FALL ON ICE-CAUSED SHOULDER DISLOCATION

Washington, Mount Rainier, Kautz Glacier

On July 25th, the fifth day of a successful expedition via the Kautz Glacier route, a client with International Mountain Guides suffered a shoulder dislocation during a short fall while descending from high camp back to the parking lot. At 12:10 p.m., four guides were leading eight clients down “The Turtle” snowfield (part of the Kautz Glacier approach route) at approximately 10,000 feet when the accident occurred. The team was divided into four rope teams of three, each with two clients and one guide.

At the time of the incident, the weather was clear and sunny and the temperature was mild. The team had spent the morning packing up camp and waiting for the snow to soften, which usually makes downhill travel easier on the knees. By the time the group descended, the snow had softened enough to allow plunge stepping in most areas; however, small patches of hard snow and ice still existed in some places. Climbers would warn each other when icy patches were discovered so that the next person moving through the area could avoid a potential slip.

The climbers were wearing light clothing layers and carrying heavy multi-day packs. The terrain was benign (20 degrees) in comparison to the technical sections of the Kautz Glacier Route that the group had already climbed. The snowfield both above and below the accident site was slightly steeper than 20 degrees, and each team of clients was being short-roped. This is done with the guide at the upper end of the rope with short, tight distances between each of the two clients on the rope below. In this way, the guide can more easily catch a slip or note fall before momentum is gained.

The accident occurred when the client on the front of one rope slipped on a patch of ice while descending and yelled, “Falling!” The second/middle climber went into self-arrest. Together they slid only a short distance before coming to a stop. The front climber jumped up uninjured, but the middle climber remained prone in the snow. Another rope team was very close, which allowed two guides to perform a quick visual and physical assessment of the patient and the injury. They determined he would be able to walk but that he needed assistance with the heavy pack. They regrouped at a safe rocky area nearby in order to further assess the injury and figure out a way to approach the rest of the descent.

The client was responsive and showed little signs of discomfort other than favoring his right arm. He explained that as he dropped into self-arrest, his heavy pack pulled hard across his back and contributed to the pain he felt in his left shoulder. After a more detailed assessment, he also indicated that he only felt a small amount of pain on the inside of his bicep and had a limited range of motion. Otherwise, he was fine, had a positive attitude, and showed no other signs of injury.

The guides decided that he could continue the descent to Paradise unassisted, but only with a very light pack—no more than ten pounds. Everybody agreed to continue this way, and it took the group about four more hours to reach Paradise. The guide continued to check on him during the descent and reported that he was doing fine and had no additional pain or discomfort.

Once at Paradise, the climber was transported to a hospital for an X-RAY. There, the doctors found a dislocated shoulder. The climber was treated and released that day.

Analysis

Dislocated shoulders are one of the most common injuries on Mount Rainier. A shoulder dislocation can be difficult to detect sometimes, as this incident shows. However, if left untreated, dislocated shoulders can lead to long-term disabilities in the arm. Fortunately for this climber, doctors were able to reduce the injury, and he walked away without any serious complications. Based on the information the guides had during the incident, there wasn’t a compelling reason to risk a helicopter flight. (Source: Mike Gauthier, Climbing Ranger)