Austrian CRO hauling Becka across loose slope in 161
Based on a document from Oxford University Cave Club by Gavin Lowe
A brief guide to carrying out a rescue on expedition.
This booklet aims to give some information that may be of use in the event of a rescue being necessary. You should read it and familiarise yourself with the contents before you need to perform a rescue.
On most expeditions there are a couple of incidents that lead to some sort of rescue operation getting underway. Nearly always these are caused by groups just being slow and missing their call-out times. While these false alarms are annoying, they do provide useful practice in case there is ever a real rescue.
In the event of a serious injury, the Austrian cave rescue organisation should be called upon to help. However, there will be a considerable delay before they arrive (especially if the call-out is at night): it is your responsibility to do as much as you can in this time.
It is most important in a rescue that the rescuers do not neglect their own safety: having one injured caver is unfortunate; having a rescuer injured as well is a nightmare.
There are three main parts to the guide. This first section makes a few general points about rescues, about how to avoid rescues, and equipment you should carry with you for use in an emergency. The second part describes the procedure to be taken in the event of a rescue. The third section describes techniques that may be useful in a rescue.
Caving on expedition is more dangerous than in Britain for a number of reasons:
Therefore
CAVE CAREFULLY.
Do not go caving if you are ill or particularly knackered. Take a day off to recuperate. Also, don't be scared to turn back early if you don't feel up to a trip.
Make sure at least one person not involved in a trip knows how to find the cave you intend to explore - if you wish to explore a cave you have just found, leave someone on the surface and be sure they can find the way back to camp !
Before going caving, write trip details in the call out book at top camp.
Be realistic about the time you set: allow yourself enough time to achieve the goals of the trip, with a bit spare to allow for minor cock-ups; but don't set the call out time too late---if there is a problem, you will want to be rescued earlier rather than later. To help with this problem it is best to give two times - the expected time back, and the definitely late time back. This gives rescuers some idea of just how overdue you are. It's also useful to give an expected time at the entrance as well as at top camp or the car park.
Make sure that your gear is in decent nick, particularly your lights. If you have any trouble with your gear, make sure you sort it out before your next trip.
When going caving you should take with you:
When walking in the mountains you should carry the same stuff, and also a compass and a good map. A GPS may sometimes be more useful, but is not a substitute for map and compass and the skill to use them.
Don't go shaft bashing on your own: if you have an accident, nobody will know where to find you - it could be years before they find your body :-).
There are various sorts of incidents that may need some sort of rescue action.
Statistically the most common cause for a rescue is the last. Fortunately actual injuries are very rare.
CUCC tends to be a fairly anarchic bunch, not much into 'leaders' and 'chains of command'. However, in a rescue it is important to be well organised: to know what you are responsible for doing, and who is responsible for other specific tasks. People should be appointed to the following positions:
There are various ways in which you will realise that some action is needed:
If a group is overdue then you should aim to start rescue procedures as soon as the call out time is reached. A group of four cavers, ideally including a doctor, should go to the cave immediately. If it is dark they should leave a light at the entrance to guide other rescuers. Check whether the victims' surface gear is still at the entrance: if not, or their underground gear is there, then they are probably lost on the mountain (see section 3.8). Take a radio (if available) so as to communicate with top camp.
One caver should head down the cave quickly, carrying just the mini rescue kit (see section 3.5.1), with the aims of:
This person should cave quickly but carefully.
The others should follow behind carrying the equipment listed in section 3.5.2 and a bag of hauling gear (section 3.5.4). They should cave carefully and preserve their energy as far as possible, as it may be a long resue. Their main aim is to prevent the deterioration of the victim. Their secondary aim is to start getting the victim(s) out of the cave, if they have sufficient personnel.
Another three cavers should follow about half an hour behind, carrying the equipment of section 3.5.3. Their aim is to start getting the victim(s) out of the cave if they think they have sufficient personnel.
Further cavers should follow carrying the rest of the rescue gear after a further half hour, if necessary.
When the overdue cavers are found, one person should head out to let everyone else know what the situation is. If those underground are sure that they can sort out the situation, then the rest of the rescue can be stood down.
If there is an injury, goto section 4.2.
If a caver is too knackered or ill to get themselves out, then goto section 4.1.
Meanwhile, those left at camp should: prepare the rest of the rescue gear; radio base camp to tell them to stand by; cook lots of food. They should rest and await word from the cave.
If word of an injury reaches base then a group of about three cavers, ideally including a doctor, should go to the cave immediately. If it is dark they should leave a light at the entrance to guide other rescuers.
They should head down the cave quickly, carrying:
Their aim is to:
Three more cavers should follow carrying the baby bouncer, the stretcher, and a bag of hauling gear (sections 3.5.3 and 3.5.4) if there is any chance of it being needed.
More cavers should follow with more hauling gear, food and carbide (see section 3.5.5).
Meanwhile, the Austrian rescue authorities should be alerted. Ask the BergRestaurant (if it is open) or the Loser Hütte to radio for help, or phone directly if a working mobile phone and german speaker are on hand. Failing this, contact base camp and get them to alert the rescue services. However, there will probably be a delay of at least 4 hours before they reach the cave (longer if it is dark). Do as much as you can in this time. A German speaker is almost essential for this - if not available, it may help to know that the Toll Road manager speaks English, though there is no guarantee that you can get hold of him.
If there are any other cavers in the area, alert them as well. Other expedition groups should be willing to help with any rescue (as, equally, CUCC should be ready to lend them assistance if they have an accident). If other groups are in the area, make sure they know CUCC's mobile phone numbers, and get hold of theirs, if they are so equipped. Do this before a rescue occurs !
Most people at base should walk up the hill, carrying more rope, rigging gear, food, and carbide, as needed. One person, ideally a German speaker, should stay behind to liaise with the Austrians.
If rescue in a stretcher is necessary, goto section 4.4.
If the caver is able to get themselves out, with help from the others, then goto section 4.1.
As soon as possible, word should be sent to the surface, giving instructions to those there.
Those left at camp should cook lots of food, and rest: you should save your energy as you will probably be needed later. If possible start organising a rota system if it looks like being a long rescue, and carry food and some bivvy gear to the cave entrance.
This section lists some of the gear that may be useful in the event of a rescue. This equipment should always be at camp in case it is needed. If you are reading this at camp, then check that it is.
The following gear should be carried by the first rescuer down the cave. It should be packed in a prussik bag in advance, ready for immediate action.
The following equipment is designed to prevent deterioration of injured cavers; it should be carried in by the first wave of rescuers:
The following equipment is designed to start getting the victim(s) out of the cave:
Two or three tackle bags should each be packed with the following, for rigging past particular obstacles, including short pitches:
Plenty of food and carbide will be needed on a long rescue.
The following gear may be needed in particular situations:
This is most likely to be either somebody too knackered or ill to get themselves out of the cave: see section 4.1.
Stuck cavers can probably be extricated using hammers and chisels, or washing up liquid as a lubricant, or simply by providing slings and things to help them push, pull or climb in the right direction. You may need to cut them out of their caving gear, so take down some large knives (but be careful you don't injure them or cut important rigging in the process). Small knives may be useful if space is restricted, and a pair of wire cutters or similar could also be useful.
If cavers are flooded in, then it's probably best to leave them: sending more rescuers down may lead to the rescuers also being trapped. People have been able to escape in all the flooding incidents CUCC have experienced so far, although in some cases they may have to sit it out. Floods invariably render pitches impassable rather than sumping anything off. Leave the victims a dump of food, carbide, dry clothes and a stove, somewhere where they will see it, but where it won't get washed away. If spray is a major problem, electric lights might be worth providing. When you think the water is dropping again, send a team down to make sure they are alright, and to give moral support.
It should be obvious how to deal with most other problems (eg. light failures).
Give as much first aid as possible (see section 4.2).
If the injury is minor, and you are sure you can cope, get them out of the cave.
For more major injuries you should prevent their condition from deteriorating while sending somebody out to get help. If you are near a campsite get them to the camp---or bring the camp to them---and keep them warm. Failing this, put them into a survival bag (which you should have with you) and insulate them from the ground---get them to sit on a rope, a kit bag, or you. See section 4.3.
If you only have two people in the group you have to decide whether to stay with the victim or go for help. This is why it is generally safer to have at least three in a team. Your decision should be based upon how soon you would expect the rest of the expedition to come and rescue you (how soon is your call out time), or when other cavers in the cave may pass this way, and how much the victim's condition is likely to deteriorate if you leave them. If you must leave an injured, confused or unconscious caver, secure them against further falls.
There's not really a lot you can do about this. Walk along the route they should be taking, blowing whistles. But don't get lost yourself. It's a good idea for the rescuers to carry sleeping bags and bivvy bags in case they do get lost. If you have no luck, then leave them: they'll have a miserable night, but they'll survive.
Morals:
In this part I'll describe a few techniques that may be useful in the event of a rescue. Familiarise yourself with these techniques before you actually need to use them.
If this is the case, give the victim as much help as possible. Maybe some food and encouragement will be enough (a Carbide Assist: light a flame under their butt, and out they go).
You can help them by rigging a combined hand line--life line on climbs: belay a rope to something solid at the top of the climb, passed through a krab on the victim's harness, and then back up to somebody at the top of the climb; the person at the top can lifeline and help pull the victim (with a 2:1 advantage); the victim can use the other length of rope as a handline.
If necessary victims can be hauled through vertical squeezes in the baby bouncer. On large pitches, tandeming will help to give moral support, and means that somebody is on hand to help with change-overs. See section 4.6 for details of dealing with particular obstacles that are to be found in our caves. Consider setting up a temporary camp site to let them get some rest, and try again when they are feeling stronger.
This treatise does not aim to deal comprehensively with first aid. You should familiarise yourself with the first aid manuals from the bibliography.
The following information is based on an article by Tom Houghton in OUCC Proceedings 12, and an article by John Fogarty on the Cavers' Digest.
Do the following in sequence:
There's a lot you can do to keep either yourself or an accident victim warm. Ideally get them into dry clothing, into a sleeping bag, and insulate them from the ground. Sit them on a rope, a tackle bag, knee pads, or you. Put them inside a bivvy bag or under a survival blanket, and light a candle or carbide flame in with them: the heat given off by the flame is significant, and can be a life saver. Alternatively, put a carbide generator inside their furry suit.
Hot drinks for an injured caver are probably a bad idea on the whole. Patients with head injuries can spew them up and inhale them, and somebody who isn't drowsy now may be later. (Spew does horrible things to lungs.) Similarly with internal injuries; the patient's condition can change quickly. Also, any serious injury victim is likely to need to go to an operating theatre when they get out, and the stomach has to be empty for a general anaesthetic. Although stomachs normally empty in 4-6 hours, serious injury and stress can paralyse the normal peristalsis so a trauma victim can keep stuff swilling around in the stomach for ages. On the other hand, if you're sure there's been no serious injury, hot drinks help keep up core temperature and supply fluid and sugars, so if you're just extracting someone because their tin leg broke, then fine.
Wrap the victim in a sleeping bag inside the stretcher. Be very careful moving the victim, especially if a spinal injury is suspected. See 'back' above.
The victim's morale is very important. Keep talking to them, reassuring them, and telling them what's happening. Appoint somebody---ideally a doctor, and certainly somebody cheerful and talkative---to be in charge of this. They should also monitor the victim's condition, looking out for any deterioration, and should make sure that the victim's head is protected at all times.
Other rescuers should also help to keep the victim happy. Refer to them by their name, not "the body". When talking to them, say your name, so they know who they're talking to. Avoid stepping over them and dropping mud in their eyes.
Along horizontal passages there are various ways of moving the stretcher.
At all times somebody, preferably a doctor, should monitor the condition of the victim.
For hauling a stretcher up anything except for very short drops, you will need some sort of hauling system. You should also have an independent life line to the victim.
The counterweight hauling system is illustrated in figure XX. A rope is attached to the stretcher, and passed through a pulley at the top of the pitch. A rescuer, the counterweight then attempts to prussik up the other side of the rope. As he does so, the victim will be pulled up. The counterweight should clip himself into something at the top of the pitch. If he is the same weight or lighter than the victim then he will find himself moving up the rope---pulling up on the rope attached to the victim will compensate for this. It is important to have a lifeline from above and a trailing line leading to the bottom of the pitch: these can be used for controlling the ascent of the victim.
A simple hauling system with a 2:1 mechanical advantage is illustrated in figure XX. A rope is taken from the victim, through a pulley-jammer (figure XX) at the top of the pitch, to another jammer. This second jammer is attached to a pulley, through which a rope runs. The second rope is anchored at one end, and the other end is hauled upon, thus providing a 2:1 mechanical advantage.
Practice setting up a pulley jammer before you need to use it. Pass a rope through a pulley, and then through a jammer on the 'up' side; attach the pulley and jammer together using a krab; then anchor the pulley jammer by passing a maillon through the krab.
The Austrian cavers who rescued Becka in 1989 used a mechanical winch for hauling, at least on the entrance pitch. This has the theoretical advantage of being operable by just a couple of people, but in practice kept slipping over sideways into a position where it couldn't be used at all. Moral: the simpler you can make it, the less there is to go wrong. Simplest of all is to have lots of people pulling - but you need lots of space so this is only really effective on an entrance pitch. One person must be in charge of a hauling team and "stop!" means stop immediately. Although it is easier to lower off with a team pulling than with a pulley-jammer or similar, it is essential to avoid pulling the rescuee into danger or where he cannot be manoeuvred. Necks have been broken this way !
If you have cause to call out the Austrian rescue, then they will most likely turn up with a helicopter if at all possible. This is a very effective method of evacuation, and will save the injured party much delay and possible rough handling to get across the plateau. However, do not rely on a helicopter being available. On Becka's rescue in 1989, a small Alouette helicopter was used, but not everyone got a ride back, as these cannot fly at night, and must therefore be back at their base before sunset. You will also not see a helicopter if visibility is crap or if it is needed for some military purpose - civilian rescue is a "background use" for this kit, though, as with the RAF Mountain Rescue in the UK, real rescues are regarded as better training than any exercise.
If a helicopter is to land near an entrance, there must be no loose clothing, Inglerip bags or anything else which could be blown up by the downdraught and into the rotors. This is not usually achievable, so the chopper will most likely land some distance away. Do not approach the helicopter until signalled to do so, and then always stay in the 180° area in front of the machine, where the pilot can see you. The tail rotor and exhaust stream are extremely hazardous places !
In this section are a few ideas for dealing with particular problems that may be found in our caves.
This document has, at best, scratched the surface of cave rescue techniques. The following publications give general information about cave rescues:
David Judson (ed), Caving Practice and Equipment, especially
chapter 17, "Accidents to Cavers", by Dr John Frankland.
A particularly relevant extract is on this site.
Jim Eyres and Dr John Frankland, Race against Time. The story of the Yorkshire CRO, hilarious, and very informative.
Steve Hudson, Manual of US Cave Rescue Techniques. Needs to be taken with a pinch of salt.
The following give information about first aid:
Dr Peter Glanville, First Aid for Cavers.
James A. Wilkerson, Medicine for Mountaineering and other Hazardous Activities. Earlier editions are called Medicine for Mountaineers.
St John's Ambulance, First Aid.
The following give information about vertical rescue techniques:
Neil Montgomery, Single Rope Techniques, especially chapter 9, "Self Rescue from a Vertical Cave".
Mike Meredith, Vertical Caving, especially chapter X, "Mini-rescue".
Rescue topics:
Caving
Accidents: Management from Site to surface. An article by Dr. D.Gibson
in the 1987 NPC Journal.
Trapped by flood in 113, 1980
Sitting out flood in 145, 1984
The 1989 rescues
Hit by flood pulse in 182, 1991
Mislaid for 27 hours in 161, 1993
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Taking bearings to locate caves
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