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  • Act As You Should!

    It's 4 pm in January and you are in a party of two descending the trail from Nippletop to Elk Pass. The temperature is 5F. You come upon a lone hiker with a broken leg. (Tib-Fib just above the ankle) The hiker is in a lot of pain and is shivering hard. You are chilly, damp and tired and have no communication devices. What would you do?
    Project-100: 100 peaks, one winter. https://project100singlewinter.wordpress.com/

  • #2
    Well, if it's 5F then I'll have the following, no ifs ands or buts:
    SPOT device
    Bivvy sack
    Spare socks, shirt, gloves, down puffy jacket
    Spare tie-down devices

    What I will do depends on conditions and who else I'm with. I would offer the down jacket and/or spare clothes to the injured person, and offer a makeshift splint using hiking poles and tie-down materials. (That's actually WHY I carry them.) I would offer to help carry them out on the splinted leg.

    If the person can't take the splint or is simply incapable of moving, I would offer the bivvy sack too. Assuming conditions suck, it seems more dangerous to split with the hiking partner, so I would set off the SPOT, leave it with the injured person and then haul ass with my partner to get help.

    Edit to add: Starting a fire for the wounded guy would be great, but I doubt that I could do it, as I just commented on another thread. I don't always carry a lighter, but sometimes do.
    Last edited by autochromatica; 11-22-2017, 05:45 PM.
    ADK 46/46W, Grid 235/552
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    • Makwa
      Makwa commented
      Editing a comment
      Sorry... no SPOT as per Neil's condition of "have no communication devices" in the original post. :(

  • #3
    If a splint can be fashioned, it is applied and if possible getting out or at least getting lower is attempted. You could attempt to make a litter, but that area is pretty steep and you're not likely going to be able to carry them down. If they cannot be moved, one of you stays with the injured hiker and one goes out for help, first being sure of the location where the victim is and taking only the bare essentials of their pack for the exit and leaving anything of use for the "nurse" and the injured hiker. Before leaving, a structure to protect against the elements and elevate off the cold ground is constructed and perhaps a fire started(if possible). Please tell me this scenario is not triggered by an actual event where people left an injured person on the mountain! :(

    Comment


    • gebby
      gebby commented
      Editing a comment
      autochromatica I would split up and take extra precaution while exiting not to become injured or fall. How does it help if three people are sitting there freezing, if no one knows they are there? If the argument is, they'll come looking for you because one or all three of you properly left an itinerary: 1. where should they look?(exiting party will tell them) and 2. when you are each overdue, they will find all three parties wherever they may be based on the left itineraries, the exiting hiker first most likely, who will narrow down the search area for them by telling them exactly where the other two are.

    • autochromatica
      autochromatica commented
      Editing a comment
      gebby no, I mean the both of you leave to get help together. Sorry, wasn't 100% clear!

    • gebby
      gebby commented
      Editing a comment
      autochromatica Got it. Got to do what you feel comfortable with.

  • #4
    I would probably have me or my hiking partner (whomever is more able) run for help. Leave one of us behind with as much gear as can be spared to help keep the injured person company.

    Is that should?

    Comment


    • #5
      Agree with most of the above. Tib-fib you are probably not going to be able to stabilize well enough to move. Leave all that can be spared to keep hiker and partner warm. Try to build shelter, try to build fire, but spend minimum time at it. Fastest and most competent of your pair runs for help. Ugly situation - maybe someone's going to die. Need to do the best you can.

      Reinforces the old knowledge that winter travel calls for a strong party of 4.

      Comment


      • #6
        Obviously , there is no clear-cut answer to this scenario. Here are my thoughts. The fracture isn't life-threatening but hypothermia is (and also potentially shock due to the severe pain).

        The main issue is avoiding death of the victim, who is shivering hard. You arrive on the scene and "blam", you're it. My first reaction would be to stop and remove my damp base layer shirt, put on a dry one plus my other insulation (Marmot Baffin Down jacket and Rab under-jacket). Once having taken care of my own needs I would then empty the vic's pack and hopefully find warm layers to put on him or her. Hypothermia would be the main concern and I would do whatever I could in the cold night to get my body heat into the vic's.

        My partner would have high-tailed it out in order to alert the DEC and may or may not have left some of his or her warm clothing behind.

        I would dig a pit in the snow (using my snowshoes) and line it with a deep layer of conifer boughs. The next (difficult) step would be to lower the vic into the pit. Next, (after having him void his bladder) I would cover him with a lot more conifer boughs and finally cover everything with snow so that only his neck and head were exposed.
        Now, considering that it's only 5F and that I myself am cold and tired and that my partner is well on his way to alerting SAR I might leave the vic all alone (with all of my remaining food and water) and leave one of my headlamps on strobe facing down the trail and hike out.
        Project-100: 100 peaks, one winter. https://project100singlewinter.wordpress.com/

        Comment


        • FlyFishingandBeer
          FlyFishingandBeer commented
          Editing a comment
          Not bad, but visibility is crucial. If you're going to turn the casualty into a Hawaiian style hog roast, then you'll also want to consider marking the area so they can easily be spotted from the air in low light/visibility conditions. Check the victim's gear for brightly colored things that they don't need to have on their person; create a passive signal in addition to your terrain oriented active signal.

        • Trail Boss
          Trail Boss commented
          Editing a comment
          A silly idea I've had is to bring a packet of cherry-flavored Jello. I haven't proven it to myself yet but if you toss it on snow it should stain it red and become visible (marker). If not that, then just eat it like candy or dissolved in water.

        • FlyFishingandBeer
          FlyFishingandBeer commented
          Editing a comment
          That’s a good way to scare the ever living hell out of the next person who comes along. Interesting concept though.

      • #7
        Another use for large winter packs... empty the gear out of his or yours and get as much of his body inside it as if it was a sleeping bag. Adds another layer and some insulation from the cold ground.

        This is a good what-if scenario. It's no so far fetched to think you might encounter this someday. Having thought through possible solutions ahead of time will certainly be beneficial if the situation ever arose in real life. Trying to come up with intelligent solutions to a problem when you're cold, tired, and damp yourself doesn't always work so well.

        Comment


        • #8
          If conscious, ask if the victim requires your assistance. If permission is granted, or victim is unconscious, administer assistance.

          Triage. Determine severity of injury. Basically, where does it hurt and can you move? In this example, the victim is immobile and in great pain.

          What Neil said, prepare yourself first; don more clothing to stay warm. It's akin to depressurization aboard an aircraft; you put on your oxygen mask first, then assist someone else with theirs.

          Perform a more detailed assessment of victim's condition. Broken leg, shivering, possibly in shock. No severe pain anywhere else. No bleeding. Pulse rapid but strong. Reassure victim you will help and they will survive.

          If movement causes terrible pain, immobilize the broken leg immediately. Wrap the foam backpad from your pack (or from partner or victim's pack) around the leg to serve as a splint. Use whatever you have on hand to hold the splint in place (I always carry an elastic bandage).

          Help move the victim onto emptied packs to temporarily insulate from cold (or onto whatever else you have on hand). Dress victim in additional clothing. Have victim drink any hot liquids you may have and eat sugary food. Try to have victim in a seated or semi-reclining position.

          What Neil said, make a bough-bed to insulate the victim from the ground. However, if boughs are not free of ice and snow, skip this step because they won't offer much insulation. Pack down a platform in the snow, just off the trail's side, and create an insulating mattress of boughs (or whatever). Lay the empty packs on the mattress and carefully move the victim onto it.

          Whoever is stronger and faster now goes for help. It's not too far to the Lake Road so the odds of the "runner" encountering a problem are low. Runner leaves whatever clothing, gear, and food that can be spared. Runner understands that if you cannot maintain your own safety while tending to the victim, you will also leave and exit to the Lake Road.

          Runner records GPS location. If no GPS then note current time and time when you reach the next recognizable milestone on the trail. If nothing else, count the number of paces. This is useful when describing the victim's location ("25-minute descent to the ElkPass-Colvin junction"). Look for skiers along the Lake Road (or AMR staff on snowmobiles) to deliver the message faster. Perhaps someone else has a SPOT or inReach (phone if there's cell reception). Briefly inform any inbound hikers about situation ahead of them.

          Create a fire. The activity of making a fire, and keeping it fueled, will keep you warm. The fire will provide heat and psychological comfort for the victim. It will also be visible to rescuers.

          It won't be easy to make a fire along the sloped section of the Elk Pass Trail. The woods are mostly conifers and likely to be coated in snow. Look for dead, spindly branches and twigs under the boughs. Collect a lot more than you think you need to start a fire (you'll need a crapton more to keep it going). Collect birch bark and any spruce tar you can find. Harvest whatever wood you can find along the trail's sides because plowing into the woods, through deep unbroken snow, is likely to just get you soaked and exhausted. Build the fire on the trail (the most packed surface to be found) on a bed of dry boughs (if possible). You're unlikely to find "dead and down" wood because it'll be buried under snow. Maybe there's something that fell across the trail nearby. Keep talking to the victim to keep their spirits up.

          Your fulltime job now, until rescuers arrive, is to eat, drink, keep the fire going, and try to keep the victim comfortable, warm, fed and reassured. It'll take several hours before help arrives. If the runner got lucky and met a snowmobiler or skier, it'll shave off an hour (tops).

          If you can't build a fire, or keep it going, or are in danger of also succumbing to the cold, then do your best to insulate the victim and leave. The runner already knows this is your "Plan B" and has communicated it to the rescuers.







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          Comment


          • Yury
            Yury commented
            Editing a comment
            "In the dead of winter, your half-rotten trees ... wet enough for a foundation will be either frozen to the ground or hidden under the snow or both. I have pics of the area in mid-winter and it's a smooth landscape of snow."

            I agree. I said that I may be able to start a fire.
            I would not even attempt to start a fire if I do not have wet wood for a foundation.
            If you have at least a toy saw you may try using some live tree as a base layer for your fire.

          • Yury
            Yury commented
            Editing a comment
            "As for the Dyatlov Incident, you have tremendous selective-reading skills."

            I apologize for my age and common sense.
            I am not that young and naive to 100% trust BS I see in Wikipedia, social and mainstream media.

            'Wikipedia offers a summary of the unusual bits:
            "One victim had a fractured skull; another had brain damage but no sign of an injured skull.'

            Trail Boss, can you think of at least one rational explanation for these injuries considering that their tent was hit by an avalanche and that they descended a steep slope where they could have slipped and slided down the slope?

          • Trail Boss
            Trail Boss commented
            Editing a comment
            The official report's claim of "compelling natural force" was issued well before the Internet was even invented. Wikipedia is just parroting that bizarre official cause and all the other outré theories. Blame Soviet-era apparatchiks for mishandling the investigation and arriving at a tabloid-worthy conclusion.

            Of course, "compelling natural force" can be interpreted as "avalanche" and "freezing to death" except there are good Russian words for those but the officials chose to go all supernatural with "compelling natural force".

        • #9
          OK. This trail is steep and only one leg is broken.
          So my partner and I should be able to get this guy down to a flat ground near Elk Pass assuming he can stand on uninjured leg (but first we may want to put some extra clothes on him).

          Then I will stay with this guy and my partner will walk back to a trailhead (no running to prevent a risk of injury).
          Although my inReach is broken, Neil has not mentioned anything about my gas stove.
          I will be able to prepare some warm drinks and also will do whatever was already described by other people to make him warm.

          I may be able to build a fire near Elk Pass. I do not believe that I can build a fire on that slope above.
          Anyway, I should be able to somewhat warm this person with my body heat and warm drinks.

          Previously I already thought about a hypotetical situation when hiking solo I meet an exhausted uninjured or slightly injured person (e.g. with rolled or broken ankle) who can't move.
          Having two uninjured people makes this situation easier.
          Last edited by Yury; 11-23-2017, 12:24 AM.

          Comment


          • Yury
            Yury commented
            Editing a comment
            I agree that it would be practically impossible for two people to move an injured person up the trail in winter.
            However it should be doable to move him down the trail with an assistance of gravity.
            Dragging a person on a tarp (if we have one) is an option.
            It also depends on whether this incident happened closer to the pass or to the summit.
            I do not have very good recollection of that area, but believe that woods near Elk Pass provide better wind protection.
            The purpose of such relocation is to decrease wind exposure.

            I should be able to spend relatively comfortable night under such circumstances.

            My real fear is about breaking through the ice into a pool of water when hiking solo.
            I am not sure that I can satisfactory handle such case.
            Last edited by Yury; 11-23-2017, 10:28 AM.

          • Trail Boss
            Trail Boss commented
            Editing a comment
            Oh gravity will definitely want to pitch in but not in a helpful way. Besides, gravity is what started this mess.

            The trail is your typical lumpy bumpy High Peaks trail plus parts of it are a bit steeper than average. Snow fills in some of the divots but it's far from a smooth ramp. I wouldn't want to sled down it while flat on my back on a tarp. When someone is carried out in a litter they'll employ six people to create a "human caterpillar". I can see how two people with a tarp might be able to negotiate the Lake Road (or parts of the Phelps or Van Hoevenberg trails) but not the Elk Pass Trail.

            It's useful to consider the ice-climbing accident that occurred on Nippletop Slide in 2012.
            http://www.adkhighpeaks.com/forums/f...e-on-nippletop

            The victim had severe injuries (including head trauma) and moving him was a risky proposition. He was in a group so some stayed and others left to get help. Ultimately, 32 people were involved in the "grueling" rescue (ranger's adjective, not mine). FWIW, the victim survived but, last I heard, he did not come out of it unscathed.

          • gebby
            gebby commented
            Editing a comment
            Trail Boss triggered an interest in how that rescue on Nippletop turned out and had me searching for more info. http://www.adirondackdailyenterprise...to-the-rescue/

        • #10
          I almost always have my Spot device so in reality I would deploy the SOS function right away. My wife would be worried sick but there's nothing you can do about that. I don't think fire would be an option but maybe it would be. However, an all-night fire, even if small, requires a sh!t load of wood. There's no doubt in my mind that this has the makings of a life and death situation due to the cold. 5F at 4pm in January would probably lead to sub-zero temps overnight. I think the fracture is of lesser importance than the impending hypothermia. I could see leaving my big down coat with the victim and heading out.
          Project-100: 100 peaks, one winter. https://project100singlewinter.wordpress.com/

          Comment


          • gebby
            gebby commented
            Editing a comment
            Definitely appreciate the utility of being able to type a message with the Delorme(now Garmin). Just hope Garmin keeps supporting the device.

          • Makwa
            Makwa commented
            Editing a comment
            I too carry a SPOT and tell the people back home not to freak out if I ever push the SOS as it could be for somebody other than me. I would hope the Rangers could communicate with their HQ who could in turn call my emergency contact at some point to put their mind at ease. I guess one of the responsibilities of carrying a SPOT or similar device is hitting the SOS for another hiker even if it worries your loved ones back home for several hours.

          • autochromatica
            autochromatica commented
            Editing a comment
            Makwa I gave my SPOT to other hikers once. It was very late, and they were very slow having taken all day just to hike Phelps. (I was finishing Marcy-TT-Phelps in less time than they took.) They eventually made it out and left my SPOT at the Loj.

            moosebeware you're absolutely right, just the ability to get a confirmation that a message got out is reason enough to go with the Delorme. I'm somewhat worried that I won't really know with the SPOT if the emergency signal gets out or not. If I was buying it again, I would get the Delorme no question.

        • #11
          A great discussion, and to generate critical thinking.
          If by chance some day you're not feeling well and you should remember some silly thing I've said or done and it brings back a smile to your face or a chuckle to your heart, then my purpose as your clown has been fulfilled ~ Red Skelton

          Comment


          • #12
            Originally posted by NumNum View Post
            A great discussion, and to generate critical thinking.
            I think about stuff like this a lot.
            Project-100: 100 peaks, one winter. https://project100singlewinter.wordpress.com/

            Comment


            • NumNum
              NumNum commented
              Editing a comment
              I think we all should. If for no other reason than being mentally prepared.

              This discussion remind me of the class we took with WinterWarlock.

            • moosebeware
              moosebeware commented
              Editing a comment
              Me too. Every time I go hiking. I'm always afraid of choking on my food though.

            • WinterWarlock
              WinterWarlock commented
              Editing a comment
              That was a great class NumNum - I've even taken it again to maintain my certification.

          • #13
            This scenario changes if anyone has an inReach device. Assuming it is a true emergency, the SOS on the inReach is activated and DEC is contacted. DEC will get the SOS and will know exactly WHERE you are, but that's all. Meanwhile, a more detailed message about the situation is sent to a trusted inReach contact (or everyone in the Contacts list) asking someone to call DEC Dispatch. Very important is the personal contact with DEC which tells them details such as the nature of the injury, condition of patient, number of people and gear/clothing on site, etc. Otherwise, the first rescuer (usually a Forest Ranger) comes to the scene then radios back to mobilize support personnel. At any time (with cell or internet service), DEC can text message directly with the inReach to get more detail they need to plan and mobilize the rescue. A lot of time is lost with the DEC rescuer first coming to the scene, then calling back for needed support such as a crew for carrying a litter or advanced medical support.

            Messaging via inReach greatly reduces the time needed to effect the rescue by informing the rescuers what to expect and enabling planning and getting the rescue team together. With a patient in good condition, a few hours will mean discomfort and pain, but when the condition of the patient is seriously life-threatening, this time difference could mean survival vs. death.

            Comment


            • #14
              Neil , this question came up during my Wilderness First Responder training (and, recently, WFR recert) 3 yrs ago. So as you said, assume one has NO communication device (not even a text will get out). Here's what we were taught...

              First and foremost, you or your hiking partner do not immediately bolt from the scene and run for help, regardless of the conditions (summer/winter, rain/snow/shine). Those who took even WFA should recall the steps. Get the patient away from any immediate dangers, such as if they are in running water ("immediate" is the keyword here). Address any injuries that are immediately life-threatening, such as if there is a lot of bleeding. During the patient assessment, get the info about the patient and their condition into a SOAP note, because that'll be important to the rescuers. I can't tell you how many people (including myself) were dinged during training scenarios, where we had someone head out for help w/o a SOAP note of a sort. And with two people (apart from the patient), its essential to have that help so the patient can be warm, safe, and in less danger than they were before (dry clothing, a hypothermia wrap, fire and possibly shelter).

              It certainly would be a nerve-wracking situation. When I was at Camp Muir to climb Rainier back in July, the ranger asked if any of us were carrying any emergency communication devices. I few carried in inReach, and I carried the SPOT. He said the inReach's are better, because they communicate back to rescuers the nature of the problem, esp. the patient's condition.
              We are closer now than we were five minutes ago

              Comment


              • FlyFishingandBeer
                FlyFishingandBeer commented
                Editing a comment
                This is awesome and very important. As trivial as the victim's personal info may seem, it can help save the person's life should they lose consciousness. If you are unfamiliar with SOAP notes or like most of us, haven't memorized every line, all information is good information. Any note-worthy existing conditions or allergies (penicillin, sulfa, and shellfish allergies are very important to know about) should also be noted and relayed to rescuers.

            • #15
              Thanks for the post John. I never carry pencil and paper (easy to rectify) and my first thought was wondering how, with freezing fingers, I would write SOAP notes.
              Project-100: 100 peaks, one winter. https://project100singlewinter.wordpress.com/

              Comment


              • Neil
                Neil commented
                Editing a comment
                Gloves? Nope. No gloves up here in Canada other than those worn by the likes of Sidney Crosby and Maurice Richard. We do have pencils though.

              • bud
                bud commented
                Editing a comment
                Those are hockey players. Here in the US we have gloves for people like Yogi Berra and Johnny Bench.

              • Makwa
                Makwa commented
                Editing a comment
                A nitpicker like me would point out that Berra & Bench wore mitts. Gloves are for the other players on the team... except DHs whose only gloves are batting gloves.

                I carry pen & paper just to take trail notes. Time started and how long between major landmarks... stuff like that. Pens work in the cold weather if you keep them in an inside pocket of your jacket. I buy tiny 2-3" long pens that fit easily in with my map in a ziplock. Never had one stab me if that is a worry for anybody.

                As for SOAP notes... I would hope everybody at least carries a card or notes on their own medical history... medical conditions, medications you are currently taking, allergies, etc to get the process started for anybody responding to your emergency. I have all that info written down along with doctor's name/ phone number, insurance info, and emergency contact info. Same info also in my SPOT profile that would be sent to emergency personnel in the event I pushed the SOS button. No sense in trying to figure all that out when you're not in your right mind.
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