Backcountry rescue during a pandemic - food for thought

[snapt]

Tight seal lasts about how long when you’re wrestling with a suffocating victim to intubate?



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That’s why we give them a paralytic.

Didn’t we learn from Ebola that one of the major sources of transmissions was doffing masks? I certainly wear mine at work but when out and about at the store and such where I’m keeping a safe distance I’m a little leery of masking for the sake of masking as it’s only going to increase my hand to face contact.

[sfotex]

To covert's point, yes.

But in that analysis, there's something about risk versus reward that should factor in the effect of failure or error. And like OG wrote, an avalanche isn't contagious and doesn't have the same ripple effect.

But I still think coverts point is valid, it's just that it has to be applied in context.

"With great risk comes great reward." - Thomas Jefferson

We have had a few calls in the last week for minor injuries close to the trail head. We were able to minimize exposing the whole team, use PPE, etc. Pretty low stress for everyone. We also had a major accident we dealt with and all that went out the window. I was in close contact with the patient along with ~6 other first responders. I got nailed in the shoulder by a bowling ball size chuck of ice and took a hard hit to my helmet. Our Lieutenant wanted me to go the hospital out of precaution but I told him I would go in a week if it still hurt, I didn't want to deal with the whole healthcare mess for a precaution. I just had an ER nurse look at it at the trailhead.

Personally I'm ok with people getting out and doing low risk stuff - stuff that most of us would consider a bit boring. I'm starting to feel that 'getting after it' is a bit selfish right now.......

[summit]

Why is infection hazard different than other hazards like weather and avalanche?

If the exposure to avalanche hazard is unacceptable, don't go. If the exposure to any hazard is unacceptable, don't go.

Isn't that the most basic tenet of incident command?

In hospitals around the nation, nurses, doctors, respiratory therapists, housekeepers are being ordered to give care with suboptimal or improper PPE to patients known or highly . Cannot think of the best mountain analogy for not having PPE for a contagious disease... maybe doing swiftwater without a PFD... but rescuing the rescuer happens later.

The problem with COVID in mountain rescue is we may not have obvious signs that the patient, or a fellow rescuer, is contagious, and so one has to use PPE on presumption and the PPE doesn't work well if it is available. If the patient has a cough or a fever, I guess that is more obvious, but they probably weren't climbing the mountain...

This story is from today about a rescue last week on St. Mary's glacier. It is part of the county closed the county roads and trailheads to nonresidents.
https://theknow.denverpost.com/2020/...avirus/237147/

[MiddleOfNight]

Recent example: Sledder caught in slide and hurt, rescue responded, and guy flown out to hospital.

https://www.aspentimes.com/news/snow...pendence-pass/

One careless snowmobiler could have infected their rescue team, flight crew, all the medical staff, responding cops .. everyone. That's a real thought.

Trying not to judge, cause of course it wasn't intentional.
But it seems pretty selfish to put that many people at risk. At any time really, but especially now.

[new yabyum]

That’s why we give them a paralytic.

Didn’t we learn from Ebola that one of the major sources of transmissions was doffing masks? I certainly wear mine at work but when out and about at the store and such where I’m keeping a safe distance I’m a little leery of masking for the sake of masking as it’s only going to increase my hand to face contact.

Is rocs still the go to for paralytics? sucs still being used?

[snapt]

Is rocs still the go to for paralytics? sucs still being used?

Sucs is probably the go to prehospital. I’ve seen it used a fair bit as the initial in OR as well. We carry both. MH is a big deal in this part of the world so Roc is a bit safer without a good history.

[new yabyum]

Thanks, been five years since I cracked open RSI kit.

[Ottime]

If I leave my cell phone at home and don't leave a note is it morally acceptable I go climb a mountain? (I don't really care about your opinion when it comes to my business but just curious what people think)

How about you stop hiding and posting. Coward.

[Ottime]

this. that is all.

I shouldn't have to repeat this over and over but the risk of infection is to you, all the rescuers, the people at the hospital who care for you, the hospital workers who don't have enough PPE because it was used taking care of you. An acceptable level of risk for you is not an acceptable level of risk to impose on others. This is something that we all should do much, much more often--consider the effect of our actions on other people, both people we know and everyone else. This American idea that freedom means being able to do anything you want without worrying about how it affects other people, an idea that is expressed over and over in the Covid threads, has to die, not just for Covid, but for everything.

[Ottime]

Pu mask on before going into store. Don't touch mask in store. Come on, you have will power. You can do it. remove mask before getting back into car.

I use a buff, so I just throw it into its own bag and wash it when I get home. Not that hard.

You are not protecting yourself with these masks. You are keeping your spittle from spraying into the air. Nothing like ebola and doffing.

That’s why we give them a paralytic.

Didn’t we learn from Ebola that one of the major sources of transmissions was doffing masks? I certainly wear mine at work but when out and about at the store and such where I’m keeping a safe distance I’m a little leery of masking for the sake of masking as it’s only going to increase my hand to face contact.

[Buster Highmen]

"With great risk comes great reward." - Thomas Jefferson

Well, yeah, but that's only the success part of the analysis.

Personally I'm ok with people getting out and doing low risk stuff - stuff that most of us would consider a bit boring. I'm starting to feel that 'getting after it' is a bit selfish right now.......

This. But that begs the question of whether people can think of the consequences beyond themselves, the context now is different.

[bodywhomper]

when out and about at the store and such where I’m keeping a safe distance I’m a little leery of masking for the sake of masking as it’s only going to increase my hand to face contact.

Isn’t the point for most to wear a mask when out and about for them to not be accidental spreaders in case that they’re pre-symptomatic or asymptomatic? Appropriate distancing does not always seem possible in some areas/circumstances.

Another story:

https://m.facebook.com/todd.vogel.12...92637004115233

[old goat]

That’s why we give them a paralytic.

Didn’t we learn from Ebola that one of the major sources of transmissions was doffing masks? I certainly wear mine at work but when out and about at the store and such where I’m keeping a safe distance I’m a little leery of masking for the sake of masking as it’s only going to increase my hand to face contact.

Ebola isn't a respiratory pathogen.
Like the man says, primary purpose of the mask is to protect others (a lot to ask of Americans, I know)
I believe the risk of inhaling the virus is greater than the risk of mask to hand to face transmission.
My routine--after loading groceries into car I use hand santizer, doff mask into a plastic bag, sanitize hands again, don't touch face, wash hands at home after unloading car.

[TBS]

Recent example: Sledder caught in slide and hurt, rescue responded, and guy flown out to hospital.

https://www.aspentimes.com/news/snow...pendence-pass/

One careless snowmobiler could have infected their rescue team, flight crew, all the medical staff, responding cops .. everyone. That's a real thought.

Trying not to judge, cause of course it wasn't intentional.
But it seems pretty selfish to put that many people at risk. At any time really, but especially now.

Similar situation here about three weeks ago. Sledneck tourist from AZ got lost. The guy was an “experienced snowmobiler” who was wearing “black snow pants, a bright green snow jacket, a bright green pack, an unknown colored helmet, and tennis shoes”

When his feet got wet he wore his gloves as shoes

Hard to tell from the article how many rescuers involved. A minimum of 21, and 32 if the overnight teams did not go back out the next morning.

https://ktvz.com/news/deschutes-coun...ensive-search/

[sfotex]

Well, yeah, but that's only the success part of the analysis.

That quote came up when we had an accident during a body recovery. We took on some extra risk to save time, but there was nothing to be gained.

We do a response assessment at the start of a missions (RADeMS) and reevaluate as needed.

I've seen some people say stuff like 'Well, I just won't call for help if I get in trouble in the BC during this covid stuff' , which is BS. If you or your buddy gets hurt badly you are going to call 911. And someone is going to go out to help.

We do the response assessment to identify risks and manage them. That might be 'don't use the helicopter in this weather' to 'we can't navigate this terrain in the dark, we're going to wait until the morning' , 'we will wear masks' , but someone is always going to go and deal with the mess.

And if you are wrapped around a tree with a broken femur most crews are going to accept some more risk. That might be trying to get into a trickier LZ vs. going in from the ground or going a little faster and lighter then is ideal. That's where good training and a good head keeps your neck safe. And yes, I know there is a difference between stupidity, getting lucky, and being skilled.

[covert]

We are worried about one patient exposing the whole team at the same time and wiping out our ability to respond. We have some team members on the team that are a little older. We got issued one mask each. We were able to round up some more, but trying to wear a mask when your working hard in the mountain with a litter, etc. is a pain.

Yeah, that's exactly my point. I don't think teams should respond to a situation that entails such risk.

[frorider]

https://www.outsideonline.com/241086...kiing-covid-19

We all have cabin fever, and we all want to be out there. And we all think that everyone else will be at home and so it’s OK if I go. Here’s an example of what happens when things don’t go according to plan....
I work in a hospital in an infection hot-spot (Seattle) - it’s not a place you want to be if you can help it. 25% of COVID positive people have no symptoms, and we are currently treating all patients as though they are COVID positive if they undergo high risk procedures (like an anesthetic, or an endoscopy).
Please think about risk before recreating outdoors on skis or your mountain bike - and not just your risk, but the hazard you are potentially causing to the first responders (50 in this article), and to those of us working in high-risk areas of the hospital.
Please note I’m not telling anyone what to do, or what not to do, I’m just adding a data point to help you make a decision that may have ramifications beyond impacts on you alone.

Here’s a 29 page thread that digs in deeply to your topic, in case you’re interested: https://www.tetongravity.com/forums/...es-of-COVID-19

[coldfeet]

I see where the sense of adventure, independence, and human spirit is with most of you. I'm guessing most of you are either from urban and/or east coast judging from your responses (or Colorado which is just as bad)

What if you get severely butthurt while trolling? Is it responsible to troll under these conditions, knowing that the culture of SAR is to come get you whether you left a note or not?

Just go out and troll, but do it somewhere where you can manage the risks and won't get your feelings hurt. Go troll-running instead of BC skiing if you need the sunlight and adrenaline.

[bodywhomper]

Another incident. SAR was called off because of ability to self rescue


https://www.esavalanche.org/content/...he-piute-crags

Here’s one of the potential rescuers pov:

https://m.facebook.com/todd.vogel.12...92637004115233

[MiddleOfNight]

We do the response assessment to identify risks and manage them. That might be 'don't use the helicopter in this weather' to 'we can't navigate this terrain in the dark, we're going to wait until the morning' , 'we will wear masks' , but someone is always going to go and deal with the mess.

And if you are wrapped around a tree with a broken femur most crews are going to accept some more risk. That might be trying to get into a trickier LZ vs. going in from the ground or going a little faster and lighter then is ideal. That's where good training and a good head keeps your neck safe. And yes, I know there is a difference between stupidity, getting lucky, and being skilled.

Yep, def same here.

Makes a guy wonder though, if people knew there was no rescue team to come get them .. would they make different/safer decisions?
Ultimately that's what we're talking about - if the team (or a sizable portion thereof) goes down with the plague .. then what.

We're kinda trying out a 'designated survivor' program in case it comes to that.

[EdAbbey]

How about you stop hiding and posting. Coward.

Excuse me? This doesn't even make sense. Where is this clown from?

[skiJ]

If I leave my cell phone at home and don't leave a note is it morally acceptable I go climb a mountain? (I don't really care about your opinion when it comes to my business but just curious what people think)

comments to follow

[skiJ]

I see where the sense of adventure, independence, and human spirit is with most of you. I'm guessing most of you are either from urban and/or east coast judging from your responses (or Colorado which is just as bad)

see below -

[skiJ]

to a comment :
' how about you stop hiding and posting, (Coward) '

Ed. replied ,

Excuse me? This doesn't even make sense. Where is this clown from?

and I see your last --


my impression is :

your suggestion was - you want to continue to engage in "adventure" , figuring If you take no means of communication and leave no communication about Where you are going, that relieves SAR from responding when you get in Trouble --

in other posts, you demonstrate an at-least fundamental understanding of SAR -
accepting that it is True that you have a fundamental understanding of SAR,

I do not believe it is responsible to promote the idea of pursuing "adventure" at this time, Because that is not the way SAR works in North America :
If SAR receives a report someone may be missing ( a vehicle left at an access point for an extended period... ) , SAR responds.

SAR responds --
Many of these same people are also Responsible for EMS - particularly in your non - "urban" environment(s)...


These are unique times :
we are facing a disease that will take hundreds of thousands of lives internationally;

for some, the only thing that is important is their sense of ( personal) liberty.
And you have a Right to that opinion -

Just as others have the Right to promote ideas we believe might limit the spread of this disease --

The idea that SAR will not respond when you get in trouble if you do not request assistance is Not-responsible given the more than fifty years history of SAR in North America;
you do still have the freedom to pursue your "adventure" in many areas of North America
( you may be penalized ( fined) for doing so );

I hope I have not misrepresented your position - if I have that was not my intent ;
If that makes me a "clown" or an "asshole", we really have not advanced ideas --

Enjoy your "adventure" --
my current adventure is this unprecedented disease - literally, an infectious disease - an infectious pathogen - we are facing --

my Thanks to those in the medical field and particularly in EMS who put your lives at-risk as we face this disease -

Thank you. tj

[whipski]

Another incident. SAR was called off because of ability to self rescue


https://www.esavalanche.org/content/...he-piute-crags

Here’s one of the potential rescuers pov:

https://m.facebook.com/todd.vogel.12...92637004115233

questionable route selection