RESCUE AND EVACUATION - Medicine for Mountaineering and Other Wilderness Activities - page 84

occupant to shift position. Straps tied around each foot and secured to the side of the litter
are sometimes used but do not work if the knees are bent or a lower extremity is injured.
In mountainous or glaciated terrain, occupants should wear a climbing harness that can
secure them to lowering or belay ropes and prevent sliding lengthwise in the litter.
High-Angle Terrain
In high-angle terrain (also referred to as technical terrain), the expedition usually would
be carrying ropes and anchors. An ill or injured person who can assist the rescuer can be
lowered on vertical terrain using a tragsitz (German for “carry seat”). The original trags-
itz was made of canvas, and today the device is available with additional fabric choices.
The method described in “Improvised Transportation” later in this chapter accomplishes
the same task without a fabric seat. A rescuer splits a long coil of rope into two joined
coilsandputsthecoilsoverhisshoulders.Theinjuredpartyputsonelegthrougheachcoil,
which can also be joined in front of the rescuer, and the rescuer and the injured person are
lowered down a cliff or very steep slope. This technique is easiest in truly vertical terrain.
Both the injured person and the rescuer must be tied into the lowering line.
With the tragsitz technique, single rescuers could lower themselves and injured persons
on rappel. Rappel brakes must be located well above both individuals, both of whom must
be secured to the braking system.
Another method for accomplishing the same reresult is the single rucksack technique
(also described in “Improvised Transportation”). Rescuing an unconscious or severely in-
jured person from vertical terrain using improvised gear can be a desperate undertaking.
Although many rope and fabric stretchers have been described, none provide significant
back support. Some can bestiffened with skis orski poles, butthese are notoften available
in a vertical environment. In a pinch, an individual could be lowered in a sleeping bag, es-
pecially if a bivouac sack and sleeping pad—and preferably some other means to stiffen
the system for back support—are available. Suspension of some rope litters through loops
as tie-in points would be straightforward, but fabric carriers—sleeping bags and bivouac
sacks—typically lack tie-in points, so a harness for the litter would still need to be con-
structed. As with all rescue systems on technical terrain, the injured person and rescuers
mustbedirectly securedtotheloweringlineortothesuspensionsystemandnotjusttothe
stretcher.
The rucksack stretcher (described in “Improvised Transportation”) can be used. Ruck-
sacks are not designed to hold a human load but are generally quite strong, and this system
provides substantial back support. Properly suspended horizontally from a harness, which
is often referred to as “spiders,” the rucksack stretcher would function like a litter on a ver-
ticalornear-verticalevacuation.Aswithallevacuationsfromtechnicalterrain,therescuers
and the disabled person must both be belayed, with both wearing climbing harnesses. Both
persons are usually tied to the spider system, never directly to the litter. If the litter system