You and a companion, both proud and confident WFRs, are hiking a wilderness trail behind a horse pack string led by a young cowboy. You exchange pleasantries and learn that he is heading to the same trailhead. Suddenly one horse nips at another, a horse kicks, and horses seem to be going everywhere. The rider’s horse rears and bucks, causing him to fall off the back and land on his head and shoulder.

You find yourself in a ritual chant. “The scene appears safe. The weather is warm and sunny. The horses are milling about, no longer in a rodeo. There is one patient. He is on his back. He doesn’t look badly hurt, although he appears to be unresponsive.”  You think about gloves, realizing you don’t have a pair handy. You begin your assessment.

Your patient doesn’t respond to, "Hi, I’m a Wilderness First Responder, can I help?" You assume consent and your companion gently controls the patient’s head. The patient’s airway appears clear and he is breathing without distress. There is no obvious bleeding and he has a strong radial pulse. You control the spine because of the mechanism of injury (MOI). There are no obvious injuries to expose and investigate.