WHAT IF?

(updated 31/8/06)

Ensure your own safety and that of the casualty from a further fall or injury. 

Follow the A  – I of Mountain First Aid.

Make the casualty as comfortable as possible and provide shelter from the elements.  All injured and immobile casualties are at risk of hypothermia.

Ensure the safety of the rest of the party.

Call for help by attracting the attention of others on the fells.  Use the International distress signal of a series of six blasts of a whistle or flashes of a torch to attract attention.

Send for help.  Send two people if possible.  Write down a message giving the exact location, time of accident, nature of injuries and other details as known.

Dial 999 and ask for Police and Mountain Rescue.

STAY BY THE PHONE UNLESS INSTRUCTED TO DO OTHERWISE.

 IF USING A MOBILE PHONE LEAVE IT SWITCH ON AND STAY IN THE POSITION IN WHICH YOU HAVE A SIGNAL THIS IS VERY IMPORTANT.

By:  Mr. Mike Greene FRCS FFAEM

Consultant Accident & Emergency Medicine

Wasdale Mountain Rescue Team

A - Assess the accident site.

      Assess the safety of the casualty, other party members and yourself.

      Assess the cause of the accident -  it will provide clues to the injuries

      sustained.

A - Approach with care - do not cause a second accident.

A - Airway.  Ask the patient a question.  A casualty who can talk has an open airway.  If they are not responsive an airway problem can be anticipated.  LOOK, LISTEN & FEEL  for air movement at the mouth.

If  this is not present remove any obvious vomit or foreign material from the mouth using a finger.  The tongue can be lifted from the back of the mouth using a jaw lift or thrust manoeuvre.  Avoid  moving the neck of an unconscious injured climber.  The cervical spine should be held still by another helper and then immobilised before they are transported to prevent injury to the spinal cord.

B - Breathing.  LOOK & FEEL for movements of the chest wall.

The chest should move symmetrically and the normal rate of breathing is 12 - 16 breaths per minute.  Fast or slow rates should alert you to a potentially serious problem that will prompt a high degree of urgency for rescue.

C - Circulation.  Blood loss may be obvious from a wound or open fracture.  In general applying direct pressure and elevating the limb if this is possible should control external bleeding.  Internal bleeding into the chest or abdomen maybe expected from the mechanism of accident and the casualty’s physical condition.  Look for signs of severe blood loss - a fast pulse > 100 per minuet, rapid breathing, pallor, sweaty skin and anxiety or loss of consciousness.  These signs require a high degree of urgency in rescue.

D - Disability.  This really means conscious level.  Is the casualty Alert and can answer all your questions, only responds to Verbal commands, worse only to Pain or are they  Unresponsive ?   ( A.V.P.U. score)  This information will be helpful to the rescue team in assessing the urgency of the situation.  Reassess the conscious level of a casualty with a head injury at regular intervals and report changes to the team.

E - Exposure to the elements. Any mountain casualty is at risk of rapid cooling and hypothermia as are the accompanying party and rescuers.

Arrange shelter and insulation from the ground as soon as possible to prevent the condition from becoming worse.

F - Fractures.  LOOK & FEEL for fractures.  These are common in mountaineering accidents.  Look in particular for suspected fractures of the spine were inappropriate movement may cause further damage, rib fractures which may have injured the lungs and pelvic fractures which can bleed heavily.  Immobilise and splint a fractured limb.  Provide suitable pain relief if possible.

G & H  - Get Help.  If you use a cell phone stay where you are and DO NOT TURN IT OFF  - the rescue team will want to talk to you for more information after you have dialed 999 and spoken to the police. The number of casualties and an assessment of injuries.

I - I hope you never have to use this information!

Good Luck.

STOP AND THINK.

Get your party into shelter and assess your situation.

Decide are you in real danger or just lost?

Think back to what you have been doing.

What was your last definite known location e.g. summit of a mountain?

What type of terrain have you been walking on?  Which direction have you been walking (you need a compass to work this out!)? For how long have you been walking? Use your navigation skills to work out an estimated position.

Can you now retrace your steps to a known position of safely and start again?

Can you use the estimated position to travel on safely and collect more navigational clues until you get a definite fix of your position and can walk out safely?

Consider if  you have the equipment to navigate off the fell safety e.g. map, compass, torch.

Is the party able to finish the journey safely?

What would be the consequence of a night out on the fells – unpleasant or really dangerous?  If really trapped on the mountain seek shelter and use your emergency equipment to keep the party warm and a whistle and torch to attach attention.

If there is real danger to the party or individuals call for help using a mobile phone if it will work!

REMEMBER THE BEST WHY TO AVOID GETTING LOST IS TO LEARN HOW TO NAVIGATE PROPERLY AND TO PRACTICE IN ALL WEATHERS AND ALWAYS LEAVE A ROUTE CARD WITH SOMEONE RESPONSIBLE.

Select a route and objective suitable for the party members and their experience.

Get a weather forecast and consider its consequence on your plans.

Leave a route card with your personal details, the intended route, your equipment and estimated time of arrival at your destination with someone responsible.

Wear suitable clothing make sure you have warm windproof and waterproof clothing whatever the time of year.  Wear good walking boots with suitable soles.

Carry basic survival equipment, food and spare clothes for the time of year.  Remember conditions can change quickly on the hills and even a mid summer day can have gale force winds and rain.

Always carry a map, compass and torch and learn how to navigate before going onto the high fells.

Enjoy your day take home nothing but good memories and photographs and leave nothing behind except gentle footprints.

 Page added to Website 11 July 2002 - checked by R Warren 31/8/06 see BLS new approach here  look at First Aid and look at CPR