I was flowing down the trail in the warm afternoon sun when my karmic, solo 300-mile bike ride near Flagstaff, Arizona, on the Coconino Trail was violently interrupted. My handlebar tapped a rock, the bike stopped abruptly, and suddenly, I was flying through the air. The left side of my head hit the rocks first with a sharp crack. Then, I bounced on my right flank and all the breath left my body. When I finally stopped, I gasped and sprung to my feet at the bottom of a 10-foot rocky ravine. My eyes darted to assess the scene. The tears flowed for just a few seconds but then my emergency medical training kicked in. Taking mental stock of my bodily sensations, I crawled back to the trail wincing in pain. I was injured, but since I was alone, far from civilization, I had to activate my own rescue. I wanted to sit down and cry for help, but no one was coming.

Be Your Own First Responder

Millions of people are finding the magic of being in nature and getting off the beaten path. Nature therapy is real and the call of the wild is a pull so many of us feel. I’ve always gravitated toward the outdoors and have spent decades honing my skills to climb, bike, paddle and exist under the stars. I have racked up world championships, ultra-endurance records, and first-ever expeditions around the globe. Even with a lifetime of outdoor experience, accidents happen and being in nature is not just about having the fitness and skills to be outside, but also the knowledge and acumen how to get safely home. Often, you are your own first responder when you step into nature and away from immediate medical and rescue response. Are you trained to rescue yourself and your friends?

Each emergency situation is different, but all start with an evaluation of the patient, the environment, and the tools on hand to guide your rescue decision-making. Seconds after I crashed, I began my own medical assessment. ABCs: airway, breathing, check … circulation, check … no visible bleeding, check. Mechanism of injury: high-speed impact on head and torso. I felt my back and winced in pain, but there was no obvious deformity. The sharp pain could mean broken ribs and internal injuries. I examined my helmet. The impact had smashed through the graphic of the map coordinates where my dad’s plane crashed during the Vietnam War, which I have painted on my helmet to remind me of him and his words to me in his letters from the battlefield: “Be good.” This dramatic visual slap in the face emphasized the gravity of the situation and snapped me back from dazed patient into focused rescuer. I used my phone to take a selfie to look at my face and pupils. Dark circles under my eyes, dilated pupils, and distant stare—this meant shock and a possible brain injury. I checked my bike, which at that point, had become a tool to get back to safety, and it was fine. 

Extraction

Studying my map, I saw the next intersection with motorized access was 15 miles away. The sun was low in the sky and would be setting in a couple of hours. My body was shaking, but I straddled the bike. Since I could move, I had to. Self rescue was the fastest way to safety, as opposed to activating a professional rescue. I had my Garmin InReach satellite communication device. This handy little unit gives me the ability to communicate when I am out of cell range, which is pretty much all the time. I sent a message via the InReach to a friend to meet me with a vehicle at the trailhead. I gave clear instructions of my current location and where to meet me.

The InReach also has an SOS option for dire emergencies when self rescue is not possible. Pushing this button activates emergency responders and should only be used in true life or death situations when there is absolutely no option to move forward yourself. A very relevant factor in any backcountry emergency situation is the time it takes for rescue personnel to actually get to you on the trail or mountain. In many situations, even if a patient is only a mile from a trailhead, it takes emergency responders hours to mobilize and get someone extricated from the wild. Most times, it’s best to move forward toward safety.

Tentatively, I rode on in a haze of pain and confusion. Breathing hurt my ribs, and if they were broken I didn’t want to have the shards pierce my lung tissue. I took shallow, rhythmic breaths. When the trail turned up, I got off and walked. 

Me, Myself and I

In this terrain, 15 miles would normally take me an hour, but I knew I would be way slower in my damaged state. I talked to my phone and GoPro to document the journey, to self assess, and to keep myself company. It felt good to talk through the process with someone, even if that someone was me. When I started getting cold, a sign of being in shock, I stopped, put on a jacket, and ate some food to generate warmth. I mentally went through my EMT training about the stages of shock and treatment. 

During my rescue, I was hyper-focused internally, while also assessing myself externally. The conversation with myself as a rescuer and a patient continued: How are you feeling now? Has anything changed? Could you eat or drink something? Maybe, but I’m not sure I should. Is your balance off? You are riding sort of wobbly. Are you still cold? How much farther is it? How long have we been going? I was so grateful for my medical training during this intense few hours, even though I would have been annoyed by these questions if another person had been peppering me with them.

I made it to the trailhead before sunset and met my friend. I was cold and shaky, but stable. She loaded the bike, gave me some food and I gingerly loaded myself into the vehicle to head toward medical care.

Studying my map, I saw the next intersection with motorized access was 15 miles away. The sun was low in the sky and would be setting in a couple of hours. My body was shaking, but I straddled the bike. Since I could move, I had to.

Education First

I came away from the crash with a mild concussion, broken ribs and painful bruises. I was damaged but not broken because I was lucky and prepared. Lucky that my helmet protected me and the way I bounced didn’t crush bones or organs. Prepared with the tools of medical training, basic safety equipment and backcountry experience. I’m still not totally healed yet, but I know I will be back on the trail soon. I’m grateful to have made my way to safety and proud of how I handled my own rescue.

If you are spending time exploring outdoors, at any level, your journey to amazing adventures begins with education. Accidents happen to all of us, but how we respond to those accidents can keep us from becoming a backcountry statistic. 

How To Prepare

Preparation for a backcountry emergency is your own safety insurance. Hopefully you’ll never need to use it, but knowing you have the knowledge to handle yourself outdoors is not only self protection; your self reliance is also a collective benefit to relieve pressure on limited emergency rescue resources. To that end, I’ve compiled this list of tools that must be in everyone’s backcountry kit: 

• Basic first aid kit and basic medical skills: Carry a small first-aid kit and educate yourself with the basics like CPR, treatment of shock, how to stop bleeding and stabilize an injury. There are free CPR courses and other medical training online. I suggest a wilderness medical course for the most specific training. This is an investment in yourself and your safety. 
  • Basic wilderness medicine course / online / $95. This is the best deal going. 
  • Nols First Responder 

• Navigational knowledge and devices: Bring a map (paper and digital) and know how to use them. Plan your route, load it in multiple places, and tell people where you’re going. Nope, Siri is not going to tell you how to find your way back to the car. 
• Communication: In the backcountry, do not plan on having cell service. A satellite communication device is essential even to just let your partner or other family at home know you’ll be a few hours late.
• Backcountry competency: This is a big one. Alex Honnold’s first climb wasn’t free-soloing half dome. My first bikepacking expedition was not the Iditarod Trail. We all feel the call of the wild, but it’s important to dip a toe in the water before plunging head first. Sign up for a ride clinic or take a navigation class. Head out for an hour, then two and build from there. Be an aggressive learner to empower yourself to be able to go the places your heart dreams of going. I have spent four decades honing my outdoor skills and am still zestfully learning. The more I learn, the more places I feel confident to explore.

 

Rebecca Rusch is a seven-time world champion, a mountain bike hall-of-famer, founder of the Be Good Foundation, director of Rebecca’s Private Idaho gravel ride, author and Emmy award winner.