Plans for Mountain Rescues
The techniques of evacuation are proven techniques. They are, however, all subject to improvement and should be discarded or modified as better methods of handling victims are developed.
a. When evacuating a victim from mountainous areas keep in mind that the purpose of a rescue operation is to save a life, and physical risk to the rescuers must be weighed against this purpose. However, there is no excuse for failing to make the maximum effort within this limitation. Work and expense should be no deterrent when a life is at stake.
b. Rescues will be unplanned (improvised) or planned rescue operations. For a planned rescue, equipment that is especially suited and designed for rescue should be used. For training missions always have a medical plan developed before an emergency arises (plan for the worst and hope for the best). Ensure that the MEDEVAC plan is a comprehensive plan and must be thought out and understood by all that may be involved in a potential rescue.
c. The following actions will be done immediately at the rescue scene.
(1) Assume command. One person, and one person only, is overall in charge at all times.
(2) Prevent further injuries to the victim and to others. Use reasonable care in reaching the victim.
(3) Immediately ensure the victim has an open airway, resume victim's breathing, control serious bleeding, and maintain moderate body warmth. If the victim is unconscious, continually monitor pulse. Protect the patient from environmental hazards.
(4) Do not move the victim until you have ascertained the extent of injuries, unless it is necessary to prevent further injuries or the victim is located in a dangerous location (for example, avalanche run-out zone, hanging glacier, possibility of falling rocks).
(5) Do nothing more until you have thoroughly considered the situation. Resist the urge for action. Speed is less important than correct action.
(6) Decide whether to evacuate with available facilities or to send for help. Speed in getting to a hospital must be balanced against the probability of further injury if working with inexperienced people, lack of equipment or wrong equipment, and terrain at hand.
(7) When the evacuation route is long and arduous, a series of litter relay points or stations should be established. These stations must be staffed with the minimum medical personnel to provide proper emergency treatment. When a victim develops signs of shock or worsens while being evacuated, he should be treated and retained at one of these stations until his condition allows evacuation.
(8) Helicopters or heated vehicles, if available, should be used for evacuation. While the use of aircraft or vehicles is preferred and can expedite a rescue operation, evacuation of a seriously wounded soldier should never be delayed to await aircraft, vehicle, or a change in weather.
Planning Rescue Operations
Every commander should have a medical evacuation plan before undertaking an operation. This plan should have contingencies included so as not to rely on a single asset.
a. When rescuing a casualty (victim) threatened by hostile action, environmental hazard, or any other immediate hazard, the rescuer should not take action without first determining the extent of the hazard and his ability to handle the situation. THE RESCUER MUST NOT BECOME A CASUALTY.
b. The rescue team leader must evaluate the situation and analyze the factors involved. This evaluation can be divided into three major steps:
c. The task must be identified. In planning a rescue, the rescuer tries to obtain the following information:
d. Circumstances of the rescue are as follows:
(1) After identifying the task, relate it to the circumstances of the situation.
(2) The time element may cause a rescuer to compromise planning stages or treatment (beyond first aid). Make a realistic estimate of time available as quickly as possible to determine the action time remaining. The key elements are the casualty's condition and environment.
(3) Mass casualties are to be expected on the modern battlefield. All problems or complexities of rescue are now multiplied by the number of casualties. Time becomes the critical element.
(4) Considerations for the main rescue group for a planned rescue are as follows:
(a) Carry all needed equipment, hot food and drinks, stove, sleeping bags, tents, bivouac sacks, warm clothes, ropes, and stretchers.
(b) Prepare the evacuation route (ground transport to hospital, walking trails, fixed lines, lowering lines, anchor points, and rescue belay points). If the victim is airlifted out, attach a paper with the medical actions that were performed on the ground (for example, blood pressure, pulse rate, drugs started, and so on).
(c) When performing all rescues, the rescuers are always tied in for safety. With all rescue techniques, remember to think things through logically for safety and to prevent the rescuer from accidentally untying himself or the fallen climber.
(d) Constantly inform the casualty (if they are conscious) as to what you are doing and what he must do.
e. The rescue plan should proceed as follows:
(1) In estimating time available, the casualties' ability to endure is of primary importance. Age and physical condition may vary. Time available is a balance of the endurance time of the casualty, the situation, and the personnel and equipment available.
(2) Consider altitude and visibility. Maximum use of secure, reliable trails or roads is essential.
(3) Ensure that blankets and rain gear are available. Even a mild rain can complicate a normally simple rescue. In high altitudes, extreme cold, or gusting winds, available time is drastically reduced.
(4) High altitudes and gusting winds reduce the ability of fixed-wing or rotary-wing aircraft to assist in operations. Rotary-wing aircraft may be available to remove casualties from cliffs or inaccessible sites, and to quickly transport casualties to a medical treatment facility. Relying on aircraft or specialized equipment is a poor substitute for careful planning.
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