I still have a few leads to call at the U.S. Forest Service, but I thought I'd post this question to the list for more input.<br><br>My son has asthma and we passed on a canoe trip to Boundary Waters in upper Minnesota becasue of the belief that he would be days away from medical help if he suffered an attack, which hasn't happened during summer camping trips. I read a newspaper article that said the US Forest Service has a float plane that is the only plane allowed in the Boundary Waters.<br><br>This has led me to believe that I may have been premature in deciding the trip was impossible. I have found out that the plane is used in medical emergencies and that they flew out an asthma victim just last week.<br><br>So for future reference, I'd like to know peoples experience and opinions on wilderness communications. I know there will be regional variances and different contact points. But I am encouraged that he may not need to pass on future trips, which include tentative plans for South Dakota and Isle Royale!<br><br>Thanks.<br><br><br><br>Willie Vannerson<br>McHenry, IL

Good question;<br>Let me add my two cents worth.<br><br>I am currently a medical responder for a rural ambulance service in "corn field county" Illinois, and I have seen delayed response even in areas that you would think had virtually immediate response by rescue/medical personnel.<br><br>In your case "asthma" you have a valid concern since with breathing problems you need to have response within three - four minutes, in the worst case scenario.<br><br>My suggestions would be.<br>Talk to your physician about your travel plans, he/she may be able to prescribe medications that you could administer yourself to assist while rescue personnel is enroute. (note also check laws on bringing medications into other countries)<br><br>Investigate modes of rescue/travel and types of medical assistance in the area you are traveling to (which you are doing). Never assume that a call to 911 is like what you see on television. I have seen 25-30 minute response/ transport times just 10 miles away from a hospital. In remote areas hours and maybe days could pass before help arrives.<br><br>As far as communications, don't rely on cell phones 100% you may consider ham radio but this may extend response times as well as confuse the issue since the messages may have to go through several people before it gets to rescue.<br><br>If you have a guide, ask him/her these questions, not all guides have been trained in wilderness medicine nor do they take suitable emergency communications with them.<br><br>I don't know if this helps but I understand your concern.<br><br>Ted Fisher EMT I/D<br>Vermilion County Search and Rescue<br><br><P ID="edit"><FONT SIZE=-1><EM>Edited by tfisher on 08/08/01 11:47 AM (server time).</EM></FONT></P>

Thanks for the reply.<br><br>>>>Talk to your physician about your travel plans, he/she may be able to prescribe medications that you could administer yourself to assist while rescue personnel is in route.<<<<br><br>We have. Besides his daily regiment of meds, I have a six-pack cooler that holds a nublizer for delivering emergency meds when his peak flow meter drops below an acceptable level. This tool has virtually eliminated the need for us to take him to the emergency room for moderate attacks that his inhaler alone could not control. If that does not work, I have a steroid syrup that I can administer. That's a last resort for him and he needs to get to a doctor immediately at that point. Fortunately, I have never reached that point. Most of his severe attacks occur within reach of a hospital, which is the preferred choice in that situation.<br><br>The nebulizer runs on AC current, but I have a power inverter that I plug into my car's cigarette lighter. I have seen battery-powered nebulizers that are pretty pricey, but would likely be a good investment in a wilderness area. Right now we've never been to far away from AC power or a vehicle. South Manitou Island was the exception but the Ranger station was only a half-hour hike away and they had power there.<br><br>>>>...don't rely on cell phones 100% ...<<<<br><br>I know for a fact that most areas, if not all, the troop visited last week do not have cell phone coverage. And it may not be the most responsive communication tool if there's no one on the other end to pick up.<br><br>My future strategy is to spend more time in advance researching local options. So as we head into South Dakota or Isle Royal, I need to get on the phone and get details how best to reach emergency personal in those specific areas and what type of evacuations are possible if any.<br><br>Given that, I guess what I was looking for was some practical advice on what works and what doesn't. For example, several of Doug's reviews on the site mention communication and locator gear that can be rented. Is something like that available for landlubbers? If so, what's a common tool? And where does one look to rent? (At an airport?)<br><br>I know this sounds a bit open ended. That's because I know very little on such equipment.<br><br><br><br>Willie Vannerson<br>McHenry, IL

Two options you might consider are:<br>1) Amateur radio<br>2) Satellite phone<br><br>Amateur radio licenses are easy to get these days, and you can have decent range (50mi+) on the popular 2m band if you can hit a repeater. Other bands can reach around the globe, but require larger equipment not well suited for portable / survival use.<br><br>A satellite phone is also an option, provided you have a clear view to the sky. The Iridium network (www.iridium.com) is apparently back in business, with global coverage. <br>INMARSAT phones might work as well, but I don't know much about those. Any internet search could help you there<br><br>Obviously, these won't necessarily cut down the response time by much, but they may be able to put you in contact with medical personnel who can direct any potential treatment while help arrives. <br><br>Good Luck<br>-Matt<br><br>

There was an article over the weekend in the Raleigh newspaper about "wilderness" use of cellular phones. It seems that a large number of outdoor enthusiasts venture out ill-prepared and then request that the park service come and help them. Others request directions or don't know where they are (can't read a map). The best one was a guy who requested helo evacuation because he didn't believe that he could hike out in time to make it to his connection for an out-of-town meeting.<br>The point of my writing is that if your plan is to go out in the wilds, you need to be prepared for the worst case. In Bill's case, in traveling with a child with a chronic illness (asthma) adequate preparation must be undertaken to treat the illness. I have only once seen an asthmatic whose asthma attack could not be broken by aggressive medical treatment, treatment that could conceivably be provided in the field. HOWEVER, the one case that did not respond died. People still die of asthma. Something to think about.<br>Finally, if I were to go on a trip such as you propose, I would rent a satellite phone and assemble a substantial medical kit with your doctor's assistance (peak flow meter, nebulizer, compressed gas to power the nebulizer, bronchodilator solution, oral, inhaled, and injectable steroids, antibiotics, etc.). These supplies plus written (?plastic laminated) protocols on treatment of asthma based on peak flow readings should keep you from requiring emergency assistance. Keep in mind that emergency evacuation may not be available (aircraft busy, down for maintenance, weather, etc.) or that you may not be able to reach them for any number of reasons related to electronic equipment.<br>No plan is foolproof.<br>A locator beacon on 121.5/243.0 would be picked up and acted on within 24-48 hours by the Russian COSPAS satellite. The newer EPRIB's actually will mate with a GPS and show your position and serial number and can be rented as well through some marine outfitters. I don't know about the use of those transmitters on inland waters. Canoes are vessels, same as any other!!<br>Have fun, sorry this is so long and rambling.<br><br>Jeffery S. Anderson, M.D.<br><br>

>>>...assemble a substantial medical kit with your doctor's assistance (peak flow meter, nebulizer, compressed gas to power the nebulizer, bronchodilator solution, oral, inhaled, and injectable steroids, antibiotics, etc.).<<<<br><br>Two points. One, I do carry most of these with us on trips, with the exception of the compressed gas and the injectable steroids, which have not beed required to date because we have always been close to electrical power sources and reasonably close to medical help. Two, I plan on following up with the key piece of advise in your statement, "doctor's assistance." The kit and procedures we've used so far were developed with his allergist's aide and they have met our needs to date. So it makes sense to go back and discuss our new set of needs, or "desired" needs. The information you have provided will certainly help as I now know more options to discuss, such as the use of compressed gas to drive the nebulizer.<br><br>>>>...you need to be prepared for the worst case. <<<<br><br>This is exactly what I am doing, with everyone's help. My son has never had even a mild attack during the summer months while camping. The fall is the worse time of year for him and he's had mild attacks triggered by campfire smoke at camporees where there are dozens of campfires in a relatively small area. He's also had an attack during the winter at a cabin campout because of the wood burning stove. So I know I would not even consider a trip like Boundary Waters in the fall as the risk is way too high. We still may decide, along with his physician's imput, that a summer trip is still too risky. But I'm investigating the options in advance to make such a determination.<br><br>>>>People still die of asthma. <<<<br><br>Too true. It was just over a year ago that a lawyer in our office, who was in his mid-forties, died, literally on the doorstep to his apartment in Chicago... from an asthma attack. He was an intelligent man who knew of his condition. So it is a serious condition and should not be taken lightly.<br><br>>>>... plus written (?plastic laminated) protocols on treatment of asthma based on peak flow readings ...<<<<br><br>I do have instructions written down along with his physicians' phone numbers in the case with the nebulizer and emergency medicine. But the instructions are written more from my point of view and may not be easily understood by the average bystander. I need to rewrite them in case I am not available or my son is unable to communicate instructions (he actually manages his asthma very well and does not need much direction). I also plan on creating a credit card size set of instructions for a his PSK altoids tin. Plus I need to laminate them both.<br><br>>>>I don't know about the use of those transmitters on inland waters. Canoes are vessels, same as any other!!<<<<br><br>Actually, this was the crux of my initial question as information on this site relates to marine communications, primarily with the Coast Guard. And I wasn't sure if land based emergency or SAR organizations have different communication devices and protocols. My impression is that emergency procedures are chiefly localized resposibilities and that there is no common SOP between responsible agencies (please correct me if I'm wrong).<br><br>>>>Have fun, sorry this is so long and rambling.<<<<br><br>No appologies needed. Your reply is very informative and helpful.<br><br>BTW, the US Forest Service did respond to my inquiries. The local counties are responsible for emergencies in their own counties. And they can and do contact the USFS for use of their float plane in an extreem medical emergency.<br><br>She also pointed out to me that there are areas of the Boundary Waters that are more acesable than others. This was something I had not taken into consideration. If and when the troop decides to return there, I can lobby for a crew (they split into 3 crews this trip) that stays in the more accesable areas. <br><br><br>Willie Vannerson<br>McHenry, IL

Bill, Inland waterways (Mississippi river, LakeTahoe, great lakes) are under Coast guard jurisdiction and patrol. But in the real world you would probably be assisted by other agencies. This is simple logistics. The Coast Guard ( SOP) is grossly underfunded. My own recent misadventure bears witness to that. When I talked to the local SAR unit , they related they were to overwhelmed to get out to us that night. The C.O. at least added that upon learning there was an ex coastie involved they attended to more urgent missions. I think? that was a compliment?Also, to be blunt, Some Coast Guardsmen of my period were total salt water sailors. This was tragically born out when a Warrent officer lost his ship with casualties. He was utterly confused by the inland buoy system. This is totally different from our well known "red right returning" of the ocean. Best bet always; find out who will be out there and say hello. It's amazing how even a cursory familiarity with each other can better prepare both parties for potential problems.<br><br>

>>>The Coast Guard ( SOP) is grossly underfunded. <<<<br><br>Too true, especially since many members are in harms way more often than traditional branches of the military (not meant to be slight to any serviceman).<br><br>The lack of funding has played out here in Chicago recently. When Glenview Naval Air Station closed, the Coast Guard only had funding for crews out of Grand Haven, MI, across the lake. I believe it's about 45 minute to an hour flight each way. This while Chicago and Milwaukee to the north have the highest density. Recently, they did receive funding for a helocopter stationed on the west side of the lake, near Waukegan I believe.<br><br>>>>find out who will be out there and say hello. It's amazing how even a cursory familiarity with each other can better prepare both parties for potential problems.<<<<br><br>Excellent advice.<br><br><br><br><br><br>Willie Vannerson<br>McHenry, IL

One thing to think about before your trip. It may be useful to speak to your son's doctor before his trip and see how he feels about an inhaler of Advair (combination of Flovent and Serevent) to use prophylactically to prevent an acute asthma exacerbation.<br>Just a thought.<br><br>Jeffery S. Anderson, M.D.<br><br>

After you have a viable solution for your situation (meds, radios, gps), I would pack all of it in a nice orange, generously sized and padded Pelican box. It would be tragic for you to go to these lengths to insure the safety of your son to have it compromised because something got crushed, wet, misplaced, etc....<br><br>