Help, he's fallen

[CC64]

Send the rope-rescue certified guy to the edge of the easily accessed part and look down with a flashlight. Does he see the guy? Have him take a radio, for better communications with you. (It'll still be fairly LOS and short-range.)

If no, bring him up and try another spot in that area.

If yes, have him start yelling down to the patient, and see if there is any response.

If there is some sort of response from the guy, stop and reassess the situation. Do the people who have rope training feel comfortable going down to the guy and then having to wait potentially two hours or so? Yes, send them down with equipment and have them start to stabilize the patient; if you can get him loaded on a backboard and in the stokes, then you can haul him up with the assistance of the guy trained in rope rescue, weather dependent.

In the meantime, look at the maps and see if there is a safer way to get to the bottom!

If, at any time, it becomes dangerous due to the weather, the search will have to be put on hold. No sense in risking your own lives to help what may just be a body now.

[Chief1C]

Send the guy w/ 8 hours down over, and keep the guy who knows what he's doing in the "control center". If we bring someone up even a gradual slope, there are at least three different ropes involved. Pulleys, bear claws and a bunch of other devices nailed to and wrapped around trees. I'd tie off the a large tree, since I'd be unfamiliar w/ both it and the tractor, I'd put more trust in the large tree.

[Just Plain Ruff]

ok, what you do now is you send the rope certified guy to the edge. He makes 3 different descents to the edge before he sees the patient.

the patient is about 100 feet from the edge at the bottom of the quarry

the visual is like this.

Straight down - sheer wall

Patient is lying on his back with both legs angulated outward indicating fractures of both lower extremities.

The right arm is at another unusual angle.

The patient responds by moving his hand on his good arm but no verbal response

It is now dawn and the gravity of the situation hits you. HOW do you get him up

Another person arrives on scene just as your mutual aid radio crackles to life with this message

Army rescue helicopter 301 to field operations. We are 10 minutes out of your position. What's your sitrep?

[AnthonyM83]

I'd ask what a site rep is...and if they had equipment to airlift him out from that location.

Otherwise, I guess you'll have to makeshift? I've learned about these situations, but perhaps you could secure him on a long spine board and loop a cord around each of the four sides and have you rapell up the side of the cliff with the board to keep it from hitting the side of the cliff.

Any medical helicopters available from neighboring areas? If it's a cliffy area, you would assume someone would have proper rescue equipment, airlift baskets, etc...

[triemal04]

Well hell, at that point you can just go back and grab a cup of coffee from the store.

Although, if the helicopter is set up for rescue (cross your fingers that they have a hoist) that's really not that far off. Let them now the specifics of the situation, and have them lower their medic (cross your fingers for that one too) down. At that point the one guy at the edge should be able to rappel down to assist with loading the pt into a stokes. From there hoist the patient, the army medic, and maybe the other guy into the helicopter. Or leave the other guy behind and let the rest deal with getting him out using a technical system.

Now is the only sticky part, and it'll depend on how trained the personnel on the helicopter are, how bad off the guy is (probably pretty damn bad) and how far the nearest trauma hospital is. If it really is a trained Army medic on board, send them directly to the nearest hospital, unless it'll be an extended trip. If it is, then either land the helicopter at a location for the paramedic to get on, or hoist him as well. (course, if that would take more time than just flying to the hospital, don't do it.) If it's not a fully trained medic, there's no choice; pick up the paramedic and get out of there.

If for some reason the helicopter doesn't have a hoist, thank them for wanting to play but let them know they came without the right equipment. Then have them find a suitable LZ and wait. If that was the case and it was me, I'd rappel down to the pt. And given the lack of trained personnel (and personnel period) it'll still be faster to wait for a hoist-equipped helicopter to lift the pt than to set up a technical system. Assuming they can beat the weather. If not, start looking for another way to get the pt out; more people can rappel down with a Stokes litter is there is a way to take him out overland.

[Eydawn]

Boy scouts... always a good idea. Girl scouts don't play with knots and ropes in my experience, FYI... the troops I've seen SUCK.

Are the SAR guys who are 15 minutes out bringing more rope? Please say yes. I'd send down a 2 man team with the Stokes basket... If I trusted the tree enough to belay 2 responders plus a basket full of injured dude. Get them to rappel down on either side of this guy... have them control the basket as best as possible, and have the guys on the surface ready to take the extra weight. To be honest, I'd grab this guy wherever it was possible and try to keep the spine in-line, but not be too worried about it because this is a truly difficult rescue move. Put him in the basket, have the basket and the responders pulled back up.

Or if you don't have a stokes basket... some really really good straps and a scoop or LSB. Duct tape, if you must... anything to keep this patient strapped to the board.

But again, that's my semi-uneducated guess.

Wendy

CO EMT-B

[AnthonyM83]

Boy Scouts is actually a pretty good idea. Probably not the actual scouts themselves, but the adult leaders who teach them the skills. It's probably good idea for your dispatch to have a phone list of resources for all these things.

Why didn't FD handle this btw? Couldn't they easily call in for more resources for neighboring FD's, even if an hour or four away?

[Eydawn]

I'd actually prefer a passel of the older boys to come with the leaders... have you looked at your typical scoutmaster lately? They got the skillz... but some of them are approaching McFatarse status! You need the older fellows who are in better physical shape if you want to accomplish something.

But for the love of god, unless you want them to take photos and make a photocollage of the scene, don't invite the Girl scouts....

So now what? Can the helo get this guy out of here? Is the duct tape and LSB trick even viable?

Wendy

CO EMT-B

[triemal04]

Is the duct tape and LSB trick even viable?

Wendy

CO EMT-B

Absolutely not. The scoop either. Or KED, or almost anything else that is routinely carried on the average ambulance. The longboard is in no way, shape or form rated for any type of rescue. Hell, it's not even really rated for half the lard asses we normally carry on it. It's not designed to be used in a high-angle rescue; be hard to rig, and depending on how you decided to rig it, it might not even stand up to the strain. There's also no buffer between the pt and cliff-face, no way to protect the pt's face from any falling debris. To make it real simple: you're trusting a piece of plastic that's maybe 2 inches thick to lift someone 100 feet up a cliff. Bad idea.

Unless you're unit happens to carry a Stokes or SKED, you're out of luck.

[CC64]

Exactly. Anything that includes moving a patient with ropes requires a Stokes or SKED. Sadly, those are both things that aren't on your average ambulance...

Determine what equipment the helicopter has. Your sitrep: patient visualized, voice contact made only, no physical contact made. Ask them if they have a winch and basket to extract the patient. (Rescue helicopter...I'm going to make what is possible a VERY bad assumption and theorize that they've a medic on board with all of his/her supplies at the ready.)

Send the guys over the edge with some basic equipment - LBB, collar, CIDs, all that fun stuff so that they can make an initial assessment and start packaging him. Send an emergency blanket down, too, he's most likely shocky and needs some protection from the elements. Just be prepared to tape it down so that it doesn't present a risk to the helicopter.

Now, if the SAR team shows up before the helicopter, and the helicopter needs to land to take this guy on board - does the SAR team have the ability to get this guy up the cliff? (Not all teams do, either in the equipment or training)