Hey Everyone! I put this together to help some friends out, and realized it's probably useful to a lot of other folks. I also wanted to see if anybody had any suggestions or comments. This also applicable to Boston and DC, as those are roughly the three main places that transit to the trail goes through.
Backpacking the AT via Mass Transit from NYC: Harpers Ferry to Maine
The Appalachian trails goes right by NYC, and is perfectly suited for a transit accessible section hike. In fact, the 870 mile section from the Harpers Ferry to the NH/Maine border has decent transit options every 20-50 miles, which I’ve covered in this guide. I’ve also included a segment linking to transit options in Maine, which are not as closely linked.
If you’re going to do some part of this, I highly recommend downloading the Guthook Map and buying these sections. It’s both a good map app, and a great guide to the trail, covering water sources, food resupplies, tent and lean-to sites etc. It also has comments from other hikers with the latest info on water and trail conditions
Below I’ve listed the AT mileage as found in the Guthook App (measured from the Southern Terminus in Georgia), and Transit options at each point. Using Guthook and these references, you should be able to put together any type of trip from a single overnight, all the way up to a month long backpacking trip through the entire area.
Couple of Notes:
This is a wall of text, and can be intimidating. I suggest planning this out in manageable chunks. For example, I think that the Delaware Water Gap (Mile 1296) is a great start/finish point for a section, due to convenience of buses to Manhattan, and good food options. Other notably good points to get access include: Greenwood lake (1372), Harriman (1385), Garrison (1411), Harlem Valley/Wingdale (1453). These could all be looped into a short or long weekends, and this area of the trail isn’t called the “Deli to Deli” Section for nothing. The logistics are probably the easiest of the entire trail, while also being full of beauty.
Taxis: While I have provided numbers for various taxi companies, I make no guarantee as to if you’ll have a good experience. I recommend contacting them well in advance, and get a cost before you get in the car. If the cost seems unreasonable, it probably is, and I recommend contacting another service. I also haven’t listed every road crossing that you can get a taxi at. I’ve selected ones that make sense due to proximity, or being the first/last area that makes sense for a while. For pretty much all of the NY section of the trail, catching and Uber is also an option. The Trek also maintains a list of shuttles covering this whole area as well: https://thetrek.co/appalachian-trail/accessing-the-appalachian-trail-shuttles-buses-taxis/
Amtrak: Amtrak occasionally has issues with being significantly late, especially on the line going by Harrisburg. I wouldn’t recommend planning on a close connection, and if you do, have a backup plan (ie, take a $20-$30 Uber ride to a trail head if you miss a bus).
Also, I make no guarantee that all of the options work. I as a random redditor take no responsibility for any misadventures you might have from this info. I’ve found google maps to be fairly reliable, but have included direct links to every transit operator so you can check latest schedules with them. Be sure to check everything before you go, especially with all of the uncertainty surrounding COVID. Enjoy!
1025.9 Harpers Ferry - From here you can walk a couple blocks to the train station and catch either an Amtrak or MARC train back to Washington’s Union Station. See 1048.6 for info on Union Station.
MARC: https://s3.amazonaws.com/mta-website-staging/mta-website-staging/files/Routes+Schedules/marc_brunswick-washington.pdf
Amtrak: https://www.amtrak.com/routes/capitol-limited-train.html Or you can take it to Chicago. You do you.
1048.6 US-40 - Walk 4 miles to the Meyersville Park and Ride https://goo.gl/maps/Q8Ajy3h7Qz9rK2jKA and catch the 505 Bus. https://s3.amazonaws.com/mta-website-staging/mta-website-staging/files/Routes+Schedules/505.pdf This bus can take you to the Shady Grove Metro train station. You can then take the train to Washington DC’s Union Station, https://goo.gl/maps/PyfbpJDEFbjKd3VC9
At Union Station you can catch a bus or Amtrak train back to NYC. Bus operators include: Bolt Bus: https://www.boltbus.com/ Megabus: https://us.megabus.com/stops Greyhound: https://www.greyhound.com/ Note: This bus runs weekdays only
1096.3 Shippensburg Rd - This is an 8.5 mile road walk https://goo.gl/maps/9XHQTdrzW7fAXVEj8 or call a taxi or shuttle:
Chambersburg Taxi - (717) 377-0806 Express Taxi - (717) 977-9539
Once at the Walmart you can take the CAT 81X to the Harrisburg Amtrak Station. See 1184.7 for info on Amtrak. https://www.cattransit.com/wp-content/uploads/sites/2/2020/06/Route-81X-Public-Schedule-2019.11.04-v2.pdf Note: This is a weekday only service
1131.9 US-11 Carlisle Pike - Walk 1.2 miles west to catch the bus at Country Club Rd. There are two buses that stop here that will take you to the Harrisburg Amtrak Station:
CAT C Bus - https://www.cattransit.com/wp-content/uploads/sites/2/2020/03/Route-C-Public-Schedule-2019.11.04.pdf and take it to Harrisburg Amtrak Station. Note: Route is Weekday only, but does run hourly/every other hour. Be very careful if crossing Carlisle Pike! See 1184.7 for info on Amtrak.
CAT 81X Bus - https://www.cattransit.com/wp-content/uploads/sites/2/2020/06/Route-81X-Public-Schedule-2019.11.04-v2.pdf
1132.7 Bernheisel Bridge Rd - There are couple options:
Walk 1.5 miles to the intersection of Farmers and Carlisle Pike. https://goo.gl/maps/ZVbLB6R719184MuL9 Catch the CAT C bus. https://www.cattransit.com/wp-content/uploads/sites/2/2020/03/Route-C-Public-Schedule-2019.11.04.pdf and take it to Harrisburg Amtrak Station (see 1184.7). Note: Route is Weekday only, but does run hourly/every other hour. Be very careful if crossing Carlisle Pike!
Walk 2 miles to the Fry/Weg Warehouse and catch the CAT CY Bus. https://goo.gl/maps/6L9r46WLZYxdbXxK8 https://www.cattransit.com/wp-content/uploads/sites/2/2020/09/route-CY-2020-10-18.pdf Note: There are currently are only 2 trips a day, 6 days a week from here. Be very careful if crossing Carlisle Pike!
1151.3 US-22/Susquehanna River - Catch the CAT 23X Commuter bus from the Park and ride, and take to the Harrisburg Amtrak Station https://www.cattransit.com/wp-content/uploads/sites/2/2020/03/Route-23X-Public-Schedule-2019.11.04.pdf Note: Route is weekdays only, and has only a few trips See 1184.7 for info on Harrisburg Amtrak Station info
1184.7 Swatara Gap - Walk along the rail trail, and then surface roads to the Mattel distribution center area https://goo.gl/maps/jj8rapAMNgGVHwvY6 where you can catch Bus 16. From there you have two options. There are two options. One is to transfer to Bus 8 and take it to Hershey Intermodal center, and transfer to CAT Bus 322 to the Harrisburg Amtrak station.
There are several options throughout the day to take this route. https://goo.gl/maps/kreW1xWNx3ovnf4w7 -> https://lebanontransit.org/map-schedules/routes/route-10-old-forge-road-express/ https://lebanontransit.org/wp-content/uploads/2020/05/Route-8-Schedule.pdf https://www.cattransit.com/wp-content/uploads/sites/2/2020/03/Route-322-Public-Schedule-2020.03.09.pdf
The other option is to take the express bus, which runs twice a day Round Trip: https://lebanontransit.org/map-schedules/routes/harrisburg-commute-king-express-a-b-schedules/ You take the same Bus 16 https://goo.gl/maps/VzpESaLHVHG77Cup9 , and transfer to Express Bus 22 https://goo.gl/maps/GGHTXskjxnrsxbGg7 https://lebanontransit.org/map-schedules/routes/harrisburg-commute-king-express-a-b-schedules/
Live schedule updates can be found here: http://realtime.lebanontransit.org/InfoPoint Note: Not all of these routes operate on weekends.
Google has issues with updated schedules and has issues putting these together. I recommend using the operators website to figure out transfer schedules. Both of these options will require a lot of attention to detail on the schedules to make it work. However, once in Harrisburg your options get better.
From the Harrisburg Amtrak Station, you can take: Amtrak back to NYC via Philadelphia: https://www.amtrak.com/routes/keystone-service-train.html Greyhound Bus: https://www.greyhound.com/ Pre-COVID there were other operators like Megabus that used to operate this route.
As an editorial note: given the disconnect between Google maps and updated schedules, this is the trickiest connection I’ve found on this list.
1220.5 PA 61/Cabelas/Hamburg - Walk 1.2 miles form the trail to the Walmart. https://goo.gl/maps/peCcYsM2GkNZ5BB78 Take BARTA Bus 21 http://busfinder.bartabus.com/InfoPoint to the BARTA Transportation Center in Reading. Take an Ourbus to NYC https://www.ourbus.com/ Note: Buses currently run only 3 days a week. Pickup and drop off in NYC is NOT PABT, but rather at Madison and E33rd.
1260.1 PA-248 - It’s a short walk to a stop for Bus 325. Transfer to Bus 209 to get to the Allentown Bus Terminal. https://goo.gl/maps/f3haz8mvvctVTPc69 http://www.lantabus.com/routes-and-schedules/325-weekday/ https://www.lantabus.com/routes-and-schedules/route-209/ Note: These buses are currently weekday only. Verify schedules before travel
See 1280.5 for details on travel form the Allentown Bus Terminal
1280.5 - Wind Gap - Walk one mile to catch Bus 217, transfer to Bus 107 to the Allentown Bus Terminal. https://goo.gl/maps/mLgqaNSvUszG99od6 or transfer to Bus 106 or 216 or 214 to get to the Easton Intermodal Center. I would suggest using Google Maps to figure out the best option to get to Easton, as there are so many options, and it varies based on time. Note Google has issues figuring out the trips back to Manhattan. I recommend directly contacting the bus operators. https://goo.gl/maps/MPQCzWnaZ83gGThg7
https://www.lantabus.com/routes-and-schedules/route-217/ https://www.lantabus.com/routes-and-schedules/route-107/ https://www.lantabus.com/routes-and-schedules/route-106/ http://www.lantabus.com/routes-and-schedules/route-216/ https://www.lantabus.com/routes-and-schedules/route-214/
From Allentown Bus Terminal you can catch: Greyhound: https://www.greyhound.com/en-us/bus-from-allentown-to-new-york Trailways: https://trailways.com/schedules/bus-from-allentown-pa-to-new-york-ny/ Transbridge https://transbridgelines.com/wp-content/uploads/2020/12/Allentown-Clinton-Eastbound-1-4-21.pdf Ourbus to NYC https://www.ourbus.com/
From Easton Intermodal Center: Trailways: https://trailways.com/schedules/bus-from-allentown-pa-to-new-york-ny/ Greyhound: https://www.greyhound.com/en-us/bus-from-allentown-to-new-york
NOTE: Not all bus routes do not run every day. Verify travel and make reservations in advance.
1296: Delaware Water Gap (DWG) - It’s a really cool area, and you can take a Martz bus from the PABT to their station located here https://goo.gl/maps/VqYJqZXSBTkqcpLw9 and walk to the AT by the river. You can look up schedules and buy tickets here: https://martztrailways.com/schedules/ Port = PABT Port Authority Bus Terminal in Manhattan, DWG - Delaware Water Gap
Pro Tip - There’s a bunch of great food options that you pass by walking from the bus terminal, so it’s a good place to stock up on a hot meal before setting off, or to reward yourself after finishing. I’m personally partial to Sango Kura’s Ramen/Sushi/Sake, and Joe Bosco’s BBQ.
1338: High Point State Park - At this point you’re 6.5 miles of road walking away from the Port Jervis Train station (NJ Transit). This is not a particularly fun road walk as it’s a fast, busy road, but it does have a large shoulder on one side. You can knock off a mile and half of the road walk by taking some trails to the Steenykill Lake boat launch https://www.state.nj.us/dep/parksandforests/parks/maps/HighPointTrailsFinalDraft_reduced.pdf
The better option is to call a cab, numbers for some listed below. I recommend adding a large amount of time between pickup and the train you’re going to catch. Check out Fox N Hare Brewing Company while you wait. J L Dispatching Taxi Service - (845) 856-3544 Yo Taxi - (845) 672-4171 Swift Cabs - (845) 672-4888 Port Jervis Dial A Bus - (845) 856-7999
1365: Warwick Turnpike - You will likely be able to catch an Uber from here. You have two options, either take it to catch the NJ Transit bus 197 either in Hewit NY https://goo.gl/maps/cHzsM3u1PLaYcMAu7 or Warwick NY https://goo.gl/maps/NhFD1KMGtJ56DDkb7
1368.5 State Line Trail - You take the turnoff and follow the state line trail down to the parking lot. There is a bus stop a couple hundred yards up the road where the 197 bus stops that will take you to Manhattan. https://goo.gl/maps/7kP18iv1HKWHt6iW9 Map showing trail down: https://www.njparksandforests.org/parks/maps/AbramHewittFinalDraft_reduced.pdf
1372.4 Greenwood Lake - There is a direct connector trail between the AT and Main Street in Greenwood lake. You can take the NJ Transit bus 197 to here: https://goo.gl/maps/Ji7D6u8QRs6tZMmP7
1374.6 NY-17A - There is a bus stop near the top of the hill where NJ Transit Bus 197 makes a stop. https://goo.gl/maps/4PuJLSQvH3oZLLew6 If riding too here, you should definitely let the bus driver know.
1383.4 East Mombasha Rd/1384.8 Orange Turnpike - It’s a ~3 mile road walk, or Uber ride to the bus stop in southfields, which is a ShortLine Bus run by Coach https://www.coachusa.com/bus-schedules There is currently very limited schedules on this route. I would recommend the next option, or if you really need to bail here, take an uber to the Harriman Train station https://goo.gl/maps/GZk2nuaQpenTL7re7
1385.9 Sapphire Trail/Harriman Train Station - This 2.2 mile trail goes to the Harriman Train station. This is on the Port Jervis line, so service isn’t that frequent. https://goo.gl/maps/GZk2nuaQpenTL7re7
1386.6 NY-17/Agony Grind - The Shortline Bus by Coach stops here, although has limited service https://www.coachusa.com/bus-schedules. As of 2021 this is not a reliable stop.
1405.7 US-9/Bear Mountain Inn - Ordinarily there is a shuttle bus between Manhattan and Bear Mountain. Due to COVID, this service has been suspended.
1407.2 Manitou - Ordinarily there is service at the Manitou station. Currently service is suspended due to COVID http://web.mta.info/supplemental/mnserviceupdates.htm?story=1427
1411.4 Trail Junction - Side trail to Garrison Metro North Train station. The 2 mile side trail can be viewed here https://parks.ny.gov/documents/parks/HudsonHighlandsTrailMapSouth.pdf https://goo.gl/maps/sDT7SQTyJWvXYx3f7 navigate via Avenza's free map here https://www.avenzamaps.com/maps/91861/hudson-highlands-state-park-trail-map-south This is currently the best access into Manhattan, as the train runs relatively frequently, and stops at Grand Central. Hopefully Guthook will add in the side trail route.
1444.1 NY-55 & 1451.7 NY-22 - 4 mile for NY-55 and 2.5 mile for NY-22 road walk to the Pawling Metro north station. There is the Appalachian Trail station at NY-22, but it has very limited hours normally and is not running due to COVID. Likely able to catch an Uber or you can call a cab: https://goo.gl/maps/zHaB9ojB3MJnUvgZA.
Taxi services will cover this entire area too, in case you have an issue. Pawling Train Station Taxi - (845) 855-9800 Segundo's Taxi - (845) 264-3020 Pauling Taxi Service - (845) 855-8585
1453.6 Trail Junction - This junction leads 2.5 miles to the Harlem Valley Wingdale Train station https://goo.gl/maps/JxvegjPWLJrhjzNw8 Trail map https://imgur.com/a/itWgK3S https://www.nature.org/content/dam/tnc/nature/en/documents/pawling.pdf There are a couple of other routes possible if coming from the North. Hopefully Guthook will update the side trail.
1470.1 Macedonia Rd/ Kent CT - This is ~10 miles from the Wassaic Metro North Stop. It is a fairly quick cab ride. https://goo.gl/maps/o3s5iBMHsxoTUHBL8
Morning Star Car Service - (845) 832-7933 Litchfield County Livery - 860-601-9143 Big Bully Taxi - 845-546-5707
*1502.3 Cobble Rd/Salisbury CT *- This is ~15 miles from the Wassaic Metro North Stop. It is a fairly quick cab ride. https://goo.gl/maps/o3s5iBMHsxoTUHBL8
Emerald Express - (518) 592-1074 Watson Livery - (845) 464-8178
1523.8 US-7/Great Barrington - As of now in 2020, Peter Pan is no longer running a bus service from Great Barrington to NYC. A mile and a half north of where the trail crosses US-7, there is a stop for Bus 21 https://berkshirerta.com/plan-your-trip/route-21-schedule/ at the Claire Teague Senior Center. You can take this to the Lee Outlets, and transfer to Bus 2 https://berkshirerta.com/plan-your-trip/route-2-schedule/, which will take you to the Pittsfield ITC (Amtrak/bus center in Pittsfield). https://goo.gl/maps/rGzVLzVfMrzACKiR9 These buses take awhile (it’s a 21 mile route). Note, these buses do not run on Sunday. The other faster, albeit more expensive option is to take a taxi back to Wassaic, or Catskills Amtrak station which are only 30 miles away.
Hudson Car Service - (518) 697-0056 Morning Star Car Service - (845) 832-7933
From the Pittsfield ITC, you can either take a Greyhound bus to NYC, or an Amtrak train back - both have at least one transfer, so both options take awhile. The Amtrak option also does not run every day. While I ordinarily recommend using google maps to handle the details of transit, it has issues putting it all together, especially with the schedule issues with Peter Pan. I would recommend directly checking on https://www.amtrak.com/ and https://www.greyhound.com/ for options.
1541.2 Jerusalem Road - You can walk 4 miles to the Lee Premium Outlets and catch Bus 2 behind the Polo Ralph Lauren https://goo.gl/maps/XP7pyjhkR1ecUzrT6 https://berkshirerta.com/plan-your-trip/route-2-schedule/ that will bring you to the Pittsfield ITC Bus/Amtrak station. See description at 1523.8 for info on the Pittsfield ITC. Note, these buses do not run on Sunday. It should be noted that walking along Goose Pond Rd (1548.5) is a nicer, quieter, safer road walk.
1548.5 Goose Pond Road - You can walk 4 miles to the Lee Premium Outlets and catch Bus 2 behind the Polo Ralph Lauren. https://goo.gl/maps/VoKCnn4LeJ3HZ7QCA https://berkshirerta.com/plan-your-trip/route-2-schedule/ The bus will bring you to Pittsfield ITC Bus/Amtrak station. See description at 1523.8 for info on the Pittsfield ITC. Note, these buses do not run on Sunday.
1572 Dalton- A couple blocks off the trail you can catch Bus 4 https://berkshirerta.com/plan-your-trip/route-4-schedule/ to the Pittsfield ITC. https://goo.gl/maps/amSCrFgxnZ81naQ57 See description at 1523.8 for info on getting to and from the Pittsfield ITC. Note, these buses do not run on Sunday.
1580 Cheshire - You can catch Bus 1 https://berkshirerta.com/plan-your-trip/route-1-schedule/ to the Pittsfield ITC. See description at 1523.8 for info on getting to and from the Pittsfield ITC. Note, these buses do not run on Sunday. https://goo.gl/maps/aW74Xdspo87ujXxY6
*1595.4 North Adams *- You can catch Bus 3 https://berkshirerta.com/plan-your-trip/route-3-schedule/ at the Stop and Shop in North Adams, a half mile west of the trail, or walk 2 miles into downtown North Adams. Then transfer to Bus 34 https://berkshirerta.com/plan-your-trip/route-34-schedule/, and then to Bus 1 https://berkshirerta.com/plan-your-trip/route-1-schedule/ to the Pittsfield ITC. https://goo.gl/maps/tf6YgR71RDyc86JN7 Note, these buses do not run on Sunday. See description at 1523.8 for info on getting to and from the Pittsfield ITC.
1613.8 Route-9 Bennington VT: It’s a five mile road walk into Bennington on a busy road Otherwise, there is a bus that runs a couple times a day https://goo.gl/maps/tEJRkT7NBRczZQ3X9 https://www.greenmtncn.org/emerald-line.html (it’s the LT/AT stop). You must call the bus service at (802) 447-0477 to request a pickup at the LT/AT stop. You can also check Guthook comments for info on shuttle services. Otherwise, here are some listed taxi services. Be advised that some carriers don’t have cell phone service at the trailhead, so plan ahead when you have service on one of the mountains above the road.
Mike's ALL HOUR Taxi - (802) 379-6279 Walt’s Taxi - (802) 681-7054
Once you’re in Bennington, you would ordinarily be able to take a VT Transline to Albany for a Greyhound/Trailways bus, or Rensselaer NY for Amtrak Service back to NYC. However due to COVID Transline has suspended service. Please check https://www.vttranslines.com/ for updates
1649.1 Prospect rock/ Manchester Center VT- It’s a 2.5 mile walk to Zoey’s Double Hex Restaurant, which is where one of the three daily buses to Albany stops, and ~4 miles to the Bus parking area where the other two stop https://goo.gl/maps/6ZDmBwck8Lm99m2w9 Check out https://www.vttranslines.com/bus-schedules/ for details. Note, all services are cancelled due to COVID
There are several taxi options as well: Equinox Transportation - (802) 430-9920 Mountain Drivers - (802) 772-5223 Manchester Taxi - (802) 362-4118 Northshire Taxi - (802) 345-9333
1679.9 Russell Road /Wallingford VT - It’s a 3 mile road rock to the Cumberland Farms where the VT Translines bus stops, which does daily runs to Albany. https://goo.gl/maps/6kapAzAXjhy1Q4Mn6 See https://www.vttranslines.com/bus-schedules/ for details. There are some folks listed in Guthook comments who do shuttles here Note, all services are cancelled due to COVID
*1686.2 VT-103 / Rutland * - There is a Ludlow Bus Route stop at the trailhead. The bus runs infrequently, so check the schedule and plan accordingly https://goo.gl/maps/Yv4KrkcdSYxzGSsm9 https://www.thebus.com/ludlow-route/
There are also taxi options to get into Rutland, and Uber reportedly works: Timberline Transportation - (802) 345-6917 Catamount Taxi - (802) 236-0282 Tri State Transportation - (802) 855-3130
Once in Rutland, you have two options. You can either take Amtrak to NYC via Alban, or the VT Translines bus. Once in Albany you can transfer to either an Amtrak or bus back to NYC. Note, due to COVID both the Rutland Amtrak and VT Transline have been suspended.
*1706.0 - Inn at Long Trail/Rutland * - The Rutland Killington Commuter Bus stops here. https://goo.gl/maps/m1Ksez9TCLP7fDfXA Note, this bus runs infrequently, verify schedule https://www.thebus.com/rutland-killington-commute You can also catch a taxi into Rutland. Please see taxi options and transport to/from Rutland at 1686.2
*1750.7 Hanover NH *- You can take a bus from Hanover to White River Junction, and catch an Amtrak train back to NYC. https://goo.gl/maps/Yu7tmFuaoFZHz1NS8 https://www.amtrak.com/ You can also catch the Dartmouth Coach https://dartmouthcoach.com/ to Boston, and then take a bus or train back to NYC. Currently, the Amtrak service, as well as Dartmouth Coaches’ direct service to NYC is suspended due to COVID.
1803.6 Kinsman Notch/ Lincoln NH - It’s a 7 mile road walk to the 7-11 where the bus stop is https://goo.gl/maps/YdvTtWvFw22VyRuC6 There are also several taxi companies:
Ali’s Taxi Rides: (603) 348-3914 Shuttle Connection: (603) 745-3140
Concord Coach runs a bus from Lincoln to Boston, where you can take a bus or train back to NYC. https://concordcoachlines.com/stop/lincoln-nh/
1819.9 I-93 /Liberty Springs Trailhead/ Lincoln NH - You can likely get a ride from one of the taxi services listed at 1803.6 back to Lincoln. The AMC Hiking shuttle also stops here, although is not running due to COVID. See https://www.outdoors.org/lodging-camping/lodging-shuttle for details and reservations.
1847.6 Webster Cliff/Crawford notch - The shuttle services listed for Lincoln will likely work here, as does the AMC hiking shuttle, which is not running due to COVID. See https://www.outdoors.org/lodging-camping/lodging-shuttle for details. Note, little to no cell service exists in the Notch, so plan accordingly.
1873.6 Pinkham Notch Visitors Center - Concord coach stops here, and goes to Boston. https://concordcoachlines.com/stop/pinkham-notch-nh/ From Boston, you can catch train or bus back to NYC.
1894.8 Rattle River - This is the last access for quite some time. Concord bus has a stop in Gorham https://concordcoachlines.com/stop/gorham-nh/, which is a 4.7 mile road walk from the AT. https://goo.gl/maps/fyC4g9NsfDyVnQUu6 This bus will drop you off in Boston, where you can take a train or bus to NYC. Shuttle service may also be available from the Rattle River Hostel (603) 466-5049 - and others which can be found in the Guthook comments.
Maine
From here through Maine, there are no regular bus routes, but options to exist. I’ve included a partial list here, and information sources. Overall the best bet besides these two points to split it up is to work with a shuttle operator.
2193 - The End/Start Mt. Katahdin - See the guide here on getting here https://thetrek.co/appalachian-trail/get-mount-katahdin-sobos/
2003.3 - ME-27 Carrabassett Valley - The Maine Hut to Hut trail system is nearby, and has a good rundown on transit options here https://mainehuts.org/transportation-services. The main theme is you’ll have to take a shuttle service of some variety to Bangor, Augusta, or Portland. Where you can take a Concord Bus to Boston, or a train or bus to Boston. Since the shuttle service is to order, you can also get picked up at many othe road crossings in the Rangely/Carrabassett area. Be sure to work the details out ahead of time.

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Unfortunately, posts on this topic are not a rare occurrence here. Teenagers are often kicked out of their home without support, sufficient money, or time to prepare in advance, but there are some resources and options for teenagers in this situation.
This guide also includes some information for teenagers who are at risk of being kicked out.

First, please seek help

If you need help, there are confidential and nonjudgmental services with trained helpers that you can call or contact online. Sometimes these services get busy. If you can't reach someone right away, please try again until you reach someone.
In the case of a life-threatening emergency, please call the police or the emergency telephone number for your country (e.g., 911 in the United States).
In addition to the below resources, consider talking to an adult that you trust and/or an independent institution or service provider with community knowledge and resources. There are many options such as:

• A teacher, sports coach, or staff member at your school
  
• A school guidance counselor, school nurse, or doctor
  
• A relative that you trust
  
• A family doctor or nurse
  
• A religious leader
  
• A librarian
  While most are not trained explicitly in this area, librarians tend to be resourceful and very good at research if you're feeling overwhelmed.
  
• A staff member at local shelters, food banks, soup kitchens, etc.
  Even if you aren't interested in that specific resource, they tend to be sympathetic and familiar with local resources.
  
• Another adult you trust
  It doesn't have to be one of the above options. Someone like a friend's parent or even a neighbor may be a good option for getting advice, sorting through your options, and avoiding mistakes. Most adults have a decent amount of experience dealing with government agencies, navigating complex situations, and have had their share of troubles too.
  

United States

• Contact the National Runaway Safeline. They provide a valuable resource for runaway, homeless, and at-risk youth. The service is free, confidential, and available 24/7.
  CALL 1-800-RUNAWAY
  CLICK 1800RUNAWAY.org
  TEXT 66008
  
• You can also text "HOME" to 741741 in the US to communicate with a Crisis Text Line volunteer anytime, about any type of crisis. Every texter is connected with a Crisis Responder, a person trained to bring texters from a hot moment to a cool calm through active listening and collaborative problem-solving.
  
• In most of the US, you can also call 211. They will help connect you with resources.
  

United Kingdom

• Contact Childline. Childline is a free, private, and confidential service where you can talk about anything.
  CALL 0800 1111
  More information is located under Moving out / leaving home on Childline.
  
• If you're in England, aged 16 to 25, and homeless or at risk, the Centrepoint Helpline offers advice and support to vulnerable young people.
  CALL 0808 800 0661 (Monday - Friday, 9am - 5pm)
  
• Here is some additional information about housing and homelessness resources for young people in the UK.
  

Canada

• Contact the Kids Help Phone.
  CALL 1-800-668-6868
  
• You can also text "HOME" to 686868 in Canada to communicate with a Crisis Text Line volunteer anytime, about any type of crisis. Every texter is connected with a Crisis Responder, a person trained to bring texters from a hot moment to a cool calm through active listening and collaborative problem-solving.
  
• In most of Canada, you can also call 211. They will help connect you with resources.
  

Australia

• Contact the Kids Help Line.
  CALL 1800 55 1800
  

Resources for other countries

Country	Organization	Phone Number
Belgium (Dutch)	Awel	102
Germany	Nummer gegen Kummer	116 111
Ireland	ISPCC	1-800-666-666
Italy	Telefono Azzurro Rosa	Casi urgenti e SMS adolescenti: 337 427363
Netherlands	Kindertelefoon	0800-0432
New Zealand	Youthline	0800 376-633
South Africa	Childline	08000 55555
Other Countries	Child Helpline International	Find a Child Helpline

Some housing options to consider

Read through all of these before you settle on which options to try first. If it starts to be too overwhelming or you need help, please reach out to one or more of the resources listed above for advice and support.

1. If your home living situation was not abusive and there is an option to make up with your parent(s) or caregiver, please consider it (even if it means a curfew, chores and hard work, or following rules you don't like). You can use this time to save up more money, find work, finish high school, and generally prepare for living on your own.
   If things are uncomfortable at home and you're allowed to simply spend more time elsewhere, that's often a good option to reduce tension at home. Some ideas: get a cheap gym membership, do your studying at the library, get a part-time job, join an after-school group, or volunteer.
   If you have fundamental disagreements with your family or caregivers and this would be a possible reason for you to be kicked out, it's probably best to delay announcing these until you're on your own and doing well independently. Maybe they are not great people. Maybe you don't believe in the same things. As long as you are safe, it can wait until you are in a better position to be independent. As they say, the best revenge is living a good life.
   
2. It's generally illegal for your parent(s) or guardian to actually kick you out. If your home living situation was not abusive, one option to consider is contacting the police to get back into your home.
   
   • If you're an underage child (under 18 in most of the United States) and not legally emancipated, it's almost always illegal for parent(s) or a guardian to kick you out.
   • Even if you're an adult or legally emancipated, but living at home, it's generally illegal to kick you out without following the relevant laws including sufficient notice. The specifics depend on the circumstances and your location (you may consider posting to /legaladvice as well).
   Contacting the police may be unpleasant and you will need to listen to the police officer, but your parent(s) or guardian will also need to listen and allow you back into their home. You shouldn't be carrying anything illegal (drugs, alcohol if you're underage, or illegal weapons) in general regardless, but absolutely do not have any of those items on you or in your room if you contact the police.
   
3. If you have any relatives that you can reach that would let you stay with them for any period of time, this is one of the best available options if you've been kicked out. Aunt or uncle lives in the next state? Call them and find a way to get there. Any non-abusive relative that you know is probably a better option than heading to a shelter. Grandparents, cousins, aunts, uncles, step-siblings, you name it.
   
4. Failing that, your next best bet is to contact friends, crash on a couch, and ask anyone you know that might put up with you. Try to consider any workable and safe options. For example, your ex's parents liked you and you're on good terms? Call them and ask if you can sleep on their couch for a few days until you figure something out.
   
5. While you're living on someone else's dime, in a place that isn't yours, friends, family, shelter, whatever it is, try you best to be on your best behavior. That means:
   
   • Try to avoid drugs and alcohol. If you need help with substance abuse, please reach out to some of the resources linked above.
   • Try to respect any rules of the household or establishment and stay out of trouble.
   • Keep your space clean and maintain your personal hygiene.
   • Try to avoid being a negative presence.
6. It may be very difficult to find a better option, especially on short notice, but living and sleeping on the street is very dangerous, especially as a teenager. Contact one of the above help lines and they will help you find a safe place to sleep.
   

United States

If you're 16 to 24, Job Corps is another option worth investigating (some adults with documented disabilities above the age of 24 are also accepted). Under the age of 18, you will need the approval of a parent or guardian.
Job Corps offers free education and vocational training, dormitory-style housing, food, work clothes, and other resources to help prepare youth for independent living and the opportunity to learn skills needed for a job that's somewhat better than an unskilled minimum-wage job. It's completely free for those that qualify and are accepted into the program.

Preparing if you think you might be kicked out or may need to leave soon

1. Try to avoid accelerating the process and use any time you have to save up money and prepare. Your own safety comes first, though.
   
2. Try to make sure you will have a place to stay. If you can sleep on a couch for a month and save up more money before renting a room, do it. You want to save up money as much as reasonably possible.
   
3. Try to have your birth certificate, identification, passport, diplomas and anything else you will need. Store important documents at the home of a trusted friend or family member if possible. Note that your parent(s) or guardian aren't obligated to give you their copy of certain documents and you should not put yourself at risk to retrieve these because you can order a copy later (link for United States).
   
4. Plan for the worst case even though it might not happen. Your parents may not support you going to school, fill out financial aid paperwork for you, etc. If you can't afford to pay for school on your own, you may need a different plan for continuing your education such as going to community college while working.
   
5. If and when you need to spend money for a place to stay, try to spend as little money as possible on rent. That usually means renting a room instead of an apartment, having some roommates, etc.
   

Financial Accounts

• Joint bank accounts can be emptied by either account holder at any time so if you're old enough to open your own bank account (18 or 19 in the United States), open a new bank account at a different bank from the one used by your family. Local credit unions, online banks, and online credit unions are popular recommendations here. Use a local credit union if you will need to deposit cash.
  
• If you're not old enough to open an account where you live, see if an adult that you trust will help open a joint bank account with you. When you are old enough to open your own account, open one as soon as possible and transfer your money over.
  
• Sign up for electronic statements and consider using a different postal address (e.g., the address of a friend or trusted adult) so statements don't get delivered to your home.
  
• If you're having trouble finding an bank or credit union that will allow an adult that isn't a parent or guardian to open an account with you, the Money account offered by Capital One 360 is one option in the United States.
  
• Check your credit report and freeze your credit (sign up for credit monitoring before freezing your credit).
  

School

United States

If you're still in high school, ask a guidance counselor or principal at your school about continuing your education. The McKinney-Vento Act is a federal law that mandates the right of students regardless of their housing status. The law provides resources and support including provide transportation, free meals, and other services.
If you have questions about Federal student aid, and are homeless or at risk of becoming homeless read this guide from the Department of Education.

Other resources

• /almosthomeless
• /homeless
• PF Wiki: Advice for high school students and teenagers

Edits

I made many edits based on all of the really helpful feedback. Thanks especially to BettaTesting for these ideas and Nilpunk9 for this suggestion.

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The Scottish Premiership reached week 9 before I had a football-induced breakdown; so, if you have a spontaneous craving for a thousand words on Aberdeen Football Club’s lacklustre start to the season - and a roundup of all the other events over the last two weeks in Scottish football - just wait until you see this!

Scottish Premiership

Fixtures

KEY MATCH

Sat	20/10/18	Heart of Midlothian	2 - 1	Aberdeen

I’ll admit that my personal biases may have influenced me to write about Hearts-Aberdeen instead of Celtic-Hibs, but since I’m the one forgoing a uni essay to write this on the train, I can do what I like.
Hearts have deservedly garnered the attention of a wider audience following an almost perfect first 7 games, in stark contrast to the mid-table obscurity (well, as obscure as you can be under Craig Levein) of last season. They ended up making up the numbers in the top 6 following the end-of-season split, losing all 5 games against the teams above them.
Meanwhile, Aberdeen have been busy embarrassing themselves. The club received a 50-50 split of over 20,000 tickets for Sunday’s League Cup semi-final clash against Rangers, despite “commonsense” dictating the Glasgow team should have the “Lion’s Share”. Unfortunately, under half of these tickets have been sold, so Aberdeen have been forced to return part of their allocation. The whole thing is a bit tin-pot and, like I said, embarrassing, so I can’t really bring myself to write much more than that. The silver-lining to this is that we did get BBC Sportsound tweeting a picture of current Aberdeen captain, Graeme Shinnie, holding the head of a decapitated, former Aberdeen captain and current Rangers player, Ryan Jack. Every cloud.
The fact remains, this season’s Aberdeen are a far cry from the club that finished 2nd last season (and as such were one of the teams to ease past the Jambos at the end). Currently it looks as if they would be lucky to replicate that Hearts performance. It simply has not been the Dons’ season so far. Star defender Scott McKenna served the second match of his ban following his outrageous tackle on Odsonne Edouard, and, following calls from the Aberdeen chairman for a summit on the state of Scottish football, demanding greater transparency (a move I am very proud of,) the SFA finally published their reasoning for the retrospective ban. I am now going to talk about this, but would like to add the disclaimer that I know it was a terrible tackle and I know that he deserves to be banned. If you just want a breakdown of Saturday’s action, skip the rest of this paragraph. Now, I am attempting to study law, but it doesn’t take a brilliant legal mind to realise that paragraph 11 of the SFA report, specifically the point at which the referee states he saw the incident but was unsure of the extent of the contact, clashes a bit with the SFA’s Judicial Panel Protocol (available here for your interest), specifically sections 13.3.1 and 13.3.3.2. I just don’t believe for one moment that not one of the officials saw McKenna completely clatter Edouard, and I’m frustrated by the gymnastics taken by the SFA to ban an Aberdeen player for this sort of conduct when the likes of Alan McGregor and Leigh Griffiths have gotten away with stamps and kicks which have genuinely not been seen by the refs. I can’t believe it’s gotten me so tilted that I’ve actually whipped out the JPP. Riddy.
Anyway, now I’ve got that off my chest…
Fears that the Hearts bubble may have burst following the 5-month injury layoffs of Uche Ikpeazu and John Souttar seem to be unfounded. Hearts were fully in control for the opening half, but this may be down to the unique Aberdonian big-game tactic of letting the opposition attack you until they score.
When Hearts did take the lead through a Djoum header, they remained in control, before the opportunity to double their lead from the spot came in massively controversial fashion. There was absolutely nothing in the challenge which saw Lewis Ferguson penalised against Steven Naismith, which you can see 13 seconds into the highlight video below. Naismith tucked away the resulting pen.
Aberdeen were significantly better in the second half but trailed off after a Gary Mackay-Steven penalty pulled one back. Hearts were awarded the third penalty of the game, but this time Joe Lewis kept out Naismith’s effort. Hearts now have a 10 point advantage over Aberdeen, and stay 3 points ahead of Celtic at the top of the table. I imagine they will extend their advantage against Dundee on Tuesday, whilst Celtic prepare for European action and the League Cup semi-final.
Full highlights of this game here.
Final statement: Aberdeen have now faced every other member of last season’s top 6, and have yet to get a win. The Derek McInnes known for failing to deliver solid tactical performances in big games is going to be under the microscope soon because Aberdeen won’t finish in a European spot by bullying the bottom 5. If the Dons are anything but completely bodied by Rangers in Saturday’s semi-final it’ll be a surprise.
Happy birthday Craig Levein.

Saturday’s other matches

Celtic	4 - 2	Hibernian

Just a quick introductory note - “over 2.5 goals” is an extremely sensible bet in most Hibs matches.
Capturing the hearts and imagination of the Scottish football audience this week is a bizarre song about Leigh Griffiths and bees. The only way I can think to describe it is that it’s what you’d get if you took Flight of the Conchords’ “Albi The Racist Dragon”, but replaced ‘Albi’ with ‘Leigh’, ‘dragon’ with ‘Griffiths’, and put the air-quotes around the other two words.
Anyway, it is with a heavy heart I must announce that Celtic finally appear to have a degree of motivation about them. Despite mauling St Johnstone 6-0 last week this is by far their most competent and comprehensive performance of the season.
Meanwhile one can’t help but wonder what this Hibs team could achieve with some defensive solidity. One has to assume they wouldn’t be able to attack as fluidly, so for that reason we are glad that they are the way that they are. They were without their ubiquitous right-back David Gray, so switched to a back 3, and as such conceded 4 goals.
Within 20 minutes Celtic had gone 2-0 up thanks to Olivier Ntcham and Tom Rogic, before captain Scott Brown was forced off the pitch with injury. Hibs threatened to come back twice in the second half, with Flo Kamberi’s effort cancelled out by Edouard, before Martin Boyle’s goal to make it 3-2 received the same treatment.
Hibs fall down to 5th, Celtic now breathing down Hearts’ neck.
Highlights of the best encounter of the weekend here.

Motherwell	0 - 1	St Johnstone

Quite a big result for both teams, putting 5 points between St Johnstone and the bottom of the pack, and making sure Motherwell remain firmly in amongst it.
Just like my match report, this game never really took off, and it lasted 92 minutes before Jason Kerr broke the deadlock and made sure the points headed to Perthshire. Motherwell, whose strike force terrorised Aberdeen in the Scottish Cup semi-final last season, look bereft of creativity. St Johnstone have done well to take 3 points after being battered about the park, credit to them.
Highlights here.

Livingston	4 - 0	Dundee

I can’t believe I’m finally saying it, but it has finally happened. Neil McCann has been sacked! As the international break drew to a close with no sign of any change I was wondering if Dundee would persist and we’d see a Livingston ’05/’06 type season.
Although we may still see that. Jim MacIntyre’s arrival may not have been in time for Dundee to take advantage of the ‘new manager bounce’, because they appear to have been absolutely done here.
Gary Holt was on the radio today drawing attention to the fact that 3 of the 4 goals today came from defenders. Given that previous manager Kenny Miller’s plan was to source goals from Kenny Miller, it’s probably for the best that Declan Gallagher, Craig Halkett and Alan Lithgow have got their eye in early.
Steven Lawless added another long range goal to his collection to score the third, although he did not mean it, and I will not let anyone convince me otherwise. A proper rout to welcome Jim McIntyre to Dundee. Livi comfortably in the top half, they reside in 4th.
Have a look at the highlights here.

St Mirren	1 - 2	Kilmarnock

Oran Kearney’s step into full-time management may well be wiping years off his life at this point. He must be hankering back to the days of teaching PE, winning a few games of football and an Irish cup on the side, and feeling a degree of comfort in the decisions that had led him to this point. Jack Ross’ St Mirren team were a force to be reckoned with in the Championship, ousting teams fancied far heavier than them to the title, but having lost talisman Lewis Morgan and hired um… Alan Stubbs, they’re a dumpster fire that Kearney can’t seem to put out. 4 losses in a row from his first 5 games, the only comfort being Dundee, the source of their only 3 points in Gameweek 1, being equally terrible.
Kilmarnock, on the other hand, have had no such managerial woe, they’ve been a total revelation under Steve Clarke. If I’m not mistaken, this result means no team has more points in 2018 than Killie! Between that and having the best pies in world football, not a bad time to be part of the Rugby Park loyal.
They’ve achieved all this without relying too heavily on last season’s Premiership Top Scorer Kris Boyd, a fact which was pointed out to him during his part-time punditry gig on Sunday.
Kearney’s side actually took the lead through Adam Hammill’s 14th minute goal, and held on until half-time, but Alan Power and Aaron Tshibola scored 12 minutes apart before halfway in the second half, and saw out the rest of the game.
Full highlights.

Sunday’s Match

Hamilton Academical	1 - 4	Rangers

Kyle Lafferty had to sit this game out after dropping out of the Northern Irish squad to spend some time with his newly born daughter, or, if the tabloids are to be believed, to send dick-pics on snapchat. I forget what the official reasoning was.
Anyway, contrary to what the scoreline may suggest, Rangers made pretty hard work of this one.
They were up 1-0 through a well-taken first-half goal from Ryan Kent, but in the 80th minute Stephen Boyd scored the pick of the weekend’s goals to give me the faintest hope that Rangers might just be at it again. 15 minutes later, James Tavernier has scored two penalties and Alfredo Morelos has snuck in a goal just before full-time. Life’s a bitch.
Highlights of a fun one here.
Hearts stay 3 points ahead at the top, Aberdeen now 5 points adrift of the top 6 making up a mid-table with St Johnstone. Motherwell, Hamilton, St Mirren and Dundee all languishing.

Table

#		Team	P	W	D	L	F	A	GD	Pts	Form
1		Heart of Midlothian	9	7	1	1	16	7	+9	22	WDWLW
2		Celtic	9	6	1	2	17	6	+11	19	DLWWW
3		Kilmarnock	9	6	1	2	15	8	+7	19	LWWWW
4		Livingston	9	5	3	1	12	5	+7	18	WDWDW
5		Rangers	9	5	2	2	22	9	+13	17	WWLWW
6		Hibernian	9	5	2	2	21	10	+11	17	WWWWL
7		Aberdeen	9	3	3	3	10	9	+1	12	DWLWL
8		St Johnstone	9	3	2	4	8	18	-10	11	DLLLW
9		Hamilton Academical	9	2	0	7	7	20	-13	6	LWLLL
10		Motherwell	9	1	2	6	8	15	-7	5	LLLDL
11		St Mirren	9	1	1	7	5	19	-14	4	DLLLL
12		Dundee	9	1	0	8	5	20	-15	3	LLWLL

Championship Round Relegation Round

BEST OF THE REST

Scottish Championship

Sat	20/10/18	Greenock Morton	1 - 0	Falkirk

Falkirk manager Ray McKinnon’s return to Cappielow had Morton not so much rolling out the red carpet as dishing out red cards to their support, who weren’t particularly welcoming in the first place. Incompetent Falkirk goalkeeper Leo Fasan was sent off 49 minutes in, and Robert McHugh made sure his former manager wouldn’t leave with a point.
Falkirk cast off from the rest of the table by 4 points.
Comprehensive highlights here.

Sat	20/10/18	Ross County	2 - 1	Ayr United

A top of the table clash between the two form-teams of the division. Ross County leapfrog Ayr into first thanks to two first half goals from Billy McKay and Josh Mullin, before Lawrence Shankland inevitably pulled one back.
Highlights.

NATIONAL TEAM

UEFA Nations League

Thu	11/10/18	Israel	2 - 1	Scotland

trainspotting_its_shite_being_scottish.mp4
Every so often as a Scottish football fan an event occurs which instils a fragment of hope and promise in an otherwise barren wasteland where one’s heart would reside. Such events could be, for example: Leigh Griffiths’ second free-kick against England; the sacking of Gordon Strachan; or the creation of the UEFA Nations League. Invariably, this hope is snatched away almost immediately, by events such as: Stuart Armstrong not booting it away; the hiring of Alex McLeish, a manager who has been out of work for two years, apparently with good reason; or losing by a very kind 2-1 scoreline having been completely outplayed by the 94th ranked team in the world.
Our national team is infamous for the problem of having our two perceivably most-talented players being left-backs, but, as pointed out by captain Andy Robertson himself, Alex McLeish has opted not to play a left-back in his system.
I will give Alex the benefit of the doubt here, Robertson as a full-back and Tierney on the left of a back 3 is an experiment he had to try, or he would have been slaughtered. However, that which I will not forgive him for is playing high-flying Bournemouth left-winger Ryan Fraser as the right sided full-back, the kind of thing that results in him withdrawing from the squad at the earliest opportunity, perpetuating the feeling that a lot of Scotland’s players don’t really want to play for Scotland. As someone whose dream it was as a wee boy to play for their country, it’s not a practice I have much sympathy for, but it happens.
Anyway, I digress. As I said, fully outclassed. Scotland went into the break 0-1 up, with Charlie Mulgrew converting a penalty, but thanks to a Dor Peretz goal and a classy finish from Kieran Tierney into his own net, Israel got their deserved result. Here’s a video of James Forrest running to cheer us all up.
Highlights.
Scottish League Cup semi-finals at the weekend, meaning the fixture organisation all gets a bit confusing, and I have to work out how I’m gonna do this. See yous when I see yous.
^{Check out /ScottishFootball for good patter and quality discussion of the SPFL
Last week’s roundup can be found here: https://www.reddit.com/soccecomments/9methe/fitba_roundup_spfl_gameweek_8/?
● data from soccerway.com
● generated by soccerbot}

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I originally wrote this to try and educate the masses on two important issues: (1) an evidence-based smackdown to illustrate why the sawyer extractor has no business being used for anything except botfly extraction and (2) to provide a solid set of recommendations for what you should and should not do in the event of a snakebite in the backcountry. It is a lengthy read and it gets a little tongue-in-cheek at times, but it covers an important gap in the knowledge base and I hope it will provide you and your patients with some useful information to bring with you on your next trip into snake country. It is written to be accessible to non-medical personnel as well as medical professionals, so don't get offended when you come across something that is below your level of knowledge (I am not doubting your understanding of plasma). Lastly, this applies specifically to viperid envenomations in North America. Elapid envenomations (such as the coral snake, or all snakebites in Australia) require a different approach using lymphatic constricting bands (the pressure-immobilization method) to delay circulation of neurotoxins until a medical facility can be reached. If you are in the United States, don't pick up a coral snake and you will be fine. Accidental bites from these snakes are almost impossible, barring the nightmarish situation where a young child picks up the snake. That said, I have been meaning to write out some detailed instructions for non-viperid envenomations and will try to do so in the next day or two. On to the good stuff.
Hello,
My name is Jordan Benjamin, I am a herpetologist specializing in venomous snakes and a wilderness medicine practitioner with experience treating many snakebite patients in West and East Africa, most of them in remote health centers that pose some of the same challenges as treatment of a snakebite in the wilderness or backcountry environment in the US (supplies are limited or non-existent, the patient has a long way to go to reach a hospital, etc). I have also been fortunate to have the opportunity to train a number of individuals and groups in snakebite medicine and field management of snake envenomations in remote conditions including medical officers and corpsmen with the US military, US & international doctors and nurses in African hospitals, wildlife rangers, etc. I am including my background and real name because this issue is important to me and I stand by everything I am about to write; I want to give you all the peace of mind that I am who I say I am and not some competing company throwing out baseless accusations behind the cloak of online anonymity. Feel free to look me up online, I gave a TEDx talk on the issue of snakebite in sub-Saharan Africa last year and I invite those who doubt my identity or simply want to learn more about the issue of snakebite in the developing world to check it out. You can do so here: https://www.youtube.com/watch?v=LmkTAqRH2xk
The short answer to the question of whether or not the Sawyer Extractor can effectively remove venom from the site of the bite is a resounding no: the Sawyer Extractor and all of the other "snakebite kit" variations employing suction, incisions, electricity, heat, cold, and so forth have been repeatedly shown to be utterly ineffective at the job they are designed and marketed to accomplish. They simply do not work! The caveat it that there is one clever application of the sawyer that has been proven to work great, which is for the removal of flesh-eating botfly larvae that can be acquired in various tropical regions of the world...see "Simple and effective field extraction of human botfly, Dermatobia hominis, using a venom extractor." Full text PDF link can be found here: http://cid.oxfordjournals.org/content/35/3/336.full.pdf+html I am afraid to say that at the moment that is the only medical situation where this device may possibly prove helpful. When it comes to snakebites, it is not only completely ineffective at removing venom from tissue following a snakebite, but may actually prove harmful and cause a serious local necrosis (think in terms of a cookie-cutter style wound forming a deep cylinder of rotting dead tissue under the site of application). This may be due to a concentration of residual cytotoxic and myotoxic venoms near the site of the bite, while the majority of the venom will continue to diffuse into systemic circulation - but since we really don't know exactly why this happens that is purely speculation. For any interested parties, the article demonstrating this is titled: "Effects of a negative pressure venom extraction device (Extractor) on local tissue injury after artificial rattlesnake envenomation in a porcine model." I am attaching a link to the article here: http://www.doctorross.co.za/wp-content/uploads/2009/01/bush-sp-snakebite-suction-devices-suck-emerg-med-clin-n-am.pdf
Here is a second PDF showing local tissue damage in a 7 year old boy who had a suction device applied to the site of the bite for 20 minutes prior to arrival at the emergency department: http://www.annemergmed.com/article/S0196-0644(05)02106-2/pdf
There are probably several reasons why this type of first aid does not work. One issue is that the recurved fangs of vipers penetrate and inject venom deeply into the tissues beneath the skin, and the tunnel created when a fang penetrates the skin immediately collapses as soon as the fang is withdrawn. Another issue is that large quantities of venom are believed to diffuse very rapidly into different tissue compartments. This means that there is no direct route between the visible puncture marks on the surface to the area where venom was injected, and the significant quantity of venom is already well on its way. I have read the company's testimonials and seen the occasional news stories about a snakebite victim "whose life was saved by the Sawyer Extractor" or similar device, and all too often that is a quote attributed to the physician who treated them. I don't doubt the veracity of the quote as deeply entrenched myths and misinformation about snakes and snakebite are unfortunately as common in doctors as they are in the rest of society at this time. The sawyer extractor is popular because it provides us with an intuitively sound solution to the terrifying prospect of suffering a snakebite far from medical care, suddenly rendered utterly helpless as the venom takes effect and all we (or our loved ones) can do is wait and watch as the venom takes over. It is nothing more than a modern variation of the infamous "black stone" from Asia and Africa, a charred piece of cow bone that is stuck to the site of the snakebite and remains there absorbing fluid until all the venom has been drawn out of the bite whereupon it suddenly detaches and falls to the ground, is boiled or washed in milk to cleanse it of the venom, and ready to go when the next snakebite happens. Both of them provide the perfect optical illusion by visibly extracting some quantity of blood and straw-colored fluid (which looks incredibly similar to many viper venoms) from the site of the bite, but this is nothing more than the pale-yellow plasma (whats left after you remove the red cells and clotting components from blood) and other exudate draining from the wound as edema sets in and the venom begins to show effect. If you feel like you have been duped, don't take it personally - the notion that a snakebite can be treated by somehow extracting the venom has successfully fooled us since at least the 1400's, when the black stone was first mentioned as the go-to remedy for treating snake envenomations. Several years ago, a close colleague of mine met a European surgeon who was in Central Africa on a medical mission and explained that he needn't worry about snakebite, because he always carried a black stone with him for such a situation...as you can see, even the most highly educated medical professionals are not immune to the myths that pervade the issue of snakebite. I grew up carrying a sawyer extractor with me whenever I went out to look for snakes and lizards, and no one would be happier to hear that the sawyer extractor did what it claims than those of us who work with snakes and face an incidence of snakebite many times higher than that of the larger population. But the reality is that these devices do not work for snakebites, and marketing them for that purpose is a dangerous action with potentially tragic consequences. Evidence-based medicine and all studies to date suggest that they are at best ineffective and at worst harmful. If you would like to see more evidence of this, check out:
"Snakebite Suction Devices Don’t Remove Venom: They Just Suck" [http://www.doctorross.co.za/wp-content/uploads/2009/01/bush-sp-snakebite-suction-devices-suck-emerg-med-clin-n-am.pdf]
and
Suction for Venomous Snakebite: A Study of 'Mock Venom' Extraction in a Human Model" [http://www.ncbi.nlm.nih.gov/pubmed/14747805].
This product has no business being marketed for use on snakebite. Out of more than 40 snakebite patients I have treated for viperid envenomation in Africa, 95% of them had already received bad first aid prior to seeking treatment at the hospital. Practices like cutting at or around the site of the bite, applying tourniquets to the bitten limb, and attempting to extract or neutralize venom using electricity, fire, permanganate, black stones, magic, mouths, mud, dung, leaves, ground up dried snakes, and yes - even fancy suction devices like the Sawyer Extractor - are dangerous and detrimental for two reasons. First, in a snakebite time is tissue and a lot of it is wasted performing bad first aid. Many snakebite patients injure themselves by panicking immediately after the bite, I have seen more than a few individuals who suffered serious traumatic injuries in addition to the snakebite because they took off running from the snake at full speed only to suddenly fall face-first onto a rock or trip and stumble over the edge of a steep embankment. This is particularly problematic if the venom is capable of producing a coagulopathy. The second issue is that signs of an envenomation may in some cases take hours to appear, and the combination of seeing a useless suction device drawing fluid out of the bite along with a delayed onset of symptoms is an easy way to decide that you don't need medical care after all because you the used extractor less than minute after the bite and saw it remove the venom, or you feel fine and don't want to inconvenience the whole group because you've all been planning this trip for months, or any number of other rationalizations we can make with ourselves to keep from going in to get the bite checked out. The majority of bites from venomous snakes in the United States are suffered by young men between the ages of 18 - 25 who are intoxicated (usually alcohol) and attempting to pick up, kill, or otherwise interact very closely with a potentially deadly snake. This is a demographic that is particularly prone to making the wrong decision about whether they should laugh it off cause they feel okay or should immediately seek medical care for a life-threatening emergency. I have had patients come early after the bite and I have had patients come after great delays, and I have noticed two things. The first is that those who arrive early often do so because they are suffering from a severe envenomation and become very ill very quickly, while those who come late often waited because they believed falsely that the first aid measures taken were sufficient or that they were not seriously envenomated. The second observation is that many of the patients who delay seeking care only come in when they finally reach their own line in the sand for what constitutes a serious enough problem to go to the hospital, and they often tend to have more complications, longer hospitalizations, and a higher chance that the bite will result in permanent disability because of how long the venom has been allowed to work unchecked. They often arrive in the critical condition with severe envenomations just like the group of severely envenomated patients with the shortest delay to care, but instead of showing up in a critical state of hemorrhagic or hypovolemic shock they arrive in shock with their kidneys failing, or with late-stage bleeding into the brain, meninges, abdominal cavity to compound all of the other symptoms. Late-stage complications can be incredibly difficult to treat, they are excruciatingly painful for patients, heart-wrenching cases for medical personnel, and they are entirely preventable with prompt care. If you are bitten by venomous snake or are unsure as to whether or not the snake is venomous, please, please, please focus on how to get yourself safely to emergency medical care and don't bet your life on any of these commercial snakebite kits. The only effective, definitive treatment for a snake envenomation is the appropriate antivenom to neutralize the venom of the species you were just bit by. I repeat, THE ONLY EFFECTIVE TREATMENT FOR SNAKE ENVENOMATION IS THE APPROPRIATE ANTIVENOM. Repeat that five times and then move on to the section below for some helpful tips on what you actually should do in the event of a snakebite in the middle of nowhere.
To end this on a positive note, there are several things I would suggest you do following a snakebite that are extremely beneficial.

1. Walk, don't run, and carefully retrace your steps to get out of the immediate vicinity of the snake and avoid the possibility of stepping on any others nearby. 20 or 30 feet should be more than sufficient, the snake wants to get away as much as you do.
   
2. Find a safe place to sit down. This is important! Viper venoms in particular contain vasodilating compounds that open up your blood vessels to facilitate rapid diffusion of venom out into systemic circulation, which means you may suddenly suffer a dizzy spell and faint because your blood pressure just dropped too low to pump all the way to your head while you are standing upright. This is relatively common with viper bites and often happens in the first few minutes, so do yourself a favor and sit down so you don't pass out while running and hit your head on a rock. Like I said, you would be surprised...it happens all the time. These are usually brief fainting spells and you stand a good chance of avoiding it altogether by not standing up in a state of abject terror, but if you faint it shouldn't be more than a few minutes before you are cognizant again and I guess if you want to look at the bright side, you just really nailed the whole relaxation part of step 3 and are sort of ahead of the game...but you should repeat step 3 now that you are conscious anyways.
   
3. Remove any rings, watches, bangles, anklets, tight clothing, and anything else from the bitten limb because there is a good chance it is going to get a whole lot bigger than it was when you bought that toe ring…Do this because any of these items could potential become a tourniquet when swelling makes them impossible to remove, and that could cost you the limb below whatever is choking off the supply of oxygenated blood. Tourniquets of any sort are not good for snakebite, so please don’t try to tie your shoelaces or belt or anything else above whatever part of you just got bitten. There are somewhere between 5,000 - and 10,000 snake envenomations in the US every year, but most will not suffer any major permanent disability and on average only 5 people will die in a given year (mostly very old, very young, highly allergic, and other high-risk populations). Your odds are quite good, so be grateful you live in the US and make sure you don’t become a (bad) statistic by doing something stupid that makes your situation a whole lot worse than it was already.
   
4. Now that you are sitting, take at least 5 minutes to calm down and put your mind to a productive task: planning your evacuation. Time to break out the two items that I highly recommend for a snakebite kit that will help you save your own hide. First up...Do you have a cell phone? Does it have service here? If not, where did it last have a connection? Since the only effective treatment for a snake envenomation is the right antivenom to neutralize it, a working cell phone is your best means of getting information out to the emergency personnel who will do everything in their power to bring you safely out of the field and into the best medical facility for your current predicament. If you can call right away, those 5 minutes you took to calm down are going to prove helpful in relaying key information such as who you are, where you are, what happened, how you are feeling, as well as pertinent information like any other coexisting medical conditions and medications you currently take. If you take any sort of anticoagulants (blood thinners) then that is definitely something you want to inform them of right away, and please folks - DO NOT TAKE ASPIRIN, ADVIL, OR OTHER NSAIDS AFTER A SNAKEBITE. All of those medicines thin your blood, and they can cause very nasty problems for snakebite patients. Tylenol (acetaminophen) is okay, take up to 2x 500mg tablets if you feel the need as it won't interact with the snakebite in any way but don't forget to tell the medics everything you have taken when they get there to avoid being double-dosed.
   

The second item I cannot speak highly enough of for snakebites is...drumroll...a sharpie! If you are seriously envenomated, your primary objective right now is to get to the antivenom and get the IV flowing so it can do its job. From a clinical standpoint, there are several things you can keep track of now that will prove immensely beneficial when you reach the hospital and we are assessing the severity of your snakebite to figure out if you need antivenom, how much you need right now if you do, and what other effects the venom is causing so we can treat them with the other drugs we have available and try to make your stay a little more comfortable. Here's how this works. You are going to assess yourself from top to bottom and document significant findings on your person along with the time that you are observing it. Notes can get lost during evacuation or rescue, but your leg is coming with you to the hospital whether you like or not so get ready to mark it up! First thing is to circle the site of the snakebite with the sharpie and write down the time next to it. Draw a circle around the border of the swelling, or if the bite is on a finger or toe then draw a line at the edge of the swelling as it moves up the limb, and once again: write down the time. Write down all of the things that you are experiencing right now that are not normal for you next to or within the circle you just drew - just make sure it’s clear what time you are writing them at. Go through all of your 5 senses and write down everything that is out of place, being sure to include the following:
Metallic taste in your mouth, changes to sense of smell, sudden loss of vision, double vision, visual disturbances, ringing in the ears, headache, nausea and vomiting, bleeding from anywhere, dizziness, shortness of breath, tremors or twitching or cramping that moves up the bitten limb, pain, numbness, tingling, burning, electric shocks, and all manner of unusual sensations, loss of bowel or bladder control, excessive secretion of saliva/tears/snot/sweat, droopy eyelids that feel heavier and heavier and are hard to open, can’t stick out your tongue at your friends like you could a few minutes earlier, can’t shrug your shoulders, feeling of impending doom, and anything else we might want to know about (if you suddenly believe that you have developed a sixth sense you should probably mention that too).
Not only do you get to take a break for arts and crafts immediately after your snakebite, but you are also creating a timeline charting the progression of signs and symptoms as they occur and providing the critical information we medical people need to figure out how serious of a bite you are facing and what steps need to be taken to stay on top of a developing situation. In all seriousness, the importance of doing this cannot be overstated, and it is something that you should continually reassess and update every 15 or 30 minutes as the swelling moves up the limb and your symptoms develop. The other great thing about this is that it gives you something to focus on that will play a large part in saving your life and limb, and having a task really does help you to stay calm and get things done. The first few minutes are going to play a large part in how this whole thing turns out, so stay calm and put on your thinking cap.

1. Try make contact via cell phone if it is easily doable, calm down and carefully assess/document what you find, and if you cannot get in touch with anyone then you need to very carefully think about where you are, how you got there, and what options you have to either get yourself to help or get help to you. I have had patients who walked miles out of the bush after serious snakebites to their legs, they did’t die from exerting themselves like many people fear will happen and they all recovered because they made it out to medical care. You will be much better off walking yourself out, slowly, via the same way you came in than you will be sitting around waiting for help if you couldn’t reach anyone and no one knows you need help. I am not suggesting you skip or do high kicks your whole way out (I think that it would be painful enough that you would be forced to stop doing them before you could do any serious harm), I am suggesting you plan the easiest, most well-travelled route back to civilization, take stock of your supplies and get some food and water in you so you don’t pass out on the way from something preventable like dehydration, watch your footing and move slow and steady to your target destination.

Remember, the basic principles are pretty simple. Stay calm or get calm, find a place to get yourself together and check your resources, remove constricting bands, document the envenomation, hydrate and nourish, contact help, or make a careful plan to make contact one way or another and get out the word that you need medical assistance. Don’t let fears of “raising your heart rate and increasing the speed of venom circulation” prevent you from physically moving to get to care. From what I have seen, the venom is going to get out into circulation regardless of whether or not you sit still for 24 hours or apply a suction device like the sawyer. If you apply a tourniquet you may manage to prevent the venom from traveling out into circulation, but that would be a big mistake to make because you face a very high chance of losing your limb. Don’t put a tourniquet on and unless you fall into one of the high-risk categories discussed earlier, there is a very good chance that you will recover completely following prompt and appropriate treatment at a hospital. And remember folks, when it comes to snakebite no first aid is a whole lot better than bad first aid in the long run! Tell the boy scout to put away the pocketknife, don’t kill your own limb with a tourniquet, don’t listen to the weirdo you pass on the trail who enthusiastically offers to suck the venom out with his mouth or pee into the wound because it saved his friend all those years back…And if you have a sawyer extractor or any of the other varieties, just remember that when it comes to snakebite they really do suck. Show it to someone else and pass on the word that devices like this are more likely to cost you your life or limb than to save it, because folks who are making them have thus far been unwilling to stop making claims about these devices that have been repeatedly debunked by researchers. Don’t throw it away though, because if you ever get a botfly larva under your skin while in the tropics you can seriously impress your friends with the worlds most shocking entomological party trick when you whip out the sawyer botfly extractor and expertly suck out a wriggling maggot from the painful red bump on your backside that it currently calls home. If you read this far, congratulations and thank you for listening.