RESCUE OPERATIONS NEW TRENDS IN MOUNTAIN RESCUE

The application of modern communication systems and the helicopter to mountain rescue problems have completely revolutionized the movement in the last decade. Now it appears that a new revolution may be on the horizon, one that may completely change the traditional organizational patterns of units and result in a much higher quality of victim-care as well as speedier evacuation for the injured. This change is the result of the melding of two new federal programs and their application to back- country emergencies.

The Mountain Emergency Medical Technician. Many rescue units have for some years operated on the principle that, in addition to requiring first-aid training for all field personnel, some key members would have additional training in medical problems related to altitude or extreme cold and would take the responsibility for supervising first aid and monitoring evacuation in the field. While some of these specialists became very proficient in advanced techniques, the tools for standardizing training or developing criteria for this specialized work were not available. The Committee on Injuries of the American Academy of Orthopedic Surgeons recently developed a text, Emergency Care and Transportation of the

Sick and Injured, and the Department of Health, Education, and Welfare began funding massive programs in cooperating states to train Emergency Medical Technicians (EMT) who would be capable of going far beyond the traditional first aider in temporary patient care. The primary purpose of the program was to establish a floor under the requirements for employment of ambulance drivers, the personnel attached to fireman’s aid cars, and similar emergency vehicles. Many states are now licensing EMTs, in most cases through courses in community colleges.

A number of mountain rescue men quickly became involved in this program, because it provided an opportunity to gain skill in the use of blood-pressure cuffs, bag-mask resuscitators, the administration of intravenous fluids, and similar paramedic techniques useful in the field when an emergency room might be days away. Some rescue units went further and developed programs through their medical directors in which their EMTs could gain useful experience working with hospital staff in emergency rooms and trauma centers. Additional specialized training was scheduled in the field treatment of pulmonary edema, hypothermia, freezing, and similar mountain-related medical problems.

The MAST Program. In 1970 Army and Air Force helicopters were ordered to take part in a pilot project in five states to provide free ambulance service in rural areas. Known as Military Assistance to Safety and Traffic, the program was quickly expanded to include mountain missions by local commanders. As of October, 1971, MAST had flown 704 mercy flights for 915 patients, only about half of which were related to traffic accidents. On February 4, 1972, the federal government expanded the MAST program to 14 more states. Mountain Rescue units in both Colorado and Washington were quick to take advantage of this new resource, with state Civil Defense and rescue organizations acting in a coordinating capacity.

The MAST helicopters are provided with medical oxygen and IV fluids rigged and ready, a 225-foot cable hoist system with forest penetrator, Stokes litters with flotation gear, communications with mountain rescue and State Police as well as the military frequencies, a trained military medic, and various other medical and emergency equipment. Rotating helicopters and crews provide immediate availability on a 24-hour, 365- day basis. In Washington, mountain rescue units took turns providing two- man standby teams at the base on weekends throughout the climbing and hunting season, consisting of one EMT and one Field Operation Leader. Several mountain missions were completed by these teams during 1971, the two following reports are typical examples:

Washington, Sauk Mountain. While hiking the trail to the summit with a group from the University of Washington on July 3rd, Terry Roesler (17) left the main party and ascended a steep, rocky gully in tennis shoes to cut a long switchback. As he continued up the gully alone he was forced onto snow, and nearing the top, slipped and fell an estimated 700 feet down snow and rock, coming to rest near the trail at 1315. The fall was witnessed by a physician who immediately started first aid, and by hikers who went to the trailhead and radioed a “mayday” call on their ham set. A variety of communications problems ensued, but the ham operator was able to complete a phone call dispatched to the Skagit County Sheriff at 1420 who in turn dispatched a deputy and Skagit Mountain Rescue. The sheriff tried to obtain nearby Navy and Coast Guard helicopters without success, and MAST was finally contacted at 1620.

MAST was airborn with mountain rescue EMTs Russ Post and Jim Mason within three minutes, arrived at the scene at 1720 and completed the liftoff at 1725 just as the Skagit Mountain Rescue team was arriving. Roesler’s condition at this time was extremely critical. He was very cold and wet, had no pulse, was in a deep coma, and had sustained major head injuries, face and eye injuries, chest and rib injuries, abdominal wounds, suspected spinal injuries, fractures of the left wrist and left femur, and abrasions and lacerations over the entire body. MAST radioed Whidbey Island Naval Air Station to have a flight surgeon stand by. The EMTs and crew medic cleared an airway and inserted a tube, administered O2 anl I V fluids, and splinted the left arm. Collapsed veins made for great difficulty in inserting the I V catheter. After 30 minutes of O2 and I V fluids, the pulse was elevated but count was unreliable. At 1800 the flight surgeon gave additional emergency treatment while the helicopter refueled. At 1845 the helicopter was airborn with the flight surgeon and EMTs continuing working on Roesler enroute to the University of Washington Medical School emergency room. Roesler was released from the U of W hospital after 18 days and flown to Denver for further treatment. The extent of eventual recovery cannot be predicted at this time.

Washington, North Cascades National Park, Ragged Ridge. Robert Conrad (24) and John Whitney (27) spent September 17th collecting rock samples high on the slopes of Ragged Ridge on the north side of Fisher Creek. They were descending through brushy cliffs at 1630 when Whitney fell 40 feet down a rock cliff at the 4200-foot level. Conrad provided what first aid he could for severe head and leg wounds, dressed Whitney in down clothing, and when Whitney had not regained consciousness by 1900 proceeded down a drainage to the Fisher Creek trail, marking his route with orange plastic ribbon tied to bushes. He noted logs in the stream as a reference point, and hiked about 17 miles to the Colonial Creek Campground to report the accident to a ranger.

The MAST helicopter was notified by the Washington State Patrol at 1145 on the 18th while airborn with a traffic victim. They refueled at Gray Field, took mountain rescue EMTs Dick Mitchell and Jerry Sabel on board, and proceeded to Marblemount for briefing by Conrad and park personnel. Stan Gerity, a park service employee familiar with the terrain was added to the group, and they flew directly to the Fisher Creek drainage where they searched for the correct watercourse unsuccessfully for one hour. Many parallel drainages all looked the same, with the cliffy and brushy ridge cut by innumerable avalanche paths, and the stream clogged with logs. At 1500 Gerity, Mitchell, and Sabel were lowered 100 feet by cable at the only feasible exit point with radios, ropes, a Stokes litter, and other medical and rescue gear, and MAST returned for fuel.

The ground party plotted their location with compass and altimeter, then moved up the mountain, relaying loads and searching for a better pickup point. During this relay, the orange ribbon was located. Mitchell and Garity continued to the victim, while Sabel stayed with the gear and smoke flares at a feasible pickup point. The accident site, littered with blood-soaked down clothing was located at 1640 but Whitney was gone. Mitchell located Whitney at 1700 150 feet downslope, in a semi-conscious state.

The victim was in shock, with two deep head incisions, one open to the skull, and a three inch incision on both knees. He remembered his name, but little else, and was very slow in responding to even the simplest commands. There were no fractures, pulse was 129, and he was incoherent at times. Whitney’s wounds were cleaned and dressed, hot sugared tea with salt added was administered, and he was placed on an ensolite pad with down garments under, around, and over him. After two and a half hours his pulse rate had dropped to 84.

At 1840 a MAST helicopter returned but did not respond to radio, so Sabel popped an orange smoke flare. MAST dropped a message indicating that the first helicopter had suffered engine failure as a result of bad fuel from a pre-positioned cache, and that they would have to return to Colonial Creek to refuel, transfer the cable hoist, and pick up the proper radios. Sabel then started relaying the Stokes and other equipment 700 feet up the cliffs. At 1850 a Bell 47J under park service charter arrived and disembarked ranger Gerry Wood who helped Sabel take the stokes to the victim. Whitney was then transferred to a rocky area where the Bell could make the pickup. Since the stokes could not be attached to or placed in the Bell, Whitney was strapped in the passengers seat and flown to an Everett hospital. The rescue party was flown out the following morning after a cold bivouac. Whitney is now fully recovered.

Source: Jerry Sabel and George Sainsbury.