Chip said:
I think the one that really got me was the incomplete evacuation on Gothics. That guy had a HUGE fall, was unconcious for some length of time and was not hospitalized until the following day. I'm glad he didn't expire in camp from something internal.
People need to and I think hopefully do understand that they are well outside of the Platinum 10 minutes as well as the Golden hour when they are in the woods. This guy was a candidate for a very serious head, neck, back and internal injuries obviously based upon the Mechanism of injury. He shouldn’t have even survived the fall, let alone a transport. He was also very fortunate that he had one person to stay with him and another to go get help. If there had been only one other person with him, and it was you, what would you do? Go for help, or stay with him? It’s great the doctor was at the lodge but the doctor can’t see into his skull to see if it is bleeding. You can tell if he is having problems. You can tell how he is trending. But you cannot really tell if he is
going to have problems. I relate a story down below about a case to explain what I am referring to. That is why everything we do with trauma is based on (MOI) mechanism of injury, what happened and what kind of injuries might there be. If this happened at home and the helicopter was able to fly. I would have found the closest 100’ by 100’ field that we could have landed the copter and flew him immediately to a level I trauma hospital. Well Toto, you ain’t home, so now what are you going to do? You do the best that you can and you realize, that best, varies considerably from person to person. You also realize that all the medical support systems you take for granted aren’t available where you are. So, you try to make yourself as self sufficient as you can. Not just medically but in every aspect. You realize that if someone is hurt how much time are you going to waste trying to get to the trailhead to get help and then get that help back up to the victim because your cell phone doesn’t work. Worse yet will you have to leave him/her because you are the only one. How will that make you feel knowing they may be dead by the time you get back. Maybe not even directly from their injuries. Maybe hypothermia. Maybe if you insulated them better to stave off hypothermia they won’t die? If they are unconscious what good are you going to be sitting there, but if you leave how will you protect their airway at a minimum? Maybe all you need to do was position them correctly before you left and they wouldn’t have choked to death. Would you be doing the right thing if you used a safety pin to pin his tongue to his cheek to keep him from choking on it? I’m not telling you to do this but those holes will heal and the infection can be fought. Dead from having your airway closed off by his tongue for 8 hours (4 minutes is all it takes) can’t be fixed. You also need to realize that when you get to the rescuers, they will risk their lives for your friend but it is a careful equation that needs to be worked out and rushing in will not always be what happens. There are two types of patients that need to be rescued, stable and unstable patients. Stable patients, you can take time getting too and there is no point risking rescuers. Not being glib but dead and FTD (Fixin To Die) patients are stable. This is good, solid, thinking. It is used to triage patients all the time in multi casualty incidents. There is no rush or reason to risk rescuers needlessly to get to a scene that the patient doesn’t stand a chance or is already dead. Even if they are unstable, and need help immediately, environmental factors or other reasons may delay responses as well. Read a book, take a class. Learn alternate means of communications. Learn basic lifesaving skills. Learn how to improvise a hypothermia wrap. Learn how to improvise a camp with decent shelter in case you need to stay out for a while with some who needs help. All of these skills make hiking/camping more enjoyable to me.
Also, I camp and hike solo all the time. I understand there are more risks associated with it, as I am sure most do, but I try to mitigate it as best I can. I also am not so goal driven any more that I fail to see dangers. I carry equipment to get in touch with people if I have an emergency (I’m sure by now most realize it’s not a cell phone
) and can’t self rescue or am just going to be delayed. Extra food and clothing to use if I am not unconscious and I realize that is a possible weak point in the plan. My wife knows that I should be able to get a hold of her in an emergency and if I can’t where I will be to send help. Would I survive if an accident was bad enough to make me unconscious and I was alone? Probably not, but that is hard to know. I only hope I have built up enough good juju that someone would come looking for me.
As promised I’ll you the story of a 58 y/o male who was struck by a pickup truck on a state highway in CT. Impact speed was believed to be around 35 MPH which is a pretty severe impact. EMT’s got to the scene and couldn’t tell who the victim was. There is this guy standing around smoking a cigarette. It finally comes to the crews’ attention that this is the victim. This guy has some bruising and soreness but no other complaints. For a 58 year old and tangling with a truck that is damaged pretty well he looks great. The crew follows his wishes and transports him to the nearest facility which wasn’t a level I trauma center. It's found out the next day he died in the hospital. Lots of doctors around. Still didn’t live. He had a ripped aorta. Very common trauma injury along with a fractured liver. When he crashed (in the medical sense), he crashed so fast they couldn’t do anything about it. Very sad but so this wouldn't have been for nothing it should be a cautionary tale. Some people can look great. Right up until the part were they die. Without a trauma surgeon around. It can be almost impossible to fix.
Also while I wasn't there and have no first hand knowledge, from what I read, it sounds like the crew who did the Franconia rescue did an outstanding job. Congrats to them.
Keith
