SGUK Outdoor Skills Challenge 55: Run a Table-Top Drill for a Head Injury on a Scramble

A head injury on a scramble can quickly become a serious situation. Uneven ground, exposed rock and difficult access may make it harder to protect an injured person or get help to them. In the moment, people can feel under pressure to act quickly, which is why it helps to think through a response before an incident happens.

This challenge is a table-top exercise, so you will work through a realistic scenario without climbing, creating a mock injury or putting anyone at risk. The aim is to practise decision-making, communication and safe emergency planning.

Your Challenge

Your challenge is to work through a simulated head injury on a scrambling route and explain the actions you would take.

You will consider scene safety, how to summon help, what to do while waiting for assistance and why moving a casualty can be dangerous. You can complete the exercise alone or ask another person to act as the group member who makes the emergency call.

What You’ll Need

• A written or printed description of the scenario.
• A phone or a simulated emergency-call script.
• A notebook and pen.
• A map or route description of a scrambling area.
• A first-aid kit, for discussion only.

Do not practise by pretending to fall on rock, applying pressure to someone’s head or moving a real person as though they are injured. This is a planning exercise, not a substitute for recognised first-aid training.

Take the Challenge

1. Read the scenario

Imagine that you are part of a small group on a rocky scramble. One member slips and strikes their head. They are now sitting on a narrow section of the route, appear confused and have a cut on their scalp. The ground below is steep, and other members of the group are standing on uneven rock nearby.

Your first task is to pause and assess the situation rather than immediately rushing towards the casualty.

Consider whether you can reach them safely, whether there is a risk of further rockfall or another fall, and whether other group members are in danger. Do not create a second casualty by moving onto exposed or unstable ground without a safe plan.

2. Decide how to make the scene safer

Think about what you would do to prevent the situation from getting worse. If it is safe, ask other group members to remain in secure positions and keep the route clear for emergency responders.

Do not approach the casualty if doing so would expose you or others to an unacceptable risk. Avoid moving the injured person simply to make the scene more convenient.

If the casualty is in immediate danger, any movement must be weighed against the danger of leaving them where they are. On exposed terrain, this can require specialist rescue assistance. Do not attempt a technical rescue unless you have the necessary training and equipment.

Write down two hazards you would assess before approaching the casualty.

3. Plan the emergency call

A suspected significant head injury on a difficult scrambling route needs urgent medical assessment. In the UK, call 999 or 112 and ask for the appropriate emergency assistance; in a mountain or remote upland setting, request mountain rescue through the emergency operator where applicable.

Practise explaining the situation clearly. Be ready to provide:

• Your location, using a grid reference or accurate coordinates if available.
• The route name and a description of the casualty’s position.
• What happened and the nature of the suspected injury.
• Whether the casualty is conscious and breathing normally.
• Any immediate hazards and the safest access information you can provide.
• A contact number and details of the group.

Do not delay an emergency call while trying to collect every detail. If you do not know your exact position, explain what you do know and follow the operator’s instructions. Keep your phone available for further contact.

4. Decide what care the casualty needs

For the scenario, assume the casualty is conscious but confused after striking their head. Confusion following a head injury is a warning sign that requires urgent medical assessment.

Plan to keep the casualty still and reassure them while monitoring their responsiveness and breathing. Suspect a neck or spinal injury where appropriate, particularly after a fall, and avoid unnecessary movement. Do not remove a helmet unless it is necessary to manage an immediate threat to life or the airway and you know how to do so safely.

If the casualty becomes unresponsive, check whether they are breathing normally and follow the emergency call handler’s instructions. If they are not breathing normally, begin CPR and use an automated external defibrillator if available, following your training and the operator’s guidance. If they are breathing but their airway is at risk, airway management takes priority; follow emergency guidance and move them only as necessary to protect life.

For a bleeding scalp wound, do not press directly on a suspected skull fracture or an embedded object. Follow the emergency operator’s instructions and avoid giving the casualty food, drink or medication.

Write down how you would monitor the casualty while help is on its way.

5. Plan for cold, exposure and group management

An injured person who cannot move may become cold, especially in wind or rain. Consider how the group could protect the casualty from the elements without moving them unnecessarily or blocking access for rescuers.

Use suitable clothing or insulation if it can be applied safely. Assign one person to stay with the casualty if conditions allow, another to communicate with emergency services, and another to manage the rest of the group. If there are too few people, prioritise immediate safety and the emergency call.

Avoid splitting the group in a way that creates further risk. Do not send someone off alone across difficult terrain unless emergency services direct you to do so and it is safe.

6. Review the decisions you made

Read through your plan and ask whether you would have made the situation safer, communicated the location clearly and avoided unnecessary movement.

Identify one decision that could be difficult under pressure and explain how training or better preparation could help. For example, you might need to improve your use of grid references or ensure that everyone in the group knows the emergency procedure.

A table-top drill is most useful when it reveals gaps in your plan before you need to rely on it in real life.

Check Your Results

Before completing the challenge, make sure you can answer these questions:

• What hazards would you assess before approaching a casualty on a scramble?
• What information would you give the emergency operator?
• Why is confusion after a head injury a serious warning sign?
• Why should an injured person not be moved unnecessarily?
• How would you protect the casualty and manage the rest of the group while waiting for help?

If you are uncertain about the first-aid decisions, seek recognised first-aid training and consult current guidance from a reputable provider such as St John Ambulance.

Complete the Challenge

To complete Challenge 55, work through the scenario and record a clear response plan.

Your evidence should include:

• A photograph of your written scenario notes or planning setup.
• A list of at least two scene hazards.
• A sample emergency-call message that includes location and casualty information.
• A short explanation of how you would protect and monitor the casualty while waiting for assistance.
• One lesson you would apply to future scrambling trips.

This is a planning exercise, not a practical rescue assessment. Do not attempt a real rescue or medical procedure beyond your training.

How to Submit Your Challenge

Submit your evidence

Once you have completed the challenge, share your evidence on your SGUK member profile so it can be checked.

1. Go to your SGUK member profile.
2. Open Social Activity.
3. Upload a photograph of your evidence to the activity wall.
4. Add the hashtag #SGUKChallenge55.
5. Share it for verification.

Include your written decisions with the photograph so it is clear how you worked through the scenario.

Challenge 55 Checklist

Want to Push Yourself?

Run a second table-top scenario in which the casualty becomes unresponsive or the phone has no mobile signal. Explain how your priorities would change and what alternative emergency communication options might be available in that location.

You could also review your group’s route plan before a future scramble. Check that you know how to identify your position, describe access points and share an emergency plan with everyone taking part.

For a real incident, always follow the emergency operator’s instructions and stay within your training.

What’s Next?

If you have not completed the previous challenge, try SGUK Outdoor Skills Challenge 54: Run a Kit Inspection After a Wet Trip. Practise checking, cleaning and drying your equipment so it is ready for your next outdoor trip.

You can complete the SGUK Challenges in any order, so choose the skills that interest you and keep developing your practical outdoor knowledge.

Once you’ve shared your evidence and it has been verified, the SGUK Outdoor Skills Challenge 55 is complete and the completed challenges figure will be updated on your profile.

Learn. Practise. Master.

That’s what the SGUK Outdoor Skills Challenge is all about.