Outdoor PHEC course participants have been putting their learning to great use.
Jono Hattrell, Richard Bottomley and Marius Bron from Fox Glacier Guiding spent a night in a crevasse at the head of Fox Glacier taking care of an injured climber. Marius was first on the scene and lowered into the crevasse on the West Face of Glacier Peak at 2854 by Jono. All three are members of the LandSAR South Westland Alpine Rescue Team
We caught up with them recently and asked them some questions......
What sort of condition was the patient in when you arrived in the crevasse? What were her S & S?
The patient was stable, responsive and in pain. Her climbing partner had done a great job with First Aid before he left to find help. He managed to assess her, treat her injuries and package her for what could have been a long wait.
How much room was there down there?
When we arrived there was about half a metre from the patient to a seemingly bottomless crevasse. We had safety ropes on at all times when down the crevasse. We excavated a big ledge so we had room to work around the patient and transfer her into the Baumann Bag (soft stretcher) for the airlift.
Were you able to do a secondary survey and take vital signs like you learnt on your PHEC courses?
Yes, with the MOI so great, I focussed on the secondary survey quite a bit, so I did not focus only on her open arm injury. The patient was packaged up so well it was difficult to decide how much to expose and risk cooling her down too much, but still getting a full understanding of her situation. It’s amazing how much of a secondary survey you can do through a bivvy bag.
What were your main concerns for her?
Hypothermia, Patient state of mind, Infection in her open fracture*1
Why did you end up staying the night?
We were very fortunate to get dropped off on the mountain by helicopter before cloud closed in completely. Unfortunately the cloud didn’t clear before nightfall. SAR teams always go out prepared for at least 24 hours so all was good!
What equipment did you use during the stay?
Some general first aid gear, foam for splinting and couldn’t have done without a wiz-bang Jetboil stove for the hot water bottles, they are fantastic, so simple and efficient.
How did you manage the patient during the night?
Lots of chit chat, heaps of reassurance and some talk of good food! Once we knew we were to spend the night we increased the insulation around the patient (foam mat underneath and down jacket on top) under the bivvy gear. During the night the patient was made warm by a supply of hot water bottles.
What happened the next morning? Did she get winched straight out of the hole?
Yes we long-lined directly from the crevasse, we had enough time to pack up the bivvy, sort the site and Baumann bag for transport*2. It was great to get her off the mountain.
What was your biggest learning? If you had to do a similar rescue again next week – what would you do differently?
Practice my German! But seriously our team is looking at carrying better pain relief in our medic’s bag.
Sounds like it was a great response from your team in difficult circumstances. Well done!
*1. Open fractures.
An open fracture is where the bones have pushed through the surface of the skin. Open fractures are extremely susceptible to serious infection.
If help is more than six hours away thoroughly clean the wound with saline solution and cover with a sterile dressing. Leave the wound open (i.e do not close with stitches or adhesive closures). When preparing to splint, allow access for ongoing wound care. If possible start antibiotics within three hours of the injury. From Dr Jim Duff & Peter Gormly– ‘Pocket First Aid and Wilderness medicine’. (Horizons Unlimited recommends this excellent field text by Dr Jim Duff. Outdoor organisations & qualified PHEC for Outdoor Professionals can purchase it from us by contacting email@example.com for $40.00).
*2 Baumann Bag: The Bauman Bag is a large industrial strength bivi bag with a single-point suspension for lifting a patient during helicopter hoists or short-haul evacuations. Bauman bags are designed to accept victims in bulky sports gear and on back boards.
Additional notes from your PHEC tutors:
Don’t under-estimate the effectiveness of Paracetamol. Paracetamol should be considered as an important part of your analgesic pathway [pain relief].
Paracetamol is an analgesic that works at the site of the pain. This is the first line of pain relief. Paracetamol is unique as it works differently to other pain medication and provides a base of pain relief that enhances the action of other medications. The use of paracetamol and stronger medications together results in reduced use of the more sedative medications.
Paracetamol is highly toxic. Ensure your patient is not allergic & adhere to recommended doses.
For more advanced pain relief notes see this link from our website: http://www.horizons.co.nz/documents/NewsletterWinter2012.pdf
Opportunity to join our team...
"If you are looking for a tutoring job with a difference then this is definitely worth a look...."
New Zealand's leading outdoor pre hostpital emergency care providers are calling 111!
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Has a background in either: paramedicine, nursing, ski patrolling or search and rescue emergency care
Can teach and instruct with energy and flair
Is experienced in outdoor education or guiding work.