What to Do When Someone Becomes Unconscious on the Trail
Finding someone unconscious on a trail is one of the most serious situations a hiker can face. The mountains offer limited access to emergency services, unpredictable weather and long response times, which means your ability to act quickly and correctly can be lifesaving. Knowing how to assess the situation, provide initial care and communicate with rescuers effectively is crucial. This article explains clear, structured steps that any hiker can follow to manage an unconscious casualty safely until help arrives.
Key Safety Principles and Common Risks
Unconsciousness can result from many causes, including dehydration, hypothermia, heatstroke, head injuries, cardiac conditions, altitude sickness, severe allergic reactions or trauma from a fall. The biggest risks associated with unconsciousness are:
Airway obstruction
Breathing difficulties
Hypothermia or shock
Worsening internal injuries
Delayed rescue response
Staying calm and following a structured approach ensures you do not overlook critical steps.
Practical Advice & Step-by-Step Response
Ensure Scene Safety
Before approaching, check that the environment is safe for you and your group.
Assess for falling rocks, unstable slopes, animals, traffic (in shared paths) or avalanche risk.
If the area is unsafe, move yourself to safety first.
Only approach the casualty when the environment is stable enough to avoid creating more victims.
Check Responsiveness
Kneel beside the person and try to get a response:
Speak loudly: “Can you hear me?”
Gently tap their shoulder
Look for any movement or signs they are waking up
If there is no response, they are considered unconscious and require immediate assessment.
Check Airway, Breathing and Circulation (ABC)
Airway:
Tilt the head back gently and lift the chin to open the airway.
Check the mouth for visible obstructions (do not perform blind finger sweeps).
Breathing:
Look for chest movement,
Listen for breathing sounds,
Feel for air on your cheek.
Check for 10 seconds.
If they are not breathing or breathing abnormally (gasping), begin CPR immediately.
Circulation:
If the person is breathing normally but unconscious, move to the next step.
Place in the Recovery Position
If they are breathing but unresponsive:
Roll them onto their side carefully.
Bend the top leg to stabilise their position.
Tilt the head back slightly to maintain an open airway.
Ensure the mouth is angled downward to allow vomiting or fluids to drain.
This position protects the airway and reduces choking risk.
Call for Emergency Assistance
In Europe, call 112. Provide:
Your exact location (use GPS coordinates or nearest landmark)
The condition of the casualty (unconscious but breathing / not breathing)
Details of injuries or suspected causes
Number of people in your group
Weather and visibility conditions
If you have limited signal, send a text message or move carefully to higher ground to try to reconnect.
Protect the Casualty from Weather
Unconscious individuals cannot regulate body temperature effectively.
Add insulating layers or a survival blanket to keep them warm.
Shield them from wind or rain using backpacks or jackets.
In hot conditions, provide shade and airflow.
Preventing hypothermia or overheating is essential while waiting for rescue.
Continually Monitor Their Condition
While waiting for rescuers:
Check breathing regularly
Look for changes in skin colour or responsiveness
Ensure the airway stays open
Keep them still, especially if you suspect neck, head or spinal injuries
If breathing stops, begin CPR immediately:
30 chest compressions
2 rescue breaths (if trained)
Continue until help arrives or the person recovers.
Manage the Surroundings
If you are in a group:
Assign one person to monitor the casualty
Another to communicate with emergency services
Others to secure the area and stay visible for rescuers
If you are alone:
Prioritise calling for help as soon as the casualty is safe in recovery position.
Essential Gear
Carrying the right equipment can significantly improve outcomes:
First-aid kit
Emergency blanket
Insulating layers
Whistle
Fully charged phone + power bank
GPX device with your location
Gloves (for first-aid hygiene)
These items support airway safety, temperature control and communication.
Unconsciousness on the trail is a time-critical emergency that requires calm, structured action. By assessing responsiveness, protecting the airway, calling for help and preventing exposure, hikers can stabilise a casualty and significantly improve their chances of survival. Preparation, knowledge and the right equipment allow you to respond confidently even in remote areas. With these skills, you become not only a safer hiker but also a valuable resource for others on the trail.
