Know the warning signs and decide when to evacuate
The hardest call on a remote estate is when to stop managing at home and move someone to hospital. Decide your criteria in calm times, with clinical input.
How
- Treat these as emergencies needing urgent care (ACEP list): trouble breathing; chest or upper abdominal pain or pressure lasting two minutes or more; fainting, sudden dizziness or weakness; vision change; trouble speaking; confusion or difficulty waking; sudden severe pain; bleeding that will not stop; severe or ongoing vomiting or diarrhoea; coughing or vomiting blood; thoughts of suicide or harming others.
- Add the specific warning signs your clinicians gave you for each person (medical-1), pregnancy warning signs (medical-4), and wound and burn red flags (medical-18, medical-21).
- Use a simple rule from wilderness medicine: evacuate when the person needs physician care that would be harmed by delay. Not every illness or injury needs evacuation.
- Decide early, in daylight and good weather where possible. Delays caused by darkness, weather or road conditions are a reason to leave sooner, not later.
- When in doubt, call a clinician or emergency services for advice before deciding (medical-24).
- For every red flag, write a second line: if no help can reach us, who drives, where to, and at what trigger. Use medical-33 to decide.
Safety: These lists are examples, not complete. If you are worried, seek help.
Do these first
Sources
- Is it an emergency? Warning signs. American College of Emergency Physicians, accessed 2026-11
- NOLS Wilderness Medicine Institute: Wilderness Medicine Practices and Protocols (2016). NOLS, accessed 2026-11
- Emergency preparedness during pregnancy. CDC, accessed 2026-11
- Emergency wound care after a natural disaster (fact sheet). CDC, accessed 2026-11