On the 16th of August, I had the pleasure of working with the other regional Mountain Training Co-ordinators running a training day for Mountain Training Association members here in the Chiltern Hills. Coombe Hill, with its mix of woodland, rolling chalk escarpments and wide views across the Vale of Aylesbury, proved to be the perfect outdoor classroom. 

 

The day was designed to bring together core skills that every outdoor leader should have in their toolkit: first aid, navigation, and local knowledge. 

We’ve all seen it — a slip on wet rock, a poorly ducked branch, a flying elbow in a group shelter. Head injuries happen fast and without warning, and in remote places, it’s up to you to manage the situation until help arrives — or until you walk them out. 

 

👤 “I’m fine.” – The Famous Last Words 

Mild head injuries often look like nothing. A bit dazed, maybe a scratch or graze. But beneath that could be a concussion — a brain injury. And in rare cases, a serious or even life-threatening problem. 

 

In the hills, we take every head injury seriously. Especially if: 

 

You’re halfway through a group walk when someone missteps on a loose rock. They go down hard, and you hear those classic words: 

 

“I think I’ve just twisted it. I’ll walk it off.” 

 

As an EMT, I’ve learned never to underestimate soft tissue injuries. Out here, even a “minor sprain” can turn into a major problem if not managed properly.