Ground Fall on Potash Road, Moab, 4/29/2017

My party was about 100 yards away from the accident.  Trying to find info on how the individual is currently doing.  Unable to find any information in blotter/news.

I believe the climber was on Baby Blue.  From what we could gather, the climber was nearly at the chains when he fell.  His closest piece of gear blew out.  The next piece was too low to stop the fall, resulting in a 30ft ground fall.

Two women immediately called for surrounding help, and then drove out to call 911.  A first responder was nearby and an individual from our party (who was a veterinarian) helped stabilize the victim while help arrived.  EMS arrived within 5 minutes.  They decided to call in life flight.  The helicopter pilot did a fantastic job of landing on the street, between the cliffs and the trees (well done, sir!).  During this time, some complications must have arisen as they began performing chest compressions on the victim.  They were able to start him back up with an AED.  They incubated him and got him on the helicopter, presumably to fly to Grand Junction?

It was nearly 1.5 hours between when EMS arrived and when they flew him out on the helicopter.

The injuries (as they were relayed to me) sounded to be internal.  Legs and toes were movable.

Some gear was left in the wall.

Thanks to all who were there that helped, called 911, and/or kept away so the responders who could do their job.

Stay safe out there.  Sometimes it's not worth running it out.  Prayers to all and hoping for a speedy recovery.

Charlie S wrote:

They incubated him and got him on the helicopter, presumably to fly to Grand Junction?.

The nearest level 1 trauma center to Moab is Salt Lake City. Next closest is Vegas.

Edit: Correction. The next closest Lvl 1 to Moab is Flagstaff AZ, at 260 air miles. SLC is 195 and Vegas is 350.

Bumping this as I was also there on Potash that afternoon. I appreciate the extra info on what happened, as I didn't want to get any closer and get in the way.

Hoping for the best.

Not to get off topic, but isn't Vegas a black hole for quality medicine?  I heard a piece on NPR when visiting  a few years back and it sounded pretty grim due to a lack of (any) medical schools.

St Mary's is a level 2 trauma center. I suspect most flights go to Grand Junction first. When my partner fell off the Tower of babel in Arches he was evacuated to St Mary's hospital. 

http://www.amtrauma.org/?page=findtraumacenter

I was one of two WFRs on the scene, I was climbing the 5.9 just to the left of where he'd fallen, and stayed with the patient until they flew him out on the helo. He fell approximately 40 feet from just below the anchor, his top piece busted, and he hit the deck. Cracked his helmet open, appeared to have broken all of his ribs on his left side. He went from 30 seconds of unconsciousness, to being able to communicate simply. He had a hemothorax (his lungs filled with blood), it got continually harder for him to breathe, he stopped breathing and had no pulse for a few minutes. Started chest compressions, administered 2 shots of epinepherine, after which he regained a strong pulse and determined he was stable enough to be flown Grand Junction. I neglected to get contact info from his friend or wife. If anyone knows the individual or how he's doing if you could message or call me at 7034721909 that'd be great.

Thanks for the info and all your help, Alec. It no doubt saved his life.

Alec Villarreal wrote:

I was one of two WFRs on the scene, I was climbing the 5.9 just to the left of where he'd fallen, and stayed with the patient until they flew him out on the helo. He fell approximately 40 feet from just below the anchor, his top piece busted, and he hit the deck. Cracked his helmet open, appeared to have broken all of his ribs on his left side. He went from 30 seconds of unconsciousness, to being able to communicate simply. He had a hemothorax (his lungs filled with blood), it got continually harder for him to breathe, he stopped breathing and had no pulse for a few minutes. Started chest compressions, administered 2 shots of epinepherine, after which he regained a strong pulse and determined he was stable enough to be flown Grand Junction. I neglected to get contact info from his friend or wife. If anyone knows the individual or how he's doing if you could message or call me at 7034721909 that'd be great.

Great work in taking care of him. Just curious (I work in healthcare), do WFRs routinely carry epi?

Thanks for this! We were climbing down the road and had been trying to see how everything played out.

Optimistic wrote:

Great work in taking care of him. Just curious (I work in healthcare), do WFRs routinely carry epi?

I didn't administer the epi, it was the medics from the life flight (I'm assuming paramedics). Though certified in epi injectors, pretty sure that's outside my scope of practice.

A go fund me and a Facebook support page have been created. https://www.gofundme.com/zachary-liibbes-recovery-fund and https://www.facebook.com/groups/1447873405273242/?fref=nf

Keep sending good vibes and any help is appreciated. 

Redyns wrote:

Not to get off topic, but isn't Vegas a black hole for quality medicine?  I heard a piece on NPR when visiting  a few years back and it sounded pretty grim due to a lack of (any) medical schools.

There is an emergency medicine residency in Vegas. Also, no medical school does not equal bad medical care.

Alec Villarreal wrote:

I didn't administer the epi, it was the medics from the life flight (I'm assuming paramedics). Though certified in epi injectors, pretty sure that's outside my scope of practice.

That makes sense. I was picturing it sort of rolling around in your glove compartment or pack and wondering how that worked!

Optimistic wrote:

That makes sense. I was picturing it sort of rolling around in your glove compartment or pack and wondering how that worked!

In extremis, you could try an IM/subq Epi pen if you had one but absorption might not be very good if cardiac output was low already. 

Looking at the climber's FB page, this sounds like it's going to be a great save, nice job!

Wishing Zachary a full recovery.

Alec Villarreal wrote:

I was one of two WFRs on the scene, I was climbing the 5.9 just to the left of where he'd fallen, and stayed with the patient until they flew him out on the helo. He fell approximately 40 feet from just below the anchor, his top piece busted, and he hit the deck. Cracked his helmet open, appeared to have broken all of his ribs on his left side. He went from 30 seconds of unconsciousness, to being able to communicate simply. He had a hemothorax (his lungs filled with blood), it got continually harder for him to breathe, he stopped breathing and had no pulse for a few minutes. Started chest compressions, administered 2 shots of epinepherine, after which he regained a strong pulse and determined he was stable enough to be flown Grand Junction. I neglected to get contact info from his friend or wife. If anyone knows the individual or how he's doing if you could message or call me at 7034721909 that'd be great.

Zach's a friend of mine from back when I lived in Southern Utah.  Just heard about the accident through Facebook.  Thanks for your help in administering first aid.  Not sure I'll get any updates soon, but it is really amazing to know that people were on scene to help right away.  From the sounds of it the quick response saved his life.  Can't express my appreciation enough.  

Optimistic wrote:

That makes sense. I was picturing it sort of rolling around in your glove compartment or pack and wondering how that worked!

It's been a while, but IIRC, WFRs are allowed to administer the patient's IM/Subq Epi for anaphylaxis. But if you are hours out, a WFR (or any layperson) would be probably protected by Good Samaritan Laws if they administered someone else's epi to a patient who was losing their airway due to allergic reaction. I don't think it's within WFR scope of practice to administer epi for cardiac arrest though.

doligo wrote:

It's been a while, but IIRC, WFRs are allowed to administer the patient's IM/Subq Epi for anaphylaxis. But if you are hours out, a WFR (or any layperson) would be probably protected by Good Samaritan Laws if they administered someone else's epi to a patient who was losing their airway due to allergic reaction. I don't think it's within WFR scope of practice to administer epi for cardiac arrest though.

How much does scope of practice matter in terms of good Samaritan laws? Don't they apply even to those with no medical training at all?

Was he climbing trad or sport.... I'm guessing trad.  You said his top piece busted, I'm guessing  it wasn't a bolt.

Redyns wrote:

Not to get off topic, but isn't Vegas a black hole for quality medicine?  I heard a piece on NPR when visiting  a few years back and it sounded pretty grim due to a lack of (any) medical schools.

Since there's already some drift, oddly enough I had just had a conversation with an intensivist about the same subject. I think his words were "dark ages." I don't agree or disagree, just passing that along. 

Wish the fallen climber well. 

It appears as though there was a quick response and appropriate intervention with a good outcome... this is great to hear. Regarding the use of autoinjector epi from another individuals pack or kit, I think it would behoove the administrator to have some background of ACLS / ATLS training... of course anybody can sue you for just about anything you do to a patient in a pre-hospital setting, the difference is your protection under law as a layperson and your ability to defend your actions in deposition / trial. 

In the setting of an obvious cardiac arrest without pulses who is receiving multiple rounds of CPR, yes they may benefit from some adrenaline... but if you are a layperson you must make that call in conjunction with those around you, personally yeah, I would give it. I am an ER doc though so I would feel some level of protection making decisions like that. Also, the dose of cardiac Epi is much stronger than the auto-injectors however, 1mg administered through an IV vs 0.3mg administered IM... either way I would give it. Unfortunate that we have to live in fear of performing life saving maneuvers because of legal ramifications. Anyways great work to all involved.