Skip to main content

Evolution of first aid for an outdoor generation

(Photo: Andy Pearson/Parkour Generations)

Nikki McLeary reports on first aid for an outdoor generation.

In a split second an adventure can turn into a race against time to save a life and first aid is required. A heart attack on the slopes, a surf fin laceration out to sea, a fall from height mountaineering, a head injury during an urban adventure. The emergency services could be delayed in reaching the casualty and you might be someone’s best chance of survival. Do you know what to do when it comes to first aid? Could you save a life?

The physiological and psychological benefits of participating in an active lifestyle are well documented. Benefits are further enhanced when physical activity takes place outside1. According to a comprehensive 2015 study by Sport England (Getting Active Outdoors) 8.9m people were active outdoors during this period.

In 2016/2017 Sport England released another study (Active Lives Adult Survey)2 which identified fewer people engaging in traditional sports (as an example, 283,000 fewer people were swimming regularly and 93,000 fewer people were cycling) yet adventure sports experienced growth, with 337,000 more people taking part in activities such as hill and mountain walking, rock climbing, abseiling, orienteering or high ropes.

Adventure in an urban environment

One activity that has embraced the urban environment is parkour. Data from Sport England’s Active Lives Adult Survey revealed 96,700 people throughout the UK participated in parkour at least twice for 30 minutes each time within the 28 days leading up to the survey, which highlights how accessibility can propel physical activity participation.

Outdoor adventure and risk

Parkour, like all adventure disciplines, has an element of risk and while one may assume its participants are attracted by risk, in reality research suggests practitioners are very good at managing and reducing risk through assessment prior to and during their activity; the appeal of such activities therefore resides with the positive experiential outcomes induced (for example positive psychology such as flow-states), not the possibility of injury or death3.

Given the actual and predictive trend of the general public towards adventure sports, that by their very nature have inherent risk, it could be argued participants have a moral obligation to be trained in relevant medical skills that address the risk synonymous with their sport and environment in order to ‘concern themselves with the effects of their actions on others’, or indeed the effects of not taking action in a medical emergency.

The Bystander Effect

The ‘Bystander Effect’ is a social psychological phenomenon in which the presence of others discourages one individual from taking action to help another individual in an emergency situation. Social psychologists Latane and Darley attributed the concept to the diffusion of responsibility (we believe other bystanders will take action) and social influence (inaction by others is a cue as to how we should behave)4.

There is a time-frame between contacting the emergency services and the arrival of the emergency services where two medical skills in particular could be life-saving. The first is putting an unresponsive casualty into the recovery position and tilting their head to encourage an open airway; the second is applying pressure to a heavy bleed to stem the flow5. Despite these observations there is still no mandatory first aid system in the UK and a 2018 report by the British Heart Foundation stated 95% of people would not know what to do in a medical emergency.

First aid skills are transferable in different situations (for example, the management of a penetrating wound is the same during a terrorist attack in a city as an incident up a mountain), therefore equipping ourselves with basic medical skills makes absolute sense, not only from an ethical perspective to be able to save another person’s life but the more of us who adhere to this training the safer we consequently become personally.

Urban Adventure Medicine

To address the disparity between the volume of people populating urban locations, the lack of a mandatory first aid system in the UK, and increased participation in urban adventures, a new field of study has been conceptualised:

Urban Adventure Medicine©

Provision of care by urban adventurers who arrive first on scene during a medical emergency.

Launching in August 2018 as a joint collaboration between Parkour Generations, Rapid Response Adventure Medicine (RRAM) and World Extreme Medicine (WEM), the UK’s first Academy of Urban Adventure Medicine has been established at the Parkour Generations facility in East London, the Chainstore Gym & Parkour Academy. Specifically targeting non-medics, we envisage this field becoming the link between a medical emergency taking place and the arrival of the emergency services in an urban environment. We actively encourage anyone residing in an urban environment to become involved in this ground-breaking initiative.

The course

The academy is the only facility in the UK operating 16-hour Urban Adventure Medicine courses by qualified London-based medics who deliver the training via real-time scenarios, medical kit application, lectures and informal Q&A. Topics and training include casualty assessment and primary/secondary survey, shock, tourniquets and amputation; acid attack management; firearms injury and penetrating knife wounds; CPR/AED use; common medical emergencies; trauma emergencies including head injuries and fractures; musculoskeletal injuries; wound closure and infection; and medical kit considerations. All students will receive a certificate from the Society of Extreme, Expedition and Wilderness Medicine stating the 16-hour syllabus they have completed in addition to a photo ID recognising them as an Urban Rapid Responder. Courses are currently priced at £120 per person.

Book your place

For further details on Urban Adventure Medicine courses contact Parkour Generations: or book directly via the website at

Nikki McLeary has a background in sports science, human performance and science publishing; is an invited speaker at King’s College London; has a BSc Sports & Exercise Medical Sciences; is founder of Rapid Response Adventure Medicine; and spent 15 years operating her own adventure company overseas in multiple locations and environments. You can contact Nikki on

Where to next? Check out this podcast on lifting and shifting for strength.



  1. Boddy, J. et al (2011) ‘Does participating in physicalactivity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors?’ A systematic review, Environmental Science & Technology, 45 (5), p.p. 1761 – 1772
  2. Sport England (2017), Active Lives Adult Survey:
  3. Brymer, E (2010) ‘Risk taking in extreme sports: a phenomenological perspective’, Annals of Leisure Research, 13 (1), p.p 218 – 238
  4. Latane, B & Darley, J (1969) ‘Bystander Apathy’, American Scientist, 57, p.p 244 – 268
  5. British Red Cross (2017) ‘Overcoming the Bystander Effect’