Climbing accidents happen every year—even to the most experienced climbers. The American Alpine Club’s annual reports on climbing accidents remind us of the importance of preparation and learning from these incidents. And of the importance of refreshing our wilderness medicine skills on a routine basis.
But what if you’re hours away from rescue, and your patient is in critical condition? Waiting for help can leave you feeling powerless. Instead, why not take action and initiate the evacuation process yourself? If your patient can’t walk out and must be transported, do you have the skills to construct a litter quickly and efficiently? These are the skills that can make all the difference in remote and high-stakes situations.
In today’s Wilderness First Aid courses, course curriculum is required to teach you how to build a makeshift litter utilizing everyday gear that you carry in the backcountry, but many times the only way this is taught is by utilizing trekking poles, a tarp, and large backpacks. Yet we as climbers and mountaineers find ourselves in the backcountry with minimal gear that is essential to our climbs. We rarely have that foam pad that everyone practices with!
First, flake out your climbing rope (40+ meters).
Tie an overhand or figure 8 on a bight at the working end to anchor the foot of the litter.
Lay out the rope in parallel coils, starting with smaller coils at the legs and widening toward the thighs, hips, and torso.Note: It’s easier to make longer coils initially and adjust if needed.
If possible, have someone the patient’s size lie on the coils to gauge width and spacing.
Add padding (rope bag, jackets, backpacks) over the coils and patient, protecting bony and sensitive areas.
Pad behind the knees to keep them slightly bent and make sure there is access to check CSMs.
Carefully place the patient on the padded coils and starting from the foot end, thread each bight up and through the previous one, forming a series of interconnected bights (tensioned weave) that secure the patient. These should run midline up the patient.
At the chest, have the patient inhale fully and then tighten the coils to secure without restricting breathing.
At mid-sternum, make a long bight with the running end, pass it through the mid-sternum bight, and loop it around the head and neck in a ‘V’ shape to cradle your spinal motion restriction (already built at this point). Tie it off to avoid tightening. For ropes (60+ meters), make butterfly coils with the excess and tuck them by the patient’s feet.
Have 4-6 rescuers lift and evacuate the patient. If more rescuers are available, assign one person to monitor the patient at the head and another to scout ahead for obstacles.
Communicate plan and each step with the patient.
Plan ahead for bathroom considerations while packaging.
Designate a patient advocate (can be companion on scene) to check in with patient about water, food or bathroom needs throughout the evacuation.
Provide a helmet and eye protection for the patient.
Prevent heat loss and manage shock with insulation layers.
Check patient’s CSM’s before and after packaging.
Knowing how to build, use, and evacuate someone with a rope litter are essential wilderness medicine skills. Golden Mountain Guides offers both 2 and 3 day Wilderness Medicine Courses for Climbers. If you are looking to re-certify your Wilderness First Responder, Golden Mountain Guides offers a 3-day WFR re-cert, focused on climbing related injuries and rescue techniques in both single pitch and multi pitch terrain.
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