Three climbers flew to the Pika Glacier on July 16, spent a few days rock climbing in the Little Switzerland area, and began a traverse out of the mountains on July 19. The team had planned to return to Talkeetna on foot and by packraft. At approximately 6 p.m., while they were descending the boulder-strewn moraine of the lower Granite Glacier, a large boulder rolled over and caused one climber to fall on his left side and arm. A heavy backpack and the sharp corner of the boulder on which the patient landed resulted in an open left forearm fracture between the elbow and the wrist. The injury exposed bone and caused significant bleeding and intense pain. His teammates applied direct pressure to the bleed, treated the injury to the best of their abilities, and called for help using an inReach satellite device.

Ranger Tucker Chenoweth responded to this limb- and life-threatening injury, arriving at the scene by helicopter with pilot Andreas Hermansky at 9:45 p.m. Chenoweth treated the patient before evacuating the team to Talkeetna at 10:35 p.m. Chenoweth noted significant blood loss and decreased circulation, sensation, and motion of the patient’s left arm. The patient was assessed by local ambulance providers and eventually was driven to the hospital by his climbing partners.

ANALYSIS

Unstable moraines require great care, especially with heavy backpacks. Trekking poles and a carefully loaded pack can help maintain balance, but some falls are almost inevitable. This patient was provided quality care by his teammates, who supported the injured extremity and slowed the bleeding. Without this field treatment, this climber could have lost his limb or his life while waiting for an evacuation. The value of wilderness medical training (and the means to contact rescuers in an emergency) cannot be overstated when traveling and climbing in remote areas. (Source: Denali Mountaineering Rangers.)