First Descent – You are doing an alpine ascent of a remote 13’er in Colorado’s Collegiate Range. You summit just as clouds and mist drop down to engulf you. After a quick handshake with your three buddies you hurriedly begin your descent. Somehow, in the thick clouds—like being inside a ping pong ball—you get off route on the Class III terrain (steep, with exposure, but not requiring ropes). Karen is checking out a gully as a potential descent route, when you hear a yell. You see Karen take a nasty fall, tumbling down about 20 feet to a wide ledge.
Scene and Primary Assessment: She is at the base of a gully full of loose and rubbly rock. You and your buddies after slowly and very carefully down-climbing to her. You find her unconscious and quickly and carefully drag her under a big boulder offering protection from rock-fall. Weather starting to get nasty, but terrain below you looks like it mellows out. Everyone else is okay, at least for now. Karen’s ABCs are normal.
Secondary Physical: You kneel down and shake Karen’s shoulder and she moans. She slowly comes-to, going from P to V within 5 or so minutes. Her helmet is cracked. After carefully removing it you find a nasty bruise, but no blood, on the back of the head. She improves to A on the AVPU scale. Her biggest complaint is a very painful wrist that definitely doesn’t look normal. She can’t move it nor her hand. She has very poor cap refill on that hand. Scrapes on both hands, but otherwise, no injuries.
SAMPLE: Symptoms as described. No allergies. She takes blood thinner and a daily acid reflux medicine. No relevant history. Last ins and outs normal. Karen claims she just slipped on the wet rock, resulting in her fall.
Vitals: Round 1 – HR 92, RR 22, V on AVPU. Round 2 – HR 84, RR 20, AOx3 on AVPU
Setting: ~12,500 feet on isolated peak, 2 miles and 1,500 vertical feet from nearest trail; 6 miles and 2,500 vertical feet from trailhead. It is late May, about 2 pm. It’s not exactly raining, but in the cloud’s mist it is pretty wet. No wind. You get a brief break in the clouds and you figure you are on the west side of the mountain, but other than that, you don’t really know where you are. You all are well equipped for a long day out (extra clothes, water, food, first aid kit, etc.) but no camping gear. You have a cell phone and while there is no coverage right where you are, you had coverage on the summit and most of the way up the east side of the peak.