30 Feet to Impact..

We’re dispatched up the canyon for a male that fell and is off the highway. We respond with technical rescue equipment and an ambulance not knowing how far off the road the patient will be or what kind of terrain we will have to cross with him. Even with lights and siren it takes us twenty minutes to arrive at the location on the highway where we need to be to access the patient.
A man stands on the side of the road waiting for us and ready to guide us in to the patient. I grab a bag of equipment and my paramedic partner grabs another bag and we follow the man up the steep side of a hill that is covered with thick trees. About forty yards up the hill, we find a collage age male lying at the bottom of a cliff. I look up at the cliff and recognize this climbing wall. I climbed this wall about eight years ago with some friends. It was not an easy climb. There are anchors placed in the wall of the cliff to increase the safety of the difficult climb.
As a climber ascends the wall they place a carabineer in the anchor and run their climbing rope through the carabineer so if they loose their grip and fall they will only fall a few feet. They get banged up against the rock wall but they should not fall to the hard ground below. When you are in the out doors safety should always be at the forethought, there are diverse ways to get injured. Climbing, repelling, hiking, spelunking (caving), rafting they all involve risk. In this case it turns out to be inexperience and lack of attention to detail.
The patient is alert and speaking in full sentences. This is a good sign after a fall of about thirty feet onto hard ground with rocks and not wearing a helmet. Yes, that’s right another lucky one. He landed about two feet from a huge bolder that would have surly cracked his head open like a watermelon. His complaint is his right foot and rightly so. It’s attached only by the skin around the ankle. Another tib/fib fracture but this one almost severed his foot off.
 I leave my partner and quickly get back down the hillside where the rest of the crew including a few chief officers, are just arriving. One of the officers asks me what we will need to get the patient down to the waiting ambulance. I tell him we will need to set up a lowering system for the stokes-basket and that our patient is not critical but has a serious fractured ankle. I grab the stokes-basket and give the other crew members some direction as to what needs to be done and head back up the hill. We use the stokes-basket to remove patients from off road areas. Shaped like a basket that an adult can lay down in and be immobilized while the rescue workers move them out of the back county, sometimes miles, to an ambulance.
One of the chiefs brings rope and equipment up the hill and starts setting up anchors for the lowering system while another chief helps my paramedic partner splint the ankle. One of the firefighters hold manual stabilization of the head and neck. I ready a bag of IV solution for one of the firefighters who is starting an IV. We administer pain medication through the IV. As the patient receives relief from the pain we roll him onto a backboard and secure him for the stokes-basket. He is placed carefully into the basket and lowered down the hill side. The basket is tied into the lowering system. Six of us hold up the basket and the chief gently lowers us all down to the waiting ambulance. The patient is removed from the stokes-basket, placed on the cot and readied for transport. The ride down the canyon was uneventful with repeat vital signs and reassessments.
He tells us that he side loaded an unlocked carabineer and that was the cause of the fall. I don’t say anything to him but I noticed when I removed his pelvic harness on the hill it was not secured properly. It didn’t fail this time but he will have plenty of time to learn the right way to lace it before he climbs again.