Response to Injuries in Muir Valley

[weber]

Response to Injuries in Muir Valley
Posted: May 14, 2009

Having a pre-plan when someone is injured climbing can help enormously in bringing medical care to the injured person and getting them safely and efficiently evacuated to a definitive care facility. A good pre-plan can mean the difference between life and death.

In many ways, the Red is like a third-world country. Rarely at the base of a crag can you get cell phone service. And, when you find to a place where you can call 911, the response can be frustrating and very time consuming. Unfortunately, emergency services in this area of Eastern Kentucky fall far short of those we have come to rely on in major metropolitan areas. Under the most ideal circumstances, from the time a climber is seriously injured until he arrives via helicopter at the nearest trauma center (UKCH), two hours may have passed. An accident in remote locations, such as Purple Valley, can take far longer.

Provided below is a Pre-Plan that can be used for an accident occurring in Muir Valley. It does not necessarily apply to other areas, such as the Southern Region. Hopefully, you will never need it, but having a copy in your backpack can be a good idea.

Serious Injuries
For an accident, with an injury that is more than a minor scrape, bruise, or sprain, that will require emergency evacuation to definitive medical care, follow these procedures.
1. Survey the scene and make sure it is safe for the injured person (IP) and others in the area.
2. You are under no obligation to assist an injured person under Kentucky law. You can simply walk away. If you do chose to act as a Good Samaritan and assist an injured person, then please stay with that person until his care is transferred to someone of equal or higher medical certification than you possess or until he is able to manage on his own or with the aid of someone in his party. If you chose to act, then follow the steps below. If not, then at the very least, go for, or send for, help.
3. Ask if any of the others present at an accident scene are certified in WFA, WFR, WEMT, or in another medical field. Defer treatment of the IP to the person who has the highest certification and is willing to help.
4. Unless the IP is unconscious, not fully alert and oriented, or under the age of 18, introduce yourself, give your first aid qualifications, and ask permission to assist. If the IP refuses to grant you permission, then you must not provide first aid and may wish to stand by in case the IP changes his mind or loses consciousness. If he declines assistance it is a good idea to have him sign a note to that effect.
5. Upon receiving permission of the IP, provide first aid within the limits of your training, certification, ability and willingness to help.
6. Regardless of your qualifications, if there is any possibility of a spinal injury, you should strongly urge the IP to remain still and not move until EMS arrives. With the IP’s permission, try to stabilize the IP’s head and prevent movement of head, neck, and spine.
7. Two persons will need to be sent for help.
a. One person will station himself on the Emergency Road that runs along the Valley floor to direct the ambulance to the IP’s location.
b. Another person with a cell phone will need to go to the parking lot where a connection can be established. (Cell phone reception is not possible almost everywhere else in the Valley.) If no one has a cell phone, then a runner should be dispatched to the Webers’ home where, if the Webers are in, a phone call can be made.
8. The person with the cell phone should:
a. Dial 911 and ask for the Wolfe County Dispatcher.
b. Tell the dispatcher that an ambulance and the Wolfe County Search and Rescue Team should be dispatched to an accident scene in Muir Valley. Both EMS and SAR services are needed as the EMS personnel do not have a litter nor do they have sufficient personnel to evacuate an IP from a wilderness area.
c. Tell the dispatcher the nature of the accident, observed injuries, gender, and approximate age of the IP.
d. Give the dispatcher this exact location information: Address is: 2316 KY 715. Drive down into the Valley via Weber Valley Lane, which is located 0.4 mile south of the Rogers School on KY 715.
e. Follow the dispatcher’s instructions.
f. Call or locate the Webers, who should be notified as soon as possible after an accident is called into 911 Dispatch. They can, if available, provide first aid assistance and help with a technical rescue/evacuation. Webers’ phones: Rick’s cell 317-402-0118, Liz’s cell 317-402-0123, Muir Home 606-668-9066, Indianapolis Home 317 291-0354.

Minor Injuries
If you come upon a scene where a relatively minor injury has occurred (abrasion, twisted ankle, strained ligament, etc.) for which the injured person wishes not to have an ambulance sent, you should first determine the mechanism of injury. If it was a fall equivalent to a free fall from more than ten feet, then you should advise the IP that this type of accident presumes a possible head, neck, or back injury and that he should have emergency medical personnel check him over. If the IP is alert and oriented and over the age of 18, it is his right to decline.

You may also suggest to the IP that you may be able to get a vehicle down into the Valley to assist him in getting back to his car. If the Webers are available or if someone with a 4-wheel drive vehicle offers to do so, transportation can be provided. In such a situation, driving a 4-wheel drive vehicle into the Valley is acceptable. If the Webers are home, they will also be glad to provide ice for sprains and/or first aid supplies.

Both Liz and Rick Weber are certified Wilderness First Responders and have available first aid equipment and supplies at their house. This includes Epinephrine, which they can administer in the event of anaphylaxis from a severe allergic reaction.

[weber]

So how important is it to have a pre-plan for climbing injuries? Today, less than three days after posting the previous message, our Wolfe County SAR Team, treated, packaged, and evacuated a climber who had taken a 28-foot fall near the far end of Roadside. Back, hip, and internal injuries. Helicopter evac. to UKC.

The patient had the sense to stay put until help arrived. Getting a litter out of there is rough going, but with volunteer help from climbers, it all went pretty smoothly.

BTW - this was the sixth "GriGri Freeze" accident in the past 11 months in the Red. Had to treat the belayer for ugly rope burns on his right hand.

Advice: If you need to report an accident at Roadside, tell the Wolfe County 911 dispatcher that the scene is at the rock wall across the road from "Green Thumb Park." Most dispatchers down here are not familiar with place names assigned to areas by climbers.

[GWG]

What is "GriGri Freeze"? It's not a term I've heard before. I figure it's referring to the belayer "freezing" and holding the brake open and not the grigri "freezing".

Thanks,

[steep4me]

It's when the belayer clamps down on the gri gri--holding the cam down so it can not pinch the rope.

[Meadows]

That's why we need to hold more clinic/demonstrations of proper Grigri use

It would be cool to have a map or listing of crags that have directions that an EMT could understand. We can print and keep in our packs.

[Saxman]

Maybe we can put together an alphabetical listing of all crag names with directions for emergency personnel. This could be given to local dispatchers.

[Brentucky]

seems like a weird way to define "grigri freeze," but i'm glad to know that's what it is if you're correct steep4me. "grigri misuse" personally makes me feel better about my grigri instead of thinking it might freeze up on it's own. regardless, it drives home the point of never let go of the rope with the brake hand and you'd be alright even if the grigri somehow did freeze up in a bad way.

[caribe]

Brent, I second that; ALWAYS monitor the bake end of the rope. After an ephemeral pinch for immediate rope deployment, immediately return the hand to hold the brake end of the rope. Wire it so it works regardless of your state. Accept the marginality of mental state in which we all function. Our belay tech has to safely function within this wide range of human mental state error.

[sgauss]

If you're used to calling *911 on your cell phone at home, that won't work at the Red - just call "911". I learned that from experience, trying to call in a truck wreck. The second most important thing is to know the county. The guidebook has a decent map with county names at the front.

[steep4me]

seems like a weird way to define "grigri freeze," but i'm glad to know that's what it is if you're correct steep4me. "grigri misuse" personally makes me feel better about my grigri instead of thinking it might freeze up on it's own. regardless, it drives home the point of never let go of the rope with the brake hand and you'd be alright even if the grigri somehow did freeze up in a bad way.

I have never heard of a gri gri malfunctioning--it is always the belayer holding down the cam so they can feed slack quickly to the leader. Then, when the leader falls unexpectedly, the belayer holds onto the gri gri for dear life in a panic, preventing the gri gri's cam from moving into the position in which it pinches and stops the rope. They forget to grab the rope and instead "clamp down" on the gri gri, confused as to why the leader is still falling. I have witnessed this several times.

If you are falling too far and there is no sign you will stop, yell, "let go!" several times to your belayer who is using the gri gri (NOT if they are using an atc or similar). I saw this save one guys life at Torrent. His belayer finally let go and the leader toe-tapped the ground (after free-falling from the anchor of Bandolier).