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First Responder Back Country Emergency True Stories.

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Cliffside Vertical Medical Evacuation.

Downstream of the Post Falls Idaho Spillway, the Spokane River flows through a narrow canyon composed of basalt rock, surrounding white pine, and under the nearby 4th. St. Bridge.

This landscape was a summertime hotspot for teenagers and young adults, to find relief and relaxation, basking on the wide rock ledges and diving from the cliff walls, into the pools of cold water below.

This time of year, the spillway had limited runoff, making this an ideal “Nature’s Waterpark” attraction.

Apparently, to a small group of young adults, this location was also “Party Central” during summer weekend nights.

One such summer Saturday night, hours after the night sky had darkened the North Idaho landscape, my BCMRT pager emitted it’s two tones, followed by a voice command “BCMRT…  Call the Com Center”.

Post Falls Ambulance requested our State of ID EMS specialized team respond to the 4th. St. Bridge location.

A female partier had temporarily left her group’s celebration to relieve her bladder in the nearby woods, when she misstepped and fell 30’ off a vertical cliff onto the rocks below.

She suffered multiple injuries upon impacting the rocks, requiring immediate medical attention and evacuation.

Our regional team of available EMT’s, Advanced-EMT’s, and one of our RN’s arrived at our Kootenai Memorial Hospital ER and equipment storage locker, secured our Medical Pack, Defibrillator, Drug Box, Climbing Packs, Rope Bags, Stokes Litter, and expedited travel to the 4th. St. Bridge, above the Spokane River. 

We were met in the darkness by an EMT from Post Falls Ambulance, and escorted to the rim of the cliff above the injured female, who was at this time, being assessed and initially treated by Post Falls Ambulance EMT’s.

Geared up and headlamp illuminating his descent, our RN rappelled, while on belay, with the Medical Pack on board, down to the supine Patient, performed an additional primary and secondary assessment of the Patient and relayed to us, the Patient was alert and oriented x 3, agitated, with a primary complaint of severe pain in her right arm and right leg.

Our RN assessed a possible: Concussion, Back/Neck Injury, Right Radius Ulna Fracture, Right Femur fracture, along with multiple contusions, and abrasions.

As the EMT’s immobilized the patients spinal and neck movement on a backboard, our RN started an IV of Lactated Ringers, administered pain relieving medication, and requested a Vacuum Splint and Hare Traction Splint, be obtained from the Post Falls Ambulance.

The additional equipment was expedited from the ambulance and lowered by rope to our RN and the assisting EMT’s.

While our RN and Post Falls Ambulance EMT’s were assessing and treating the Patient at the base of the cliff, our team above of EMT’s and Advanced-EMT’s, with illumination by headlamps only, set up Dual Multi-Point Anchor Systems a separate Belay Sticht Plate, a Multi-Carabiner Brake System, installed and secured 11mm Kernmantle Dynamic Ropes in the two systems, and lowered one of our Advanced-EMT’s with the Stokes Litter to the Patient’s location.

Dual Twin Rollers were secured under both ropes at the cliff’s edge to protect the ropes during the descent and subsequent ascent.

While the Patient was being transferred into the Stokes Litter, our team above converted the Multi-Carabiner Brake System to a 3:1 Mechanical Advantage with Dual Pulleys and twin Prusik Brakes.

Whereas the Stokes Litter is suspended horizontally, by the Spyder’s harnesses’ 4 point legs, Our RN would be attached to the evacuation system, as he would accompany the Patient along side, if an additional medical emergency, such as aspiration, should occur during the vertical ascent.

Also attached to the system, a 5-Step Aider, allowing our RN to ascend or descend alongside the Stokes Litter, for added patient access, during the Stokes Litter ascent.

After the Patient was secured into the Stokes Litter with our RN secured in place along side, the “On Belay!” signal was given, followed by the “Belay On!” response.

The call for “Up Rope” began the process of the slack being taken out of the 11mm Kernmantle Dynamic Ascent Rope. The Kernmantle Dynamic Belay Rope’s slack also was lessened, to keep pace with the ascent of the Stokes Litter, Patient and our RN.

The sequenced ascent up the adjacent cliff wall commenced.

Within a few short minutes of cycling the 3:1 Mechanical Advantage and synchronized Prusik Brakes, our RN’s headlamp and helmet came into view, followed by the Stokes Litter and Patient.

Once on level ground, the “Off Belay!” signal was given, followed with the “Belay Off” response, the Spyder Harness System was disconnected from the Stokes Litter.

While our team broke down and repacked our gear, our RN and Post Falls Ambulance EMT’s  carried the Stokes Litter secured Patient to the waiting ambulance, transferred the Patient to a Gurney, loaded the Patient into the Ambulance traveled to Kootenai Memorial Hospital for the Patient’s subsequent treatment and eventual recovery.

Lesson Learned:

Are you going to party in the woods after dark? 

Always carry a flashlight.

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Fun Fact:

“Patient aspirating in a Stokes Litter, during a vertical descent or ascent evacuation procedure”.

If the Patient aspirates, while secured to the Stokes Litter during the vertical descent or ascent evacuation, the accompanying BCMRT member will flip the Stokes Litter upside down, towards him/her self, resulting in the Patient being suspended upside down, secured in place by the “shoe laced” and double overhand knotted, 50’ x 1” nylon tubular webbing, as to enable the BCMRT member to clear the Patient’s airway.

No extra charge to the Patient for the thrilling amusement ride!

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