Participants on the January 2018 course undertake the final scenario: a tandem accident following a reserve deployment. Note how the team splits into groups: one group making the scene safe, the others caring for the casualty. The leader stands back and the scribe records the events as they unfold.
Our Extreme Sports First Aid and Trauma Management Course is designed specifically for practitioners, guides and instructors. The course is run by Dr Matt Wilkes (FFPP) and Jocky Sanderson (Escape Paragliding and Keswick Mountain Rescue Team) at the Flight Park in Braithwaite, Lake District.
Why a specific course?
Extreme sports accidents are often severe and remote, and fellow practitioners are usually first on scene. Recognising this, our course aims to go beyond traditional first aid teaching to focus on the management of major trauma in the remote setting. Group dynamics and scene management are integral to the programme and the course is endorsed by the BHPA.
“This course really is second to none and tailored to our sport.” Ben Johnson, Jan 2018 course.
“In the past I’ve wondered how I might react/engage if the need arose. Now I feel confident to step up in incident management. Delivered with passion, backed by experience and lubricated with good humour. Thank you” Anonymous, Jan 2018 course.
Preparation and Prevention
- Accident prevention
- The paragliding environment (sun, cold and high altitude)
- First aid kits
- Accident simulations
Scene Management
- Scene safety
- Group dynamics
- Communication
- Working with rescue services
Casualty Care
- Securing and moving casualties
- Assessment
- Haemorrhage control
- Airway management
- Spinal injuries
- Pain management
- Medical Emergencies
- CPR in the wilderness
After an Incident
- Follow up and debriefing
- Insurance and repatriation
Kit and Improvisation
What you carry in your rucksack on a flying day is rarely a full trauma kit, and even the best-stocked first aid pouch has its limits in remote terrain. Our course therefore spends a significant amount of time on improvised equipment, teaching you to think laterally about the gear you already fly with. A paraglider harness, for example, can be used to stabilise a pelvis, while a reserve parachute or a glider bag doubles as an insulating layer or an emergency shelter. Carabiners, slings and speed bars become traction splints, and walking poles or even a folded control frame can immobilise a fractured limb.
That said, certain items are difficult to improvise and we encourage all practitioners to consider carrying a small, purpose-built trauma pouch. The following lightweight additions make a genuine difference in major haemorrhage and airway compromise:
- A combat application tourniquet (CAT) or similar windlass tourniquet
- Haemostatic gauze, such as QuikClot or Celox
- Vented chest seals and a pocket mask or face shield
- Trauma shears and at least two pairs of nitrile gloves
- A space blanket or blizzard survival bag
During the practical sessions at the Flight Park, participants practise applying these items in simulated incidents, but they also rotate through scenarios where the kit is deliberately left behind. The aim is to build confidence that you can manage with what is on your back, because in our experience that is often exactly what happens.
Communication and Evacuation
Calling for help in a remote valley is rarely as simple as dialling 999. Mobile coverage is patchy, and even when you get through, the emergency operator may not immediately understand the terrain or the nature of a paragliding accident. We teach a structured approach to the emergency call: first, ask for Police and then Mountain Rescue; second, give your location as accurately as possible, using a grid reference, a what3words square or a clear description of the launch and landing area; third, state the number of casualties, the mechanism of injury and any immediate life threats.
Many pilots now fly with satellite communication devices such as an inReach or SPOT, and the course covers how to use these effectively, including pre-setting message templates and understanding the limitations of one-way versus two-way devices. We also practise preparing for a helicopter evacuation. Loose paragliders and clothing must be secured, the landing zone should be cleared of debris, and the team leader should brief everyone on how to behave when the aircraft arrives — staying low, avoiding the tail rotor, and never approaching until directed by the winchman.
Handover to the rescue team is a critical moment that is often rushed. Using a simple format such as ATMIST (Age, Time of incident, Mechanism, Injuries, Signs, Treatment given) ensures that vital information is not lost. On the course, participants run through full handover drills with mock rescue personnel, because in our experience this is where good scene management either pays off or falls apart.
Environmental Challenges: Hypothermia and Packaging for Rescue
Extreme sports accidents frequently occur in cold, exposed environments, and a casualty who survives the initial trauma can still deteriorate rapidly from hypothermia. The mountain environment, wind chill and damp clothing all accelerate heat loss, and a shocked patient is often unable to shiver effectively. We teach that hypothermia management begins the moment you reach the casualty, not when you decide to evacuate. Removing wet layers, insulating from the ground, and creating a windproof shelter using gliders or bothy bags are all immediate priorities.
Packaging a casualty for a carry-out or a helicopter winch requires care and teamwork. The course covers techniques for constructing improvised stretchers from walking poles and ropes, as well as correct use of vacuum mattresses and split-stretchers where available. We emphasise gentle handling throughout, because rough movement can worsen spinal injuries or trigger cardiac arrhythmias in a cold patient. The goal is to create a package that is warm, stable and ready for whatever extraction method the rescue team chooses.
Participants practise packaging in realistic weather at the Flight Park, often with wind and rain adding genuine difficulty. By the end, you will have a clear mental checklist for hypothermia prevention and a working knowledge of how to move a casualty safely over rough ground without causing further harm.
Team Leadership and Decision-Making Under Pressure
In a serious incident, someone has to step forward and take charge — but leadership does not mean doing everything yourself. The course explicitly teaches a model of distributed leadership, where the nominated leader stands back, maintains situational awareness and delegates specific tasks: one person manages the airway, another controls bleeding, a third prepares the landing zone and a fourth writes everything down. This mirrors the structure of professional rescue teams and prevents the tunnel vision that often afflicts a single well-meaning individual.
Decision-making under pressure is practised through timed scenarios with incomplete information. You may have to choose between moving a casualty out of a dangerous gully or keeping them still because of a suspected spinal injury. There is rarely a perfect answer, and the course instructors — Dr Matt Wilkes and Jocky Sanderson — deliberately avoid grading participants on outcomes alone. Instead, we focus on the quality of your reasoning, your communication with the team, and your willingness to reassess when new information arrives.
We also discuss the emotional weight of leadership. After a serious incident, the person in charge often carries guilt and self-doubt, even when their actions were correct. Building a culture where leaders can be supported and where decisions are reviewed without blame is a core part of the programme. By the end of the course, you will have practised leading and following, and you will understand that both roles are equally vital in remote trauma care.
A proportion of the proceeds from each course will be donated to Karma Flights (Cloudbase Foundation) to help provide first aid kits and training in rural Nepal.