Discussion of first aid, basic rescue equipment & training

[Joanne]

Hi all,

The tragedy in northern Nevada has the whole mine exploring community discussing rescue in a mine environment. Leaving that specific situation out of this discussion, I think that a dialog about first aid, rescue equipment, and rescue training would be appropriate. I know that the caving community has had these discussions for years and maybe we should start doing so too.

A few weekends ago when we were at the bottom of the Columbia Ken, Matt and I had a short chat about how even a minor injury down there could become a life threatening situation. The level we were at required descending a steep inclined shaft, two 175’ rappels, a tight squeeze to a 30 foot ladder into a steep stope that led down to the working level.

Let’s say that one of us fell and broke a wrist (or even a severe sprain). It would be extremely painful, but wouldn’t normally be a life threatening. However at the bottom of this mine the situation takes on an entirely different complexion. Climbing 400’ of ladders would be out of the question. Even climbing up the stope and the inclined plane could be a real challenge. Now what?

So, I think there are three parts we want to discuss:

- What items would you include in a first aid kit? (I’m not talking O2 and a defib unit. Rather items that a reasonable person would include in a kit and would be portable enough to get down to an injured person.)

- What rescue items would you stock in a “rescue kit”? In this sense I’m talking about an assisted exit rather than a full extraction of an unconscious explorer.

- What extraction scenarios would you train for given a conscious “victim” and the rescue gear list we develop?

Maybe you can see where I’m going with this...

I’m thinking it would be beneficial for our community to have some members who would be willing to assist someone in a difficult situation. I’m not suggesting that we replace the appropriate EMS authorities in a life threatening emergency, but rather that we could be prepared to assist in a situation that requires additional help for an injured explorer. I think it would make sense if we had trained folks up in SLC, Vegas, and So Cal.

Am I wasting our time or does this seem like a worthwhile discussion?

Joanne

[Mike]

Its a good thing to discuss for sure. Mine safety is #1 to all of us.

The first aid kit I carry with me in mines is very simple (for weight). It includes a small bottle of ibuprofen, stints, a series of wraps and bandages of different sizes, tweezers, a very small bottle of distilled water, triple anti-biotic, an insta-cold pack, a heat pack, gauze, 2oz everclear, and a few other basic anti-septics. Its not much, but its enough to get the basic jobs done and at least get an injured person out until he/she can get real medical attention. I also keep my CPR training up to date.

[Kiel]

Is the everclear to drink when you get hurt and just get numb and do it?

[Mike]

Pretty much! Cleaning - and climbing out of some mines takes several hours and doing so with a busted ankle could be pretty tough...

[Therrin]

I have up-to-date First Aid/CPR cards, and in the past have completed LA County EMT.

I almost always carry a small kit on my person. It has 4x4's, roll guaze, & triangular bandages. EMT Shears, Ibuprofen, alcohol wipes, antibiotic ointment, bandaids & a space blanket. I always have fresh water with me.

Then in the truck I always have a much more well-supplied medical bag.

On the last 6 trips or so I take a big rubbermaid tote in the back of my truck which is purely "rescue gear".

200ft of 5/8" rope, 1,630lb WLL 16,300lb tensile
1 - Block pulley, 2,000lb WLL, 20000lb tensile
1 - Port-a-wrap III descending device with a 5,000lb WLL
1 - Orange Rescue Rope Bag
- 200ft 7/16" BlueWater 2 Rope (new)
- 45ft 1" tubular webbing
- Petzl Rescue pulley
- 2 Steel autolockers
- 4 Aluminum lockers
- 4 Aluminum ovals
- Spare N95 masks
- Leather gloves
- 2 prussik loops

Then in my normal gear loadout that I use I have 3 other pulleys, 20 or so assorted pieces of webbing & cordage of different lengths and sizes, and an entire pile of other gear. I usually have 600' to 1000' of rope with me on various trips.

The way I see it, if it's a non-life-threatening injury, you treat as best as possible; then ideally 1 person stays with the injured and 2 people exit.
A call should be put in to an outside contact (if possible) that a on-site rescue is going into effect, so that the option of bringing in outside responders can more quickly be put into play if needed.

Grab the needed rescue gear and re-enter the mine, set anchors and create a mechanical advantage haul system to assist the exit of the injured person.

Reassessment of the situation is made on a continual basis, and factors which would cause the extraction to be unworkable or which would cause undue threat of harm to either the injured or the rescuers will scrap the self-rescue and outside aid will be immediately notified.


First, I realize there are two immediate arguments to this situation.
1. Why notify outside personel and risk getting the ball rolling if you don't need it?

Answer: Because the risk of not getting the ball rolling could be greater. Assume that Mr. Murphy will poke his ugly little head in somewhere and mess with things. Also, if your outside contact isn't notified of progress within a strict time limit, they can call in a full scale rescue, if for any reason your crew becomes fully trapped or injured.

2. Why even attempt an on-site immediate rescue, instead of just calling in outside assistance from the get-go?

Answer: It truly depends on the severity of the situation and the dynamics of the mine that you're in.
Anyone who has never had rescue training, or is uncertain of their ability to facilitate an immediate on-site rescue should call in outside help as the first step.
However, if you have the equipment and training to rig a rescue system for whatever specific situation that a NON-LIFE THREATENING injury occurs, then doing an immediate rescue will prevent a lot of bad PR for mine explorers everywhere, and will likely remove the injured person on a faster time-frame.

No two rescues are ever the same, you can train on the basic skills used during a rescue, but in every situation your skills must adapt to what you're faced with.

There are countless hybrids to a rescue situation. Depending on the injury, you could arrange for an ambulance to meet you on-site after an exploration crew rescue has been performed.


Rescue beacons are very affordable these days and come in several different varieties.
Spot and ACR are two of the most widely used, and each has it's own pro's and con's.
I think every exploration crew should make an effort to have one of these devices in their loadout on trips.

[offroadcmpr]

One thing that I learned from a mishap a couple years ago when a friend slid down some ice and busted open his leg is that the small little band aid's are not going to be much help. We ended up using a t-shirt to stop his bleeding. I realized that the small stuff that comes in most first aid kits don't do much in a real emergency. A small cut that slowly bleeds on the way out of a mine won't be a problem. Once you get out you can worry about the small stuff, but while in the mine it is the large stuff that you have to worry about. After that hike I started carrying a bunch of gauze pads and some wrap because the handful of small band aids won't help.

[Mike]

Bandaids are for the weak, feeble, and scared.

[Mike369]

I carry a small first aid kit with some basic trauma stuff in it (triangle bandages, quikclot, 4x4s, sam split, etc). I also carry some super glue and some gorilla tape. Numerous times (not just in mines) I have found myself with a laceration that is less that 2" but bleeds profusely; the gorilla tape holds it together and the glue works like stitches. I use gorilla tape because it will literally stick to anything wet or dry. I agree the small stuff can usually wait since you aren’t likely to bleed out from a small cut but the blood sure gets annoying.
Also everyone knows that duct tape can fix anything!

[acidman1968]

Being as I haven't explored IN any mines, I don't have any specific gear for rescue that I carry along. However, I typically carry along some basic first-aid supplies - as well as my pistol, knife, fire starter, extra ammo, food, warmer clothing, etc. in my day pack when I go hiking/exploring...

...and one of these days, a GPS will be an addition to my gear that I tote along.

In the truck, I carry an EMT kit from when I was a certified EMT, and just for "s**ts and giggles", I carry a DOT Emergency Response Guidebook as well - so if I ever come across a wrecked semi with placards on it, I'll know how far I need to run away.

[Therrin]

One thing that I learned from a mishap a couple years ago when a friend slid down some ice and busted open his leg is that the small little band aid's are not going to be much help. We ended up using a t-shirt to stop his bleeding. I realized that the small stuff that comes in most first aid kits don't do much in a real emergency. A small cut that slowly bleeds on the way out of a mine won't be a problem. Once you get out you can worry about the small stuff, but while in the mine it is the large stuff that you have to worry about. After that hike I started carrying a bunch of gauze pads and some wrap because the handful of small band aids won't help.

Sorry bro, I gotta disagree on a bit of this. Bandaids are actually great for smaller cuts that don't require 4x4's or roll guaze. It's easily possible to cut fingers which will bleed quite a bit. If you're at the BOTTOM of a few sets of vertical ropes, that you still have to ascend up; I'd rather be a wimp and use bandaids to both keep my hands from becoming slippery and sticky with blood, and to keep from having to use "the big stuff" to turn my hand into a mitt, effectively losing my dexterity.

Also, consider that you're right in the first hour or two of your trip but you don't want to wrap your entire hand, or walk all the way back out for a bandaid. If you're in somewhere like War Eagle (a silver mine), silver's main ore is galena, which is mostly LEAD. I'd rather bandaid the small stuff to effectively seal it and have a worry-free 4 to 8 hrs more of exploration.

Now those little tiny bandaids...CRAAAAP! But the nice big beefy ones are hella handy.


People who mostly do not use vertical access while in mines probably have different ideas than those who need the use of their hands to get back out.

[ryan162]

i have two of these on hand at the top. i probably should bring one down with me

http://www.youtube.com/watch?v=wMRklQkfDLE

[Joanne]

I carry a small first aid kit with me. Like most of you I have tweezers, a magnafying glass, triple antibiotic ointment, band aids, 4x4 gauze, bandage, butterflies, and tape. Certainly not a trauma kit, but just enough to take care of a minor mishap.

I used to have a pretty comprehensive kit that I kept in my car, but 30 years after my EMT training would items like a BP cuff and stethascope really be of use? That said, I do think I will start gathering a more fully stocked kit for the vehicle. I travel quite a bit in remote parts of the state and it wouldn't be unlikely to come upon an accident where EMS response might be an hour or more away.

With regard to rescue equipment, I would like to get a couple of high quality pullies for rigging a haul system. I think a small rigging plate would be useful as well. I have a couple of steel mallions and may grab a couple more just to ensure a safety margin with rescue loads.

One last thing that came to mind is food and water. Most of us who are out for the day don't really prepare for an extra day "on site". Here in the desert drinking water is crucial. A couple gallons of water and some MREs would make a stressful situation a bit easier for all involved.

I've read some 4x4 forums where the discussion turned to preparadness gear. I swear that some of these folks have to be pulling a 20' box trailer behind them for all the gear they haul. Of course when they get home without needing any of it, nothing is harmed. Break down or get injured in the middle of nowhere without it, might be a different story.

Joanne

[Norman Johnson]

I camp about every other weekend year-round in the desert or local SoCal mountains. I have a first aid kit, but most of my first aid needs are more specific than what the kit has. Leatherman pliers are crucial for cactus thorns--either for yanking them from me or the dogs. Then there are the analgesics--Tums, Benedryl, Motrin, cold remedies, asprin, Pepto tablets, bandaids, super glue (works great on many cuts), foot powder, etc. A small bottle of Kaopectate can rescue a camp out.

First aid is about great injuries and saving lives, but largely neglects all the common ailments that are what we really encounter on most of our trips. Don't be caught unprepared. By the way, I have been in hundreds of mines and try not to do something that will require more than an asprin or some Everclear and oj.

NJ

[Therrin]

Funny that we just started talking about this. I had an emergency situation last night.

In the cop car on the way to the ER.



We had drove/hiked 6 miles into the backcountry to hit a mine site. We had set up camp, and it was dark outside and getting verrry cold, so we started a fire in this big steel box of a stove. Went around gathering and breaking up firewood to fit in the thing. We were placing the wood against this rock ledge and busting them up to make the pieces short enough to fit. Had done it prolly a hundred times over already, over the hours.

I placed a smallish piece of wood down, and broke it with my foot, but the upper edge of it had caught a lip of rock and hurled the 10 to 15lb piece of rock straight into my face. Completely demolished my glasses, headlamp went flying, and I ended up sprawled out on the ground. About 10:30pm.

My right eye felt very strange, hurt like crazy, had blood pouring over my face from a gash above my eyebrow, broken vessels in my eye... had to get out my spare glasses and my mini-medkit that I had previously mentioned on here. Had blood soaking through the 4x4's for a bit, but it finally stopped bleeding. Taped around my head to fresh 4x4's. Couldn't hike out at night... too far, too cold, terrible roads. Too much pain.

Ended up leaving early in the morning. Arranged with my dad for a CHP to meet me at the nearest road, then drove me code 3 to the hospital 60 miles away. I was in so much pain from every bump and jolt on the way coming out that I was crying nonstop, and moaning; and I usually have a high pain tolerance.

Got rushed through the ER sign in, got a cat scan, my bones are all fine, no bleeding in my brain; but my eye is bleeding on the inside and from behind. The pressure in my right eye is at 40. (12 being normal). Got a shot of morphine, and 3 kinds of eye drops and some oral meds.
I have to see my opthalmologist tomorrow morning, and each following morning for a week.

So, I'll know more tomorrow. Till then I've got this plastic shield taped over my eye, and loaded down with medications and pain killers.

I was within a hair or having a medevac flown in, from the intensity of the pain last night; almost more than I could bear, and had no idea what was happening inside my head. Just cried and screamed a bit and made it through the night.

It gives a perfect example of a bad situation that would be easily taken care of when you aren't stuck in the back country.

In the ER about to be released.

[acidman1968]

Dang dude, that's a bit on the scary side... I've almost been whacked by a piece of wood like that myself in the past.

Hope everything works out for you and that there's no lasting damage!