RESCUE AND EVACUATION - Medicine for Mountaineering and Other Wilderness Activities - page 80

The existence of a problem is not always clear. Communication may be nonexistent or
interrupted. The famous self-rescue of Joe Simpson ( Touching the Void ) was a result of
Simpson's partner thinking Simpson had died in a fall. Many expeditions have suffered ac-
cidents about which base camp or other groups were completely unaware.
Decision Making
Once a problem has been defined, members of the expedition must attempt to solve it.
The ultimate success of the expedition may depend on the solution. In many cases, ill or
injured members may be unable to move under their own power. In a few instances, such
as high-altitude pulmonary edema (HAPE) or venomous snakebite, moving under one's
own power may worsen the prognosis. Individuals with frostbite of the feet often can self-
evacuate, but frostbite of the hands may make it impossible to do necessary tasks, such as
descendingtechnical terrainwithfixedlines.Individualswithhigh-altitude cerebraledema
(HACE) are generally too ataxic, even after recovering, to be allowed to descend on their
own.
If a member is ill or injured enough to require evacuation, the expedition must devote
sufficient resources to the task. On water, this may be quite simple. On a mountain, this
may only require a few members to lower the person, but on trails or even on level ground,
thetaskofcarryingatotallydisabledpersonanydistancecanbequitedauntingandrequire
manypeople.Aprominentmountaineeringtextproclaims—notentirelyinjest—thatasuc-
cessful rescue requires a basket stretcher and two dozen stretcher bearers.
Beforeproceedingwitharescue,theteammustspendadequatetimediscussingtheplan.
Everymembershouldhaveadefinedrole,andtheteamshoulddeterminethetechniquesto
be used. A few minutes spent in planning prevents many mistakes and delays later on.
Search and Rescue
The emphasis in this chapter is on improvised techniques. On large expeditions with
multiple teams in the field and possibly a support group in base camp, expedition rescue
may sometimes take on aspects of organized search and rescue. Search and rescue skills
are best acquired through formal training and participation in rescue missions in an organ-
ized rescue group. These skills can be adapted to the expedition setting. Written resources
includeseveralusefulbooks. Mountain Search and Rescue Techniques byWilliamG.May
(Boulder, CO: Rocky Mountain Rescue Group, 1973) was written as a training manual for
an active mountain rescue group, whereas Wilderness Search and Rescue by Tim J. Set-
nicka(Boston:AppalachianMountainClub,1980)isamoregeneraltextandcoversrelated
areas such as white-water and cave rescue. Although both topics are now out of print and
somewhat dated, the basic techniques have not changed. Other specialized topics include
River Rescue: A Manual for Whitewater Safety , 3rd edition, by Slim Ray and Les Bechdel
(Boston: Appalachian Mountain Club, 1997) and On Call: A Complete Reference for Cave