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Self Rescue when using the climbing rope as your anchor


Tammy Gueterman · · Seattle, WA · Joined Jun 2019 · Points: 0
Harumpfster Boondoggle wrote: Bullshit.

Any unconscious victim of blunt trauma needs full c--spine precautions and airway management. It is foolish to suggest that those are immaterial concerns and a simple chest harness to maintain an upright posture is adequate.

Lack of consciousness post blunt trauma is diagnostic of brain injury and cervical spine injury cannot be ruled out. The idea that management of such a patient is an ideal that anyone should aspire to is #woofuckery run amok.

I didn't say these concerns were immaterial. It's obviously a concern, and I said as much. But even in the context of a blunt head injury, it's never the only concern and shouldn't always be the one that dictates your next steps. Granted there are many scenarios where waiting for help is by far the best option, but this certainly isn't a reason not to learn and consider a tandem rappel which is perfectly within your physical ability. SAR capability varies, not to mention there are countless ways your partner could be incapacitated that don't involve movement or airway concerns. 

Calling for help and self-rescue is not a dichotomy. If you want to be in the position to give a partner the best chance, being able to move 1 kN of deadweight is completely feasible and useful. Moving even 1 pitch to a different ledge can shave hours or days off your rescue. Being on a cliff versus the ground is often a deciding factor of whether an air mission is approved. SAR teams take cold calculated risks. If your concern is your partner's life and limb, you can tip this calculation in your favor by taking some risk yourself.

The vdiff website has really good drawings on a tandem rappel setup.

As a sidenote, I don't want to get into an EM debate on spinal immobilization, but just for the record, this is more representative of the current line of thinking.

Wilderness Medical Society Practice Guidelines for Spine Immobilization in the Austere Environment: 2014 Update
The concept of spinal immobilization has been predicated entirely on philosophical, theoretical, and medicolegal grounds, and the justification for its use remains unchanged despite more than 4 decades of widespread use. Despite a lack of evidence clearly supporting spinal immobilization, an absence of documented cases of neurologic deterioration as a result of inadequate immobilization, and in the face of accumulating data challenging both the philosophical and theoretical grounds of immobilization, no randomized controlled trials have yet been performed in an attempt to validate its ongoing use or stratify any risk-benefit ratio. In the urban setting, the routine use of spinal immobilization likely adds little to improve the care of the injured patient, but correspondingly likely accounts for little harm to the patient (in the absence of penetrating trauma) or first responders. The financial harm to the system (if indeed there is little evidence to support routine use) is likely enormous, measured in both direct (expense of increasing the time and complexity of extrication as well as unnecessary tests and procedures) and indirect costs (inadvertently “validating” subsequent medicolegal claims of spine injury). Conversely, the routine use of spinal immobilization in the austere environment not only increases the financial cost of rescue operations, but also greatly increases the time, logistics, and complexity of the operation, thereby also exacting a cost in terms of increased morbidity and mortality to not only the patient but rescue personnel as well.
Derek Doucet · · Unknown Hometown · Joined Apr 2010 · Points: 64
Tammy Gueterman wrote:

If you're in contact, you should definitely call for help early if you think there is even a tiny chance you need it.  But you should  also strive to develop the skills to get yourself and your partner out of any situation you choose to get into. You should be able to aid climb, rappel, and haul, to get yourself and a completely incapacitated partner down or up an arbitrary number of pitches. You should be limited by your physical endurance, not a lack of skill or failure to plan ahead. Now realistically, this would be a last resort or done in conjunction with an outside rescue, but a pair of climbers should not be stranded on the wall indefinitely just because 1 climber is unconscious.

I’m willing to bet that I have considerably more training and practical experience with self rescue skills than most, and if there’s one thing of which I’m certain, it’s that there are situations in which self rescue is simply not realistic, or in which the slim chance of a successful outcome doesn’t justify the risks inherent in the attempt. Anyone who claims otherwise is fooling themselves. And yet we do agree on this much at least: it is irresponsible to venture into any sort of committing terrain without a robust toolbox of self rescue skills. 

Dana Bartlett · · CO · Joined Nov 2003 · Points: 890

Discussions that don't involve a specific accident scenario and/or some agreed on definitions of rescue skills aren't productive and usually don't go anywhere.

It's an individual's choice to decide how she/he wants to prepare for a climbing accident - cost and time of learning and practicing rescue skills, possibility you'll need the skills you are learning and the equipment you will carry, how effective they might be, how well you think you can pull it off, what type of accident might occur and where. You have to decide for yourself.

If I had to vote, I'd go with John. I think that self-rescue - as it seems to be commonly thought of - would rarely be useful.

Idaho Bob · · McCall, ID · Joined Apr 2013 · Points: 452

Regarding Dana's comment, I submit that being proficient in self-rescue and first aid is not about you, it's about your partner. At a roadside crag not an issue, but in the back country could be.  I personally think that every climbing team that ventures into the back country needs self-rescue and Wilderness First Responder skill.  Applies not only to climbing, but other activities such as glacier travel, etc.

And if you never have to use those skills-----Great!

Dana Bartlett · · CO · Joined Nov 2003 · Points: 890
Idaho Bob wrote: Regarding Dana's comment, I submit that being proficient in self-rescue and first aid is not about you, it's about your partner. At a roadside crag not an issue, but in the back country could be.  I personally think that every climbing team that ventures into the back country needs self-rescue and Wilderness First Responder skill.  Applies not only to climbing, but other activities such as glacier travel, etc.

And if you never have to use those skills-----Great!

I'm embarrassed. It never occurred to me that I might have to help someone else. 

m Mobes · · MDI, ME · Joined Mar 2006 · Points: 905

Self rescue is when you tie the unconscious partner off and GTFO real quick right?

Jon W · · Bishop, CA · Joined Dec 2011 · Points: 0
Fran M wrote: why not? Sounds like a great plan to me. Specially for the OP given their question (or for myself given my skills and desire to live).

You always climb somewhere with cell reception and fast EMS?

Fran M · · Germany · Joined Feb 2019 · Points: 0
Jon W wrote:

You always climb somewhere with cell reception and fast EMS?

i guess so. Cell reception or VHF channels and fast rescue services. Having a heslth insurance thst covers the latter is also nice.

Robert Hall · · North Conway, NH · Joined Aug 2013 · Points: 16,716

Somehow this conversation has been focused on the extreme case of a totally unconscious climber who can be of zero assistance and who can communicate zero information about him-herself. (..."my back hurts and I can't feel my feet")
.
In reality I would suggest that in 90+% of the cases that is NOT the case.  I have been personally involved with about 10 accidents, most of them in the mountains, and I have yet to see a person who is totally unconscious. One included a 50ft, unroped ground fall (although he did sort of "bounce back and forth" between the cliff and a tree).  Several were "stunned" and deemed unable to act independently immediately after the fall, but over the course of 5-10 min. this wore off and then they were deemed able to execute previously-learned tasks. (Like slinging a tree on a ledge and clipping into it after being lowered.)

 About 7 of the 10 were able to help themselves some way, but were not able to rescue themselves. Three required a "call for help" type rescue.

 It is also my experience that, unless the accident happens in an area whose Search and Rescue team is extremely competent on technical rock, you simply are not going to get a rescue off of a technical climb in anything like a reasonable length of time. First, your 911 call has to go through only something like 50% of the land mass of the "lower 48" is covered; second the 911 system must correctly identify where you are.  In my experience, and the experiences related to me by our local, well trained SAR group, this is not as easy as it seems, since the 911 system is set to find people on roads and in civilization.  Once I called to report what I thought might be a forest fire, they had my position 2 miles "off"; in another instance I know of, the 911 caller was identified as being on a state highway 3 1/2 miles from his location 100 ft off of a well-traveled hiking trail. Third, assuming you are located, AND assuming there is a "local" technical-rock-rescue team in the area and that you can be put in touch with them (there may be some bureaucracy involved...all while your battery is dieing...911 will want you to "stay connected") then in a few hours they will arrive to help.  BUT if there's no local team, and/or it isn't very well trained, you really don't want to know how long it might be.

In the absence of a well-trained SAR team coming, all efforts should be made to get the injured climber off of technical terrain.  With all due respect to those who volunteer for emergencies, you really don't want a dozen or so, semi-trained, non-climbers trying to reach you from above...kicking off stones and trying to lower one long rope.  Much, much better to meet the volunteers and their litter and first aid equipment at the base of the cliff with your partner saying "thanks for coming!"    

In short - in the absence of a well-trained SAR team, all efforts should be made to get the injured climber off of technical terrain. Then let the first responders do what they do best,

  Most instances the injured climber can assist with his/her rescue.  The key time seems to be the first 10-15 minutes when he/she is likely to be incoherent, aka "groggy".  "Rescue" may be as simple as lowering the climber back to the belay ledge (if less that half the rope is out), clipping him/her in and waiting for more lucidity , then, if the lower extremities work, lowering him to the next ledge, the partner then raps to the next ledge and the process is repeated.  Much to think about...especially if only one rope is available...e.g. "can I lower him a full rope length, have her tie in independently, then untie so I get the whole rope back and then make two  raps with the single rope..(or maybe 3, depending on anchors).

Unless you limit your climbing to areas where a simple, verbal "HELP !" will bring a host of other climbers,  it is important to know the basics of self-rescue. They will probably work in 70+% of the instances.   Know how to assess important injuries (sprained ankle vs smashed/broken ankle) and how to assess what the injured climber is able to do...and to continually assess this as the "rescue" proceeds.  Sometimes its said that "A little bit of knowledge is worse than none.", but I assure you in the realm of first aid this is NOT the case.  In the realm of self rescue on technical terrain, it may be...you have to assess what might go wrong and for this you need at least some training; hands-on is best, but a book is better than nothing.  As someone said earlier...THINK and constantly assess.

   

Harumpfster Boondoggle · · Between yesterday and today. · Joined Apr 2018 · Points: 148

@Robert

Excellent post. This is the difference: The victim is able to assist and communicate. This scenario IS common and every climber should have a plan to help their partner to the ground.

The completely unresponsive victim hanging on the end of a rope is a whole nother kettle of fish and realistically beyond the scope of one individual to manage down a rock face multiple pitches off the deck. It also simply is not common enough to "be a thing" that anyone beyond SAR professionals should dwell on, imo.

Tammy Gueterman · · Seattle, WA · Joined Jun 2019 · Points: 0

What skills you deem worth your time are ultimately up to you and your partners. Everyone is free to choose how much risk they are willing to take on. As someone who switches hats between climber and SAR. There are things I would never suggest a climber try to learn. There are even things I would never suggest an excellent SAR crew try to learn without serious outside consultation from a master: backcountry highlines (not the slackline type).

If you are okay with being forever stuck on the wall because 1 climber is down, that is your group risk tolerance, but some of the reasons you have given make me think you have serious flaws in your cost-benefit calculation.

It's too hard. The idea that managing 1 kN of deadweight down multipitch is unfeasible. No, it truly isn't. I watch still-scared-of-heights, never-worn-a-harness, rope access technicians learn to rescue a casualty on day 3. If we can climb for months or weeks at a time, we can find the time to learn a comprehensive set of self-rescue skills. The fact that rescue skills are rare is a total shame born out of ignorance and a failure of culture, like declaring it unnecessary or impossible having not even tried.

Call for help. A major takeaway of Robert's post that you seem to overlook is the idea that the current landscape of SAR infrastructure should provide essentially zero security worth factoring into your assessment. I share this feeling having trained with well regarded mountain rescue teams across the US on the east and west coast. Suffice it to say the availability and capability varies wildly. Wearing my climber hat, knowing what I know about SAR, to me, "call for help" is closer to "not a thing" than the "kettle of fish" in question is to "shouldn't be a thing".

Harumpfster Boondoggle · · Between yesterday and today. · Joined Apr 2018 · Points: 148

Tell me how many times in climbing a climber injured by trauma and completely unresponsive has been lowered multiple rappel lengths to the ground by his partner solo and that has meaningfully affected his/her outcome.

I will then contrast this with the innumerable preventable accidents that happen to climbers nearly daily that could be avoided by better basic skills and hang my hat on that.

m Mobes · · MDI, ME · Joined Mar 2006 · Points: 905
Harumpfster Boondoggle wrote: Tell me how many times in climbing a climber injured by trauma and completely unresponsive has been lowered multiple rappel lengths to the ground by his partner solo and that has meaningfully affected his/her outcome.

I will then contrast this with the innumerable preventable accidents that happen to climbers nearly daily that could be avoided by better basic skills and hang my hat on that.

You worded that nicely without being a total ahole, nice work doc, I agree!

Tammy Gueterman · · Seattle, WA · Joined Jun 2019 · Points: 0
Harumpfster Boondoggle wrote: Tell me how many times in climbing a climber injured by trauma and completely unresponsive has been lowered multiple rappel lengths to the ground by his partner solo and that has meaningfully affected his/her outcome.

I will then contrast this with the innumerable preventable accidents that happen to climbers nearly daily that could be avoided by better basic skills and hang my hat on that.

If it was the expectation that climbers, some of whom have been climbing for several decades, learn a few relevant skills that rope access technicians do in the first 3 days, everyone would be better off in all of the situations you mentioned. It is a side consequence that the task we have argued about would suddenly stop sounding so big and impossible.

Em Cos · · Boulder, CO · Joined Apr 2010 · Points: 5
Harumpfster Boondoggle wrote: Tell me how many times in climbing a climber injured by trauma and completely unresponsive has been lowered multiple rappel lengths to the ground by his partner solo and that has meaningfully affected his/her outcome.

I will then contrast this with the innumerable preventable accidents that happen to climbers nearly daily that could be avoided by better basic skills and hang my hat on that.

This is a false dichotomy. Basic skills, risk management, accident prevention, and self-rescue can (and should) all be learned by climbers, no need to support one and reject the others. 

Robert Hall · · North Conway, NH · Joined Aug 2013 · Points: 16,716
Tammy - you make a good point.  Having learned decades ago how to rap with an injured climber (granted, only on a non-vertical cliff face, and only for 1/2 a rope length) it isn't really that difficult....as long as the constraint of total neck-and/or-back non-movement are not required.  Yet, it was the last thing taught on that weekend of self rescue, the last thing because it was the least likely to be needed, at least in the then-opinion of the experienced climbers teaching the class.  In my 50+ years of climbing since, this has proven to be the case.

I totally agree that climbers should "learn a few relevant skills that rope access technicians do ".  That many (most ?!) do not is more symptom of our age and a symptom of  "call 911 and everything will be alright" that so many actually believe in.  Your confirmation of the status of SAR's today should be an eye-opener to those who believe the government will take care of you...just call 911.

Yet Harumpfster   also has a point - most accident victims, whether by a mountaineering fall, auto accident, or industrial accident, who are so badly injured as to be totally unconscious and remains so for the length of time it takes to initiate and start to execute a mountain rescue (even a self-rescue) [which I will estimate as 1 hour] are probably in such bad shape that they are not going to survive. I have routinely read and studies "Accidents in NA Mountaineering" for 5 decades and I do not recall ever reading of a self-rescue of such a climbing accident victim.  The usual scenario is something like this: "the climber was found unconscious and remained so, CPR was initiated but halted after xxxx hour(s)"

 

 
Guideline #1: Don't be a jerk.

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