Wilderness Risk Management Committee Incident Reporting Project

Wilderness Risk Management Committee
Last page update 1/1/98

The Wilderness Risk Management Committe collects incident data from outdoor programs across the globe in order to identify trends and establish directions for improvement in outdoor programming. All outdoor programs are encouraged to submit data on an annual basis.

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Incident Reporting Project Instruction Sheet

This report was designed with the intent that it be useful for program records and incident documentation as well as the incident data gathering needs of this project. The form itself can be used both to record pertinent incident data, and essential patient information. As a reminder, statements of witnesses are recommended information for a program to obtain in the event of an incident, but are not necessary to submit to this database.

Reports for each incident should be submitted to:
Association for Experiential Education
Wilderness Risk Managers Incident Report
2305 Canyon Boulevard, Suite #100
Boulder, CO 80302
FAX 303-440-9581
Tel. 303-440-8844

Incident Report Instructions

Accurate and complete reports are essential to the strength of this database. The following instructions are provided for completing the Incident Report Form. Questions about completing the incident report should be directed to the AEE Office (303-440-8844)

A reportable injury or illness meets one or more of the following criteria

requires more than simple first aid such as a bandaid
requires more than cursory staff attention
requires follow-up care by staff in the field
requires use of prescription medications
interferes with the participants participation
is evacuated
is a lost day case

Incident Report Forms

Select the appropriate file save as option from your Web browser to save the following files to disk.

Submit your data directly into the WRMC database.
Adobe Acrobat 3.0 version of the Incident Report Form (17K).
Adobe Acrobat Reader (free)
RTF version of the Incident Report Form (20K). This is a complicated form done in Word 6.0 using tables and multiple columns and may not translate properly to your word processor in RTF format. In that case use the Adobe Acrobat version.

Full GIF version of page 1 (65K)

Full GIF version of page 2 (33K)

Program/Course name and address
The name of the program. It will be used to confirm unclear data and will be kept confidential.

Program/Course type

This should be a brief description of the type of program, i.e. outdoor adventure, therapeutic, adjudicated youth, etc.

Name

The name of the person involved in the incident. This is included for completeness of the program’s records. The name can be omitted or covered on forms submitted to the WRMC.

Age, Gender and Staff or Participant, Incident date, Time

Self explanatory

Day of course incident occurred

The number of days the participant was in the field prior to this incident.

Program,Course area

This should be a geographical description of the program area; e.g. Wyoming, Bighorn Mountains, Mt. Baldy or Vermont, Green Mountains, Long Trail.

The weather at incident time

Air temperature, wind speed, precipitation amount and type, visibility

Type of Incident

An incident may result in injury, illness, motivation/behavioral outcome or a near miss. Check each applicable category. Injury includes damage to property e.g. van, kayak.

Lost day cases

A lost day case occurs if a participant missed one or more days of activity beginning with the day following the incident, or if it causes loss of more than half of the day of the incident for morning mishaps.

Near miss incidents

A “close call”
A potentially dangerous situation where safety was compromised but that did not result in reportable injury.
An unplanned and unforeseen event. This rules out situations such as routine toprope falls, failure to roll a kayak for a beginning student, or a fall on the trail with no injury. A situation where those involved express reflief when the incident ends without harm.

Motivation or behavioral incident

Examples would be unwillingness to participate, running away, alcohol or drug use, assaultive behavior, suicidal ideation, or an emotional or psychological situation that compromises the students ability to participate in the program.

Evacuations

Evacuations are incidents in which the person leaves the field as a result of the incident. There are several levels of definition which aid in defining the seriousness of the incident:

participants who leave the field
participants who seek medical care
the type of evacuation (assisted by litter, helicopter, etc. or the patient was able to walk out unassisted)
if hospitalization was required
if the participant returns to field

Property damage

This is included to make the program’s records complete for insurance purposes. Circle if property, equipment or vehicle damage occurred.

Type of injury

All the applicable categories should be checked. Please specify the injury if the “other” category is checked.

Anatomical location of injury

All the applicable categories should be checked.

Type of illness

All the applicable categories should be checked. Please specify the illness if the “other” category is checked.

Activity at incident

The applicable categories should be checked describing the program activity the person was engaged in at the time of the incident.

Immediate cause of incident

This is a list of common incident causes in outdoor programming. Prioritize the applicable categories 1, 2, 3, etc.

Narrative

Describe the incident. What, how and when it happened, any medical treatment, the final medical outcome or diagnosis.

Analysis

Include any observations, recommendations or suggestions regarding prevention.

Patient report

This section is included to make the program’s records on the incident complete and is designed to serve as both a field report form or “run sheet,” a record of medical assessment and treatment, and corresponds to the Field Report Form carried in many first aid kits.

This page is maintained by Rick Curtis Director, Outdoor Action Program. Rcurtis@.princeton.edu