PSYCHOLOGICAL RESPONSES TO WILDERNESS ACCIDENTS - Medicine for Mountaineering and Other Wilderness Activities - page 32

CHAPTER 4
PSYCHOLOGICAL RESPONSES TO WILDERNESS ACCIDENTS
Lawrence C. Salvesen, M.D.
Principal Contributor
Emotional reactions to traumatic accidents by the people involved and by their rescuers
should be expected. Most responses are normal and tend to be consistent. Many are benefi-
cial; only a few are harmful. Everyone involved in an accident can benefit from attention to
their psychological responses. For some individuals, care for emotional needs is as essential
as care for physical needs if they are to return to a functioning role in society.
PSYCHOLOGICAL RESPONSES OF RESCUERS
Psychological reactions by first responders have been well recognized by police, fire, and
emergency medical services. Many have professional counselors on their staffs or on call to
help with such reactions. In most situations, such aid is provided for humanitarian reasons.
However, financial considerations alone would justify counseling because individuals leave
their jobs when the cumulative response to psychological trauma becomes overwhelming
and training replacements is expensive.
The potential magnitude of personnel losses was dramatically illustrated by the response
tothecrashofAmericanAirlinesFlight191in1979.Thiswide-bodiedjet,aDC-10,lostthe
hydraulic system in one wing when the engine on that side pulled loose from its mounting
during takeoff. The flap on that side retracted, and the aircraft rolled, inverted, and crashed.
None of the 271 passengers and crew survived, and two people on the ground were killed.
The city of Chicago had staged a rescue drill only two weeks before this accident, and 351
rescuers were at the scene within twenty minutes. Experiencing hundreds of mutilated bod-
ies was devastating for these responders, but no program to alleviate the emotional impact
hadbeenestablished.Oneyearlater,275ofthoseindividualshadlefttheirpositionsforjobs
that did not involve rescue!
Wildernessrescuersalsorespondpsychologicallytoaccidents,andtheirreactionsrequire
attention, but this need has not been as well recognized as the needs of police, fire, and am-
bulance service members. Such problems, labeled “rescue trauma,” are well knownto many
rescuers, but few discuss them with their colleagues, possibly from fear of appearing un-
manly or even unbalanced.
Case Study: Rescuer's Responses
AprofessionalrescuerwasonaHimalayantrekwithaclosefriendwhobecameseriously
ill and clearly needed to be evacuated. The leader decided to split the party, most continuing
to their objective, while the rescuer and two physicians stayed behind with the person who