RESCUE AND EVACUATION - Medicine for Mountaineering and Other Wilderness Activities - page 82

medical gear. If the expedition has motorized resources such as wheeled vehicles, snow
machines, or boats, they usually can carry more gear than self-powered teams.
Depending on the nature of the expedition and the terrain, saturation search may have
norole. Invegetated areas orinavalanche debris, specialized line searches may beneeded.
CARRYING AN ILL OR INJURED PERSON
On all but the largest expeditions, taking specialized rescue equipment in addition to all
other necessary equipment and supplies is hard to justify. The bulk and weight of such
equipment—and costs—would add a significant burden. In most instances, the equipment
is not available where a person needs to be rescued.
Many types of stretchers are available. In rescue work these are usually referred to as
littersandincludebasketlitters,flatlitters,andsoftlitters.Adiscussion,withspecificlitter
examples, mostly from North America, can be found in the chapter “Litters and Carries”
in Wilderness Medicine , 5th edition, edited by P.S. Auerbach (St. Louis: Mosby, 2007).
Whereas having a litter at base camp might conceivably be worthwhile under unusual cir-
cumstances, most expeditions have little use for heavy, bulky equipment. If long, overland
evacuation with a litter from base camp is a real possibility, an expedition should consider
havingawheeledlitter,withwhichitismucheasierforasmallnumberofrescuerstomove
a disabled person over long distances.
An item that might prove useful under some circumstances is a vacuum mattress (also
referred to as a full-body vacuum splint). These devices provide the best means of immob-
ilizing a person for a long transport. They are superior to backboards for stabilizing spinal
injuries because they are far more comfortable and much less likely to lead to decubitus
ulcers from pressure points. A vacuum mattress is essentially a mattress-shaped beanbag
with a valve for evacuating air. Once the air is removed, atmospheric pressure causes the
mattress to assume a rigid shape that conforms to the person's body. A vacuum mattress
can be used alone as a stretcher in nontechnical terrain but more commonly is placed in a
litterforeaseoftransport.Foralargeexpedition,avacuummattresscouldbekeptatabase
camp.
Improvised techniques, although not as satisfactory in some ways as commercial equip-
ment,havetheadvantagethattheycanbeusedimmediatelywhereneeded.Themostuseful
ofthesetechniques arediscussedin“ImprovisedTransportation” elsewhere inthischapter.
On most expeditions, the initial stages of transport, if not the entire rescue, are dependent
upon improvised techniques. The basic improvised litter is the rucksack stretcher, which
also is described in the “Improvised Transportation” section of this chapter.
Packaging
No matter what type of litter is used, individuals must be protected from further injury.
All injured areas must be stabilized with dressings and splints, including traction splints