RESCUE AND EVACUATION - Medicine for Mountaineering and Other Wilderness Activities - page 78

CHAPTER 7
RESCUE AND EVACUATION
Ken Zafren, M.D.
Urs Wiget, M.D.
Principal Contributors
Withsatellitetelephones,globalpositioningsystem(GPS)navigation,andmodernairtrans-
port,fewmajorexpeditionstoanyarea,nomatterhowremote,areasisolatedasfamousex-
peditionsofthepast.Thedaysofcrossingoceansinsailingships—exceptasanovelty—are
over.Theepicstories,suchasShackleton'sheroicsurvivalafterhisship Endurance became
trapped in ice and sank, are destined to be largely historical. However, ships still sink, and
climbers still are lost and their bodies never recovered.
Expeditions still entail risk of illness, injury, and death and have limited resources for
coping with such threats. Problems are best prevented by minimizing the hazards. Ascend-
ingslowlytopreventaltitudeillnessorsailingjudiciouslytodecreasethedangerofcolliding
withanicebergareprudent.Ifpreventivemeasuresfail,thenextlinkinthechainofsurvival
is preparation for untoward events. The ability to recognize altitude illness and to descend
promptly, or providing life rafts for ship passengers and crew, are preventive measures that
can save those who otherwise might die.
This chapter has been written to aid in preparation for coping with adverse events. Meas-
urestakeninadvance,suchassecuringcommunicationsgearandsettinguprescueplans,are
essential elements of rescue planning. Other measures, such as including expedition mem-
bers with search and rescue experience and medical skills, and bringing along rescue and
medical equipment, enhance the ability of an expedition to care for and evacuate ill or in-
jured members.
DECISIONS THAT PREVENT PROBLEMS
Expeditions cannot bring along unlimited equipment. Expeditions in which members must
transport the gear may be quite limited; some may have no member with medical or rescue
training. Expeditions must carefully consider likely hazards, how to prevent them, and how
to provide for their successful resolution if preventive measures fail.
ThetransitionofHimalayanmountaineeringfromexpeditionstyle,withfixedcampsand
a supply chain, to alpine style, with climbers moving up a mountain quickly with limited
food and equipment, carried increased risk for those at the “thin end” of the rope. However,
the exponents of alpinestyle climbing justify the increased risk as necessary to achieve their
goals andattempt tocompensate forit byreaching highlevels offitness andability.Insome
ways, such efforts signal reemergence of an earlier era. Ernest Shackleton's advertisement
for the Endurance expedition read, “Men wanted for hazardous journey. Small wages, bitter