 end on to a 2x4 flat on the floor. Carpenters do this all the time, over and over, to create studs for a house wall. You drive the nail in at an angle, through the end of the upright into the 2x4 on the floor. 
When you have to go up a short, steep slope, you can ladder up the slope. Except that you hammer the head of the litter into the ground – well, no, you actually just gently place the head of the litter up against the slope, then the  calls “” and the back two peel off and work around to the front and if you’re the new  you call “” once your partner is ready. And then everyone lifts the litter a bit – it takes a bit of practice not to lift it too much – and the slides it forwards, and toenails it into the slope again.
OK, I made you say it before, and this is when you really need to say it: “I am not going to move my feet.” Because if you move your feet while toenailing, then you will lose your balance, and you will fall, dragging the litter and the whole litter team down with you. 
When you’re laddering across an obstacle, at least on the far side, you can start getting sloppy and moving your feet, and nothing bad will happen. Usually. But if you develop this bad habit, the next thing you know, you’re toenailing on a slope, and then you move your feet and kablooey, down you all go. 
Say it: “I am not going to move my feet. I am not going to move my feet.”
…
Change History
Old versions will be posted in the ASRC Archive at .
21 December 2018 (Version 1.0)
8 January 2019 (Version 1.1): fixed problem where one page was covered up by the topographic map, and minor edits to indicate how leather gloves are handy in the summer to deal with thorns, and mentions of Darn Tough socks and Outdoor Research Crocodile gaiters.