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Video of fall

Buff Johnson · · Unknown Hometown · Joined Dec 2005 · Points: 1,145
Jeffrey Butler wrote:Good to see lots of useful discussion about this journal entry. Use it to make yourselves better climbers; better people.
This is a good point and thinking on it over the eve. Let's say our partner did go down with a spinal, even though falling is not an option here; it happened. Now what?

Like I said, your start in this process is assessing mental capacity. If they lost consciousness or went otherwise incoherent, assume spinal. In reality of what happened here, the climber has mental capacity and they basically cleared their own c-spine; forcing your own would-be rescuer actions doesn't make the situation better.

However, let's assume spinal. Still go for the lower off the belayer, it's quick and with the least risk. Knowing you're within the half-way point is a bonus. What you see in the video is the climber self-correcting with a roll as he probably started getting his airway shut down at that snow transition. It is important to recognize that situation set up on itself.

You'll need a little bit of a team effort. The belayer is in the system and can't do much. When it basically became a top rope lower like this, you can still do a few things if you have people around.

Keeping in mind the true mid-wall is tough, only you and your partner, so basically you. It's situational between airway, breathing & circulation as to spinal to where you can induce neurogenic shock from a move as well as terrain/anchor position and your safety, more help would be good. Geeze that PLB/cell phone/screaming your f'n head off is a an idea as well as thinking about some of those thoughts that Ryan had on other systems coming in.

Back to this top-rope lower with people around. First thought you might have is go for the head like you learned in your responder class; must direct manual in-line stabilization...unfortunately, you'll lever their neck when their main body comes down.

What you want is either supporting the climber without fully committing to their head and rotating their torso to that vertical sit-up position, or between a couple of you, lock in the climber's head to shoulder as one unit with your arms and have your helper rotate the climber's body to the supine, laying down face up. Stop the lowering and let the system take the weight until that transition can be made.

This is a terrain dependent decision where that transition in the ice to snow happens. In this one, I would have flipped him over and gone for the sit-up. Go for the least amount of levers on a person's body and keep the airway open to the final resting position. This is basically a rapid extrication situation.

In this one if there was a spinal & once on the ground, you then want to look at an organized rescue evac, which will take time. So plan on hypothermia protection and protecting them from the scene's objective hazards.
Derek W · · Unknown Hometown · Joined Jun 2008 · Points: 20

Regarding medical care, I agree with Mark. Maintaining c-spine isn't generally a life/death procedure. (EDIT: by maintaining, I mean, committing to the head and holding that direct manual in-line stabilization. If the patient has good LOC/LOR and no distracting injuries, survival instincts tell them not to move their head and they will maintain that on their own. Usually...) Yeah, if this guy was on the sidewalk, get that c-spine right away to prevent further injury/complications.

The things that might kill this guy are ABCs and complications for a closed head injury.

The guy is hanging upside down, increasing the intracranial pressure (pressure on the brain!). The time it would take to lock off, escape belay, set up a new belay for a climb to the climber, stabilize c-spine (how?), set up a new/reinforce the old anchor to lower the PT while maintaining that c-spine (how again?). I don't see it's worth it. Nor do I see a good way to neutralize the PT's body position in this situation. Yeah, as others have noted, trying to keep the tuck'n'roll from going on at the end there would have been nice. Like Mark said though, the patient will tell you what they can and can't do most of the time barring AMS/distracting injuries. Just remember to think about what is going to kill this person first and address that. What the text book tells you to do and what the situation tells you sometimes don't line up...

Martin le Roux · · Superior, CO · Joined Jul 2003 · Points: 401
Tyson Taylor wrote:...I'm surprised that he didn't get stabbed by his tools. I'm no expert on ice. I've only top roped less than ten routes. Am I wrong in my decision to go with leash-less tools based on the risk of being stabbed in a fall? I understand that falling is unacceptable in the first place, but it definitely can happen. Seeing those tools swing around his face while he was falling was terrifying. He could have easily been impaled. Being able to pitch the tools away during a fall is nice if you can avoid the death grip response. Leashes seem to be more trouble than they're worth IMO.
Falling on ice is dangerous because of your crampons, not your ice tools. Here's what Will Gadd had to say ( gravsports.blogspot.com/201…):

"Why falling on ice is more dangerous than falling rock climbing:

"Crampons tend to catch on the ice. Even a very short (less than three feet while bouldering) can create enough energy to break ankles and legs. A friend of mine was bouldering three feet off the deck over flat ground and jumped off mostly in control, compound lower leg fracture...

"If the crampons do catch they tend to flip the climber upside down very fast, as happens in this video to some extent...

"Oh, and you can stab yourself with the ice tools too, but I actually haven't seen that done too many times."
Jeffrey Butler · · Elkton, VA · Joined Mar 2011 · Points: 10
Rob Gordon wrote:Okay Jeffery, your attitude about our discussion not being as "elevated" as that of the UK Climbing site is so off base....So honestly, take your promotion of your horribly titled film somewhere else. And your completely ignorant condescension with it.
Rob, maybe I have no business in this climbers thread but you are off base; I never mentioned this thread; never implied it, either; I said elsewhere, and that's true. I see lots of meaningful discussion going on here. That was exactly what I said in my first post, wasn't it? In fact, I thought it so good, I thought this thread would actually give a rip about some other serious conversation going on.

I only ever said I had trouble climbing out of bed, so as to the technical merit conversation, I'm not in it, but for what it's worth, you're projecting a lot of untrue motive and attitudes on us. Project away, tho. All I did was tell a true story.

Cameras affect us all; no doubt mine did, too. They can change behaviour. So you really think my presence was 100% of the reason he fell? First I've heard that hypothesis. Many seem not to support your argument.

As to the title, we glory in ourselves quite a bit for all kinds of reasons. Sometimes that makes us do stupid things; aware or unaware. Grace very much implies unmerited favor. Not dying is pretty favorable. To each their own I guess.

"I need a lot more time on TR before I start leading again. This was a good lesson"...that's all this is supposed to be. Seriously. And it's only a home movie; my personal journal entry.

So thanks for the feedback,

jeff
Derek W · · Unknown Hometown · Joined Jun 2008 · Points: 20
Rob Gordon wrote: ...with a harness that's not double-backed and the belayer is using the belay device completely incorrectly.
He's using a Kong GiGi right? I've never used one but this is how I pictured it to be used. How was he doing it wrong or how should you belay with one?
Rick Blair · · Denver · Joined Oct 2007 · Points: 266
Wehling wrote: He's using a Kong GiGi right? I've never used one but this is how I pictured it to be used. How was he doing it wrong or how should you belay with one?
Instructions say not for belaying a leader, it is strictly a plaquette device. I take issue with the Rock climber vs Ice stuff. I am not an Ice climber at all, have never swung a tool, never done it, but most of the mistakes were pretty obvious to me.
Kai Huang · · Aurora, CO · Joined May 2008 · Points: 105
Wehling wrote: He's using a Kong GiGi right? I've never used one but this is how I pictured it to be used. How was he doing it wrong or how should you belay with one?
looks like he was using it like a regular atc.

however, it should be clipped through one of the holes on each end and an extra biner between the ropes and the device, like how you would use a reverso directly from an anchor.

KONG GI GI
aviarome · · Yarmouth, ME · Joined Nov 2010 · Points: 0
Mark Nelson wrote: Like I said, your start in this process is assessing mental capacity. If they lost consciousness or went otherwise incoherent, assume spinal. In reality of what happened here, the climber has mental capacity and they basically cleared their own c-spine; forcing your own would-be rescuer actions doesn't make the situation better.
There's probably some miscommunication here. I agree that when you start you do assess ABCs and mental capacity/injury. But loss of consciousness, or altered mental status is a sign of brain injury, not spinal injury. Being coherent and oriented does not clear the c-spine. I think you may be confused between brain injury and spinal cord injury.

Also, in my previous post, I was just assuming the patient was on the ground, like when the ED doc arrived to help.

I think they did a good job with the lowering, and I agree with you that lowering the patient first was probably the best way of handling the fall. But I do believe that once the guy was on the ground, someone should have maintained c-spine immobilization. All you have to do is tell someone to hold his neck in-line, like the videographer or another bystander, and you assess the ABCs and onward. ABCs are always first, but the C-spine immobilization is basically simultaneous.

What I was saying is that, considering the fall, it is not out of the question to think he might have had a c-spine injury. If the c-spine was damaged at C3 or above, it is quite possible that the patient would not be able to breathe, because the diaphragm would be paralyzed. The patient could still be awake, just struggling to breathe. That's why someone or something should hold the neck in-line at whatever moment that it becomes possible, and hold it until the c-spine is actually cleared. It has nothing to do with consciousness or brain injury (well, if there is brain injury/AMS present, then yes), but if the spine was unstable for some reason, and the patient started to squirm and move, and then the spinal cord really becomes damaged at C3 or above, then it would be very problematic. Having someone hold the c-spine at whatever moment they could doesn't affect how the rest of the medical management continues (although it might suck for the person maintaining the c-spine).
Derek W · · Unknown Hometown · Joined Jun 2008 · Points: 20
aviarome wrote: I agree that when you start you do assess ABCs and mental capacity/injury. But loss of consciousness, or altered mental status is a sign of brain injury, not spinal injury. Being coherent and oriented does not clear the c-spine. I think you may be confused between brain injury and spinal cord injury.
Mark has his ducks in a row aviarome. He is basically talking about the NEXUS criteria for clearing a spine (only certain levels of certification are able to "clear" a spine) Using the acronym NSAID, PT does not display Nuero deficit, Spinal tenderness (you say the ER doc checking), Altered Mental status, Intoxication and Distracting injuries. If the patient does not present any of these criteria, a provider of certain certifications can effectively clear the spine. And as you heard, the ER doc was who recommended the patient slide under his own power down the hill to the car. Certainly he's not as worried about c-spine issues.
Sir Camsalot · · thankgodchickenhead, Ut · Joined Sep 2007 · Points: 201

Geez strokers, why the big 12 minute production about a fall? It wasn't even that impressive.

Rob Gordon · · Hollywood, CA · Joined Feb 2009 · Points: 115

Wehling... Here's a review of the Kong Gi Gi from Supertopo, It states in the cons: "Can't belay a leader." I'm not familiar with the device at all. Clearly these climbers weren't either. So they shouldn't have been using it at all.

supertopo.com/review/Kong-GiGi

Jeffery... I was referring to this quote of yours on the UKClimbing thread you told us to check out, and on which you condescended to other forums, of which this one would be included.

"Really glad to see this elevated level of discussion here. Quite frankly, I'm impressed. You guys are talking about the right stuff. Not fully the case in other places."

Who are you to know what the right stuff is? Like you said you don't climb. Mark Nelson and others on this site are talking about the best way to rescue an injured climber. I'm certain continuing to roll the camera is not one of them. I've helped a handful of climbers in situations that range from them being stuck, to them facing a ground fall if I hadn't stepped in all caused by incompetence and cockiness. Incompetence and cockiness have very little place in climbing... except for English Trad =).

And no, I did not mean you are 100% to blame for his fall, I meant 100% certainty you contributed to the events that led to it.

Not trying to get into a pissing match, but I just don't appreciate you "a non-climber" coming on to a bunch of climbing forums and spouting about.

Jeffrey Butler · · Elkton, VA · Joined Mar 2011 · Points: 10

Come on, dude Rob. Go read my very first post on this thread. That WOULD EXCLUDE this forum from the UK comment, defacto.

You can keep the cheap shots.

Tim Stich · · Colorado Springs, Colorado · Joined Jan 2001 · Points: 1,520

It's good that these guys posted the video because it always brings up a lot of interest in what things can go wrong. And by going wrong I mostly mean not learning how to do things right or use gear correctly. It's pretty ridiculous how fucking specialized a lot of gear is now, from ATCs with one slot meant to be sold to climbing gyms to fucking belay plates for bringing up seconds but not for lead belaying. WTF? Do guides really need those?

In any case, many of you out there learned how to climb without any formal training. In addition, you probably had just one other friend or just a small group of friends that you were learning the ropes with. This is just the outcome of that. You think you have certain things figured out from various successes and then something bad happens and it exposes just how much you didn't know and in how many areas. It's embarrassing and frustrating to be so self-deluded.

Sometimes you just get egg on your face, but other times you get really hurt or your friend dies at your feet from his multiple injuries taken in a fall. I'll tell you one thing, when your friend gets killed from both of your stupidity, no amount of name calling, joking, or snide remarks on any website matters. That is all meaningless. The deep regrets you hold for being ignorant and complacent drown all of that out.

So don't feel too bad joking around if it keeps the discussion going on. Seriously. See if you can get these guys laughing with you and at themselves at some point. Then they will start to hear what you are saying and learn something from it.

We all want each other to have fun and not fuck up out there.

climber76 · · Loveland/Vail, CO · Joined Jan 2006 · Points: 130

I think that having a sling and biner set up to clip the pommel of the ice ax in an emergency is incredibly important. Will Gadd points this out, and I would like to reinforce the idea. I girth-hitch a sling with a keylock binner to my harness. I stuff the loop into the harness, and leave the biner dangling free at waist level, so that if my hands are frozen, I can just grab it without having to fumble with unclipping it. I have heard of people looping the rope over the tool's pinky hook for the same effect, but that seems like a poor substitute given the fact that the direction of force on the tool and the effect of rope stretch is less predicatble if the belayer takes to hold the climber. Also, climbing with leashes might prevent you from dropping the tools, but in all other ways it just seems more complicated, and thus more dangerous.

aviarome · · Yarmouth, ME · Joined Nov 2010 · Points: 0
Wehling wrote: Mark has his ducks in a row aviarome. He is basically talking about the NEXUS criteria for clearing a spine (only certain levels of certification are able to "clear" a spine) Using the acronym NSAID, PT does not display Nuero deficit, Spinal tenderness (you say the ER doc checking), Altered Mental status, Intoxication and Distracting injuries. If the patient does not present any of these criteria, a provider of certain certifications can effectively clear the spine. And as you heard, the ER doc was who recommended the patient slide under his own power down the hill to the car. Certainly he's not as worried about c-spine issues.
Ahh, I understand. I was peripherally aware of the NEXUS study, but given the mechanism of injury, I would politely disagree, which has always been a criticism of the NEXUS study vs some of the other algorithms. But, you are absolutely correct, there was a physician on-site that obviously can assess the situation better than what one could get from the sporadic video footage.
Derek W · · Unknown Hometown · Joined Jun 2008 · Points: 20
aviarome wrote: Ahh, I understand. I was peripherally aware of the NEXUS study, but given the mechanism of injury, I would politely disagree, which has always been a criticism of the NEXUS study vs some of the other algorithms. But, you are absolutely correct, there was a physician on-site that obviously can assess the situation better than what one could get from the sporadic video footage.
Well said. Can't say I don't agree with the MOI argument. Tough situation overall; "damned if you do, damned if you don't" as they say.
Guideline #1: Don't be a jerk.

Ice Climbing
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