You hear a familiar crunch as your leather hiking boot bursts through a thin layer of orange leaves littering the trail below. You look up for a moment, startled by delicate footprints up and to your left, just managing to catch the tail ends of two deer before they hurriedly prance out of view. There’s a chill in the autumn air, and, if you look closely, you can see your breath manifest into a tiny cloud right before your face as you walk. At the next junction on the trail, a small, weathered sign leans squat against a tree. “Monarch Lake 1.2 miles | Crystal Lake 1.4 miles” – Which do you choose?
I skid down the side of the mountain the moment I see the crash. My trail runners burn rubber as I launch myself over a boulder to get to the victim, a 44-year-old hang glider who caught a gnarly gust of wind coming over Big Bear Lake. He is moaning and clutching his side as I ask his name to discern a level of responsiveness. He mumbles something about the fall, and I check his airway, noticing a large amount of blood in his mouth and a pale film of skin across his forehead. I bark directions at my partner to help me move him into a spine stable position, and she holds his head to ensure that we don’t further damage what could be a severed spinal cord. We check his vitals before performing a head-to-toe patient assessment in which we discover a sorely broken rib. As I frantically scribble the details into my notebook, we formulate a plan to get help before we move him into a recovery position so that he doesn’t choke on any of the blood he is coughing up. Then, we wait.