Down and dirty guideline for emergency crises in remote areas

Vacationing EMT instructor, Patrick Ochoa (on right), shown with Saboga tour guide, Terry Little

This post is also available in: Spanish

On-the-Water by Ilene Little

When an emergency occurs when traveling or in a far away place what do you do? To help others and maybe yourself, I asked the advice of Patrick Ochoa, an Emergency Medical Technician (EMT) Instructor.

“Whether it’s just you on vacation, or the emergency happens in your home location, the process is the same – it’s a matter of accessing your options and working through the process,” said Ochoa.

Ochoa’s company is Pacific LifeSafety Associates. He’s a firefighter with 30 years in the rescue profession and a former Navy diver. He was vacationing (skydiving in Contadora and spearfishing in Isla Saboga) the week prior to the ocean swells that caused many emergencies in Panama.

“Here is the down and dirty ABCs of making a difference when these situations occur,” said Ochoa.

Respond with a process

“One of the things I tell my students is that they have the knowledge and the ability to apply the skills, whether it’s controlling bleeding, opening airways, giving CPR or managing other medical emergencies.

“Witnessing an injured person can be a very emotional event, but if you know you have an objective and a job to do, you are better able to help the situation and the person. We call that ‘command presence’,” said Ochoa.

Consider the recent case on Sunday, June 15, in North Carolina where a 12-year-old girl lost part of her arm in a shark attack.

Vacationing medic, Marie Hildreth, used a boogie board string as a tourniquet for the 12-year-old’s arm, and a string from a beach tent to stop the bleeding on her leg. Hildreth activated a chain of command called “Check – Call – Care.


Are your surroundings safe for you, the injured and bystanders? Do not take action that might cause you or others to also become injured. If the surroundings are safe, check the injured to determine whether the injury is life threatening, requiring immediate action.


If action is warranted, call 911. The 911 emergency response system in Panama is managed by Hospital Santo Tomás in Panama City. It is mostly available in the Panama City metro area, but the rural hospitals also have satellite ambulances.

Outside the Panama City metro area, call someone with local knowledge to enlist their help in activating medical resources. For example, call the hotel where you are staying.

Vacationing EMT instructor, Patrick Ochoa (on right), shown with Saboga tour guide, Terry Little

Vacationing EMT instructor, Patrick Ochoa (on right), shown with Saboga tour guide, Terry Little.


The following is a 12-step emergency checklist that, when followed, will reduce chaos and focus energy on step-by-step injury analysis and action.

  1. Is the injured conscious or unconscious?
  2. Activate resources (contact the nearest trained personnel).
  3. Are the lungs working (respiratory functioning within normal limits)? Approx. 12 breaths per minute is good. If not, begin cardiopulmonary resuscitation (CPR).
  4. Does the injured have a pulse? If not, begin CPR
  5. Enlist the help of bystanders. For example, two people could work together to alternate performing CPR. Another could be making phone calls while someone else could be sent to get an automated external defibrillator (AED) or to gather or improvise medical supplies like a tourniquet or a stretcher.
  6. Is the injured severely bleeding? If so, treat bleeding with pressure.
  7. If there is a stab wound, like a knife or any thing that has impaled the patient? If so, control the bleeding around the object by pressure, but do not remove the object.
  8. Stabilize any obvious broken bones to protect against movement. Splints can be used if you have to move the patient.
  9. If conscious, can the injured follow directions like moving fingers and toes (checking motor skills) and able to answer questions (checking mental alertness)? Calm and reassure the patient.
  10. Do not move the patient, with the exception of having to move them out of harm’s way or to transport them to the nearest trained medical personnel or facility.
  11. Minimize the change of shock. Cover the patient with a blanket.
  12. Take notes, including time of injury and details of treatments to give to medical professionals.

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