It sucked to hear a couple of trips in again on Saturday by the Gardiner crew. I was blissfully unaware of any other details.

There was the limelight accident, and a dude slipped and banged his arm down at the far end of the trapps. on the carriage road. he looked ok to me, but what the hell do i know.

Are some of the ambulance runs unneccessary? I've been called stupid more than once but I've driven myself to the hospital a couple times with fractures after extricating myself from the wilderness. I'm just wondering if the rescue is too easy at the gunks at times, leading to folk pushing the gear/common sense quotient or going by ambulance when they might be able to get a ride or drive themselves to the relatively close facilities. The same injury in a wilderness area might lead you to limp out, rather than spend the night waiting, and then realize it ain't all that bad and you can drive yourself. Surely most cases that are truely emergent and need all the help they can get. Just wondering based on Evan's observation. Info about the gunks in "Accidents in N.A. Climbing" is scarce.

I'm just wondering if the rescue is too easy at the gunks at times, leading to folk pushing the gear/common sense quotient

Do you really think so? Do drivers drive more recklessly if they wear a seatbelt? I will agree that if someone isn't hurt too bad, being driven in a car to a hospital might make more sense than an expensive ambulance trip.

Not sure of details, but I understand there were at least three different sirens responding to accidents at the hairpin turn this weekend. As far as I know, none of the motorists involved were being properly belayed.

One at the hairpin was a man whose motorcycle hit the shale wall. I was there the next day set up with my pirate chalkbag shop and a group of people came by. It was the son, daughter and wife of the man who'd had the accident.

The man is 78 years old, and his bike was a large Harley(like a Goldwing type/size).

They were hoping to find some way to make sense of what happened, since they didn't have much information. They don't have an idea of what happened, how such a thing occurred, wondering if perhaps there was a stone or debris in the road. Very sad.

Unfortunately, he is in critical condition as of yesterday. The son says he has broken every damned bone in his face, and they did have him on a venitlator. Hopefully that is due to the injuries to his bones, and temporary while he is in such fragile shape.

I think the man and his family could use any thoughts or prayers for healing and dealing with this, if you are so inclined..

yes

http://www.smithsonianmag.com/science-nature/Presence-of-Mind-Buckle-Up-And-Behave.html

Quite a surprise, ShakesALot. It seems that the phenomenon takes place at a subliminal level. Thanks for the information.

Unless it is a life threatening situation 911 should not get called. We have a relative handful of ambulances available around here, limited resources. An ambulance squad tied up giving somebody with a broken ankle a ride to the ER @ Vassar is off line for two hours minimum. More than the money it costs the patient for the trip, making emergency services unavailable to somebody who really needs them is the primary concern.

excellent point whatthegunks. case in point my wife and I were down on the jersey shore escaping the hell that is the gunks on holidays. we were doing a long bike ride. about 5 miles into it she took a nasty fall going over a curb onto a sidewalk to get out of traffic. immediately a lady stopped and called 911 and the cops showed up and tried really hard to get us to take an ambulance ride. meantime we were bandaging her up with our own first aid kit and they were only distracting us by their entreaties. then we had to sign a waiver refusing the ambulance ride. gimme a break. she shook herself off and we continued the ride.

trying to make a huge deal out of nothing. all thanks to our litigous society of crybabies. are they used to taking people to the hospital for a few small scrapes?

another story, the first time I tried to lead transcon I took a fall and hit my foot on the slab. sprained my ankle. later on it really started to hurt. I could hardly use the clutch in my VW but drove myself to the hospital in POK and they gave me aspirin and some crutches. the next morning was a big job interview. I couldn't walk in there with crutches. well, that hurt. but I got the job.

You should have called in a helicopter team to airlift you to the job interview. It would have made a big first impression!

When I injured my ankle on Insuhlation I hobbled out on my own and later I regretted it. As it turned out I didn't make my injury any worse but I could have. I didn't need any emergency services but I probably could have easily arranged a ride in the rangers' truck back to the parking lot, which would have been smarter than walking on the ankle. My partner then could have taken over. Another error: once we were at her car we should have gone to the hospital instead of back to Brooklyn, where it took another full day before I found out the ankle was broken.

My point is just that the macho self-rescue stuff can go too far as well. And if you hurt yourself don't wait to get checked out.

Well, my life was technically not threatened, but what with the broken back and foot, I was nowhere near able to consider self-evac-ing, and was more than happy for the backboard and morphine.

It's a slippery slope of who needs it, and what unknown complications can arise, like muscle motion poking a bone fragment through a major vessel, or pinching off blood supply to an extremity. I'd sure hate to be on the wrong side of it.

Julie has a point. Macho talk about dragging yourself to the doc's could create a climate of social pressure that helps someone to make a disastrous decision. Where to draw the line is indeed a difficult issue, probably not subject to one-size-fits-all-guidelines.

Climbers take on risks as soon as they leave the ground. Once an accident has happened, they have to make more decisions about how much risk they are comfortable with; transport and an ambulance ride to the hospital for an aggravated hangnail at one end of the spectrum or a Doug Scott crawl down the Ogre with two broken legs epic at the other end (but remember that he had no choice).

By and large, I think we ought to stay away from second-guessing people who have called in the cavalry. Sure, there are outrages, like the party that got benighted at the top of the Trapps, but I'd say anyone who has had a fall terminated, at least partially, with an impact against something hard has earned the option to make their own judgements about their need for rescue without any Monday-morning quarterbacking from the peanut gallery.

That was a funny one, wasn't it? Good times.

I'd say anyone who has had a fall terminated, at least partially, with an impact against something hard has earned the option to make their own judgements about their need for rescue without any Monday-morning quarterbacking from the peanut gallery.

More often than not, on heavily populated days, there is likely to be someone around who's medically qualified to assist in making such a decision.

I am going to diagree with you here (which doesn't happen often). I know this is not the old days where people had to be a bit more self-relient (like a friend who fell on an A4+ on El Cap and broke his leg 75% of the way up the big stone and self-rescued) but things have gone too far.

I agree if someone takes a groundfall, trained personnel should be making the calls given the possibility of back and neck injuries. I also agree not everyone is trained (even though they should be) to deal with other injuries. But I think that today far too many get into situations that they shouldn't get into because of the belief. One needs to look at hikers on Half Dome this year to see trhat. The rangers have said that they are getting 911 calls nearly every storm that they've had with people asking for evac's, with people telling the rangers to just send the copters and bill their platnium cards. What they don't get is they don't get charged but the risk to the rescuer is significant. I've even had friends participate on rescues on El Cap for a climber who was tired and didn't want to finish thee route, but called 911 and said he had fallen and broken his hip. It tied up for an entire day 2 helicopters and nearly the entire YOSAR crew to get him down. That is a HUGE mis-use of reesouces. Now the risk to a rescuer who is attending to someone who sprained their ankle on the carriage road is minimal, the call out means they are unavailiable to others who may be having a coronary event, car accident or other significant emergency.

As for that on a given day there is person who is medically qualified to make that decision. The problem is, is when a person who is qualified is told that there is a potential for internal trauma, head trauma,... they HAVE to transport to a facility where you can accurately assess the individuals condition. If the individual has a potential risk, by all means call in the calvery. It would be stupid not to. But nowadays with help a 911 call away, the system is getting flooded with emergent and nonemergent calls that need to be treated equally, since you can't tell the difference untikl on the scene.

I may seem contradictary but yes, from what I've seen with friends in tthe emergancy sector, cell phones ad otheer technologies has increased the number of non-emergent emergancy calls. From what I've seen at a personal level, I've also seeen people tak erisks they otherwise would not have because the belief that technology will allow them access to professionals. Both are misgiven beliefs.

Chas, I limited my comments to climbers falling and hitting something. I was also speaking specifically about what you do after you've had such a impactful experience, as opposed to the mental frame of mind, perhaps including the availability of rescue, that contributed to the accident. And I stipulated that there are certainly outrages that deserve condemnation.

Chas does raise an interesting point - that "the system" is designed these days (it seems) to escalate each incident to a true emergency. Case in point - a year ago at the Trapps a climber decked very nearby to where I was; she fell from about 8 feet up, hit feetfirst and toppled over semi-heavily. I went over, applied my limited (Wilderness First Aid credentials) skills and determined that she had not suffered a spinal injury and left her and her partner on their own. They continued climbing albeit with her as a belay slave for the rest of the afternoon. Later I was told in rather clear terms that I should have deferred to the most highly FA trained in the area (who was an EMT, though I didn't know it at the time). I asked what they would have done differently. Their response - immobilize her, call the rangers, afix her to a backboard and litter, transport to the hospital for full body CAT scan to assess possible injuries, and wait for an MD to release her.

It's like no one is allowed to have a "minor" incident any more.

i find that EMT's are all about packing people up and shipping. It is what they are trained to do and are damn good at it but it's not always what people need.

This comes up in my athletic training field plenty too. I am trained to evaluate injuries in a lot more detail than EMT's. I can determine if an injury needs an ambulance, a doctor soon, a doctor if symptoms don't get better, no play but no doctor visit needed.. etc. Trust me when I need an ambulance I am super grateful for the EMT's and paramedics who show up.

I feel at the Gunks that the Rangers should have some role as evaluators to determine if an ambulance is needed. The people who got stuck in the dark didn't need the firetruck and 2 ambulances that showed up.. they needed the Rangers who are trained to get them down.

It seems to me, Mike, that you made the right call. I don't know why you got that response, but I don't know who you told, what you told them, and/or what they heard - or what they thought they heard.

Some injuries are clearly minor, some are clearly serious. With other injuries it's difficult to be sure what you're looking at, and the farther away you get from from an ED the less likely it is you will be assessed and treated by someone with sophisticated skills and knowledge base. These people also may have constraints at the scene that limit the opportunity to make a fast and accurate assessment. So the patient - in retrospect - may be overtreated. In my job I am constantly deciding treat/not treat, serious/not serious and many times with very little data, and I am doing this all via telephone. So, some times I send them in even when I know the situation won't be bad. Overtreated? Probably. Wrong decision? No. Probably the same for responders out in the field. Does all of this mean the "system" is set up to make a big deal out of every bump and bruise? Don't think so.

one word: Liability. I'm pretty sure the MP doesn't want it. You want it, Jake, you're sure you can spot any and all possible injuries?

What Dana said reminds me of an accident Scott saw last year - the woman on Frog's Head who decked. Scott saw her deck from above the (higher, I think) crux, and because of what he saw, got in a heated discussion about calling the works in. Later it turned out that she'd touched down on rope stretch. She thought she was fine. Then later turns out she broke a bone in her hand. So that story turned around a lot - it rarely was exactly how it looked at any given time.

What if one of the fragments of my burst vertebra got nudged a little further into my cord? But then I've also walked myself out, once with a broken arm from Mt Washington, once with a bad bad ankle sprain a mile from the car in JT, too (honestly I'm starting to think I'm doomed).

I just don't think there's any rule to be applied.

Mike had a two or three-day course, perhaps a total of 24 hours of instruction, some fraction of which was devoted to spinal injuries. He may well have never seen a patient with a spinal injury; he certainly didn't see one in the course.

The course is aimed at people who may have to make emergency medical decisions in remote environments where more experienced people are unavailable, and where the certainty of a bad outcome if there is a delay makes relatively uninformed decisions palatable. Such training is surely a valuable thing for remote situations, but the Trapps doesn't fit that description.

If Mike wants to say, ''according to a few hours of theoretical instruction I had (at some point in the past), you don't seem to have any signs of a spinal injury,'' fine. I suspect that's all he did, rather than ''determining,'' as he wrote, that there was no spinal injury.

You're in a situation, you make a decision - that's it. Some of them will be right, some wrong. There are a lot of possible motivations that a responder might have for going all out, but for most EMS/emergency personnel, one of the biggest concerns they have is do no harm.

I suppose, it is just a waste of (probably) competent first responders who have a great knowledge of the cliff and high angle rescue skills.

Didn't say I could find all injuries. I said that with my athletes I get a chance to evaluate their condition before deciding if transport is necessary. I went to school for 4 years and am licensed to do so. If I have any doubt I am pretty conservative and will send them just in case.

Mechanism of injury is huge for me. If someone (you) had taken a fall, had back pain, etc obviously not going to move them. my first 2 questions are where does it hurt and what happened.

Like others have said 911 is overused with the ease of cell phones.
what would happen if there had been a car crash while those guys who called 911 because they fail at rappelling? 2 ambulances and a fire truck unable to respond.


Anyway, nothing is likely to change so it is all just hypothetical babble.

I happened to be there with Mike when he did that assessment. I believe he stayed within his level of training. The spinal exam was performed after all other aspects of the exam were finished. Let's remember that EMT's operate in a roadside setting, where all the medical equipment they need is available to them, and definitive care is less than two hours away. They package and backboard everybody, because it is easy, the tools are there, and the patient will be in the hospital in 30 minutes or so. It's a no brainer.

The problem I see is that EMT's, as a general rule, tend to apply the same logic and reasoning in the wilderness setting, and it often winds up hurting the patient rather than helping them. For example..EMT's don't reduce dislocated joints in the field. They package and transport. This treatment plan in the wilderness context could seriously hinder transport, cause undue pain, and possibly further damage.

Also remember, wilderness context is more than two hours from definitive care (hospital). A mass casualty incident on the streets of New Paltz could easily be put a patient in the wilderness context. A car wreck with a complicated extraction, or indeed a climbing accident inthe middle of the Nears.

In the end, it is personal responsibility that is the determing factor.

RR

Don't worry Mike, if you had listened to the EMTs, the nurses would just unpackage the patient and tell her to stand on up as soon as she got to the ER.

There is good reasonwhy they are good at getting an individual packed up fast. Recent studies of trauma cases have shown that individuals who have life threatening injuries who get to a trauma center, the less time between the injury and the time they are in the center, the better their outcomes were. These studies were initiated somewhat in part from an observation from a trauma center in LA who had seen that when individuals who were shot in gang related cases, those that got shot, packed up in a car by fellow gang members and literally dropped off at the trauma center (as the other gang members drove off) had a better chance of survival then those that the ambulance was called.

Pain isn't a great indicator. When a drunk driver hit me, (I was running and when he finally saw me and hit the brakes he was doing 40, so he hit me somewhere between 40mph and 0mph, I had very little pain. I also had pressure on my spinal cord, and my entire right arm was completely messed up (I landed on it). Someone who sawthe injury would tell by mechanism of injury, but pain was not there.


I still contend that too many people are using the convienience of cellphones and 911. The individual needs to make the assessment of when its a real emergency or not. Is the problem going away. No, since you can't punish people except for the most grievous cases. You don't want to make people who have a real emergencies question or delay making the call. Its a Catch 22.

Unfortunately, all too true!

After many years of evaluating injuries I still can't tell for certain if an ankle is broken without an x-ray, but I can tell for sure if someone can get to the hospital without an ambulance for this type of injury. My buddy Scooter hiked out from Chrimson Chrysalis with a badly broken ankle and even gave up his hiking poles to a partner who sprained an ankle on the way out. We caried Connie out after an ankle injury and then drove her to the hospital in Summerville. The point is that most people climb with a partner and so the designated driver is pretty easy, if appropriately non-emergent,if you can get to the car.

Well now he has!

Mike - how did seeing the woman a year ago, or seeing me, augment what you'd learned in the WFA course?

Recent studies? That's ancient history. The "Golden Hour" has been common knowledge in trauma care for a long time.

In short, there is no substitute for real experience. And I'd be the first to concede that I'm a nearly-raw newbie in the first aid world. Everything rg said is true - I'm playing doctor based on VERY limited, superficial training. But that's all anyone can do, right? Work with what their training and experience have taught them. I don't pretend to be anything more than this.

The thing with FA training is that you hope you never have to use it, but doing the right things when you need to often depends on practicing those skills regularly. I have heard this offered as reasons why paramedics and other rescue professionals don't complain too loudly when they are called out on marginal calls - it gives them more practice in the field.

My comment was not meant as a call to "walk that shit off" machismo. I am a squad leader with a local ambulance service and know well the dilemma of call or don't call. I merely want to point out that ambulances and their squads are a limited resource around here and should be reserved for true emergencies.

EMS training for trauma focusses on "mechanism of injury", what caused the injury, motor vehicle accident, gun shot, climbing fall.. The protocol for a fall is that if it is from an approximate height of 3x the patient's height probability of spinal injury is high and spinal immediate spinal immobilization, a c-collar and backboard are recommended. This is not to say that the person my be uninjured (doubtful) or that someone having fallen a shorter distance may be seriously hurt, it's just rule of thumb.

Julie, I think that back pain as a result of a fall is a really good reason to call for help.

Mike, the EMT who reprimanded you may have been a little over the top.

The majority of patients that I have put on a backboard have been pulled off the thing by an ER doc after about a two minute exam. Totally fine, they're the doc and it's why the get paid the big bucks. Bottom line is that the ambulance squad and the Preserve's rangers are always going to play things very conservatively and they should as there are significant liability questions. So, if an injured person can calmly evaluate their situation and possible injury(s) and decide that they didn't bang their head and did not impact their spine and can reasonably hop their way out to the car with the help of friends (and maybe a pick up ride from ranger BE) then do it, that way the duty crew in Gardiner doesn't have to miss Wheel of Fortune yet again.

This is a really good discussion. Lots of us do relatively risky things far away from immediate help. I guess what I would like to see people take away from this discussion is a real evaluation of the level of risk they are willing to take in the backcountry. And yes, climbing in the Trapps would be considered the back country from a wilderness context perspective. if you are willing to increase your level of risk solely because the prospect of help and a cellular 911 call is readily available then you are BEING IRRESPONSIBLE!

last ice season a climber injured himself and attempted to self extricate with just the assistance of his partner. Unbeknownst to him, a passerby saw the accident and called 911 without asking him. That mentality is on the rise and it is without doubt one of the worst examples of reckless misuse of a new technology I can think of. Who the hell were they to impose their morals on someone else? Someone who was trying to do the right thing and take personal responsibility for his own actions.

In another episode, after an ice climbing accident (notice the theme here??) after the rescue was completed by many volunteer services, a climbing partner of the injured standing around on the scene questioned the skills of the volunteers, and asked, "what would've happened if this were far away from the road??" As if the climbers themselves bore no responsibility for the rescue. My answer to them is....YOU BETTER GET YOUR S**T TOGETHER AND LEARN HOW TO TAKE CARE OF YOURSELF INSTEAD OF RELYING ON VOLUNTEERS TO GET YOU OUT OF A MESS YOU PUT YOURSELF IN.

No one forces us to do stupid things. We elect to do them because they are fun. We should not expect volunteer service to be there to extricate us from our own stupidity.

I guess what I am trying to sum up is just this, everyone has their own personal level of emergency, and that is okay. But we need to do a better job as a community of educating and training ourselves so that we can take responsibility for our actions.

"Golden Hour " is ancient history, but the idea that people who were literally "dropped off" - actually more likely in the cases of gang related drop offs is that they were pushed out of the car, is that they faired far better then when people would call in the ambulance and have trained professionals transport the individual. Mind you, this was based on studies which were mostly urban based trauma centers where they are dealing with mostly gun shot wounds and stabbings, as opposed to head and neck injuries where the benefit of having trained professionals do the transport is pretty obvious.

One reason for not using an ambulance is that if the passenger doesn't have the requisite insurance, the ambulance bill will make him/her gasp loudly.

Nice post, Rob.

My most recent WFA training and the 3rd Edition of "Wilderness First Aid" put out by the Wilderness Medical Society define "wilderness" as being more than ONE hour from definitive medical care.

I think part of the problem at the Gunks is that very few climbers realize that they may be in the wilderness. I agree with what others have said about taking personal responsibility. Never mind WFR or WEMT training - a basic Wilderness First Aid course puts a major focus on triaging the "treat and continue", "treat and evacuate on your own", and "treat and call for rescue" situations. A little bit of education could make the difference between dialing 911 instead of driving your climbing partner to the hospital - or hesitating calling for help for fear of being a bother.

Coincidentally, I just finished Aron Ralston's book "Between a Rock and a Hard Place" tonight, (picked it up for a few bucks at a used book store).

He was about as removed from nearby medical help as you can get in the continental U.S. And, having worked in public service for most of my life and (contrary to what may or may not being said in a positive light about first responders), I have an incredible amount of respect for them. In ALL levels of their service.

I agree with Rob that this is a very good thread. One of the best recently. I admit I think more about the "what if" as I have been spending somewhat more time at a more remote (like 4-12 hr from qualified help) crag this year.

Question: I said upthread that when I broke my ankle I probably should have asked the rangers to help me get to the parking lot. But now reading the responses I wonder if that would have resulted in the activation of unneeded emergency personnel.

If I had notified the MP rangers of my accident would they have been required to call me an ambulance/bring in a litter team? Or would they have had the discretion to see I had no disorientation and no reason to think my head or back were impacted, and then to leave it alone?

Good question, Seth. In the old days it was pretty common for riders on the back of a ranger pick-up truck even just to get to the more northern spots on the Trapps and even more so to shorten the walk to Skytop. I don't see that happen much now. I can not imagine the rangers requiring you to call an ambulance but maybe Hank can address that if he is monitoring.
In case no one has noticed, one of my biggest concerns with the trail closure at the base of the Nears is that it tremendously complicates a carry out.

Some parts of the Gunks are remarkably remote from a rescue perspective---Millbrook comes to mind. A two-person party with one person incapacitated is in a fairly substantial pickle. Rapping to the boulder field is probably not a viable way for someone with any kind of injury to get out---I think you need your arms and legs working to navigate the large boulders down there.

An injured person has to be brought to the top of the cliff, and this could easily be beyond what the healthy party member could manage, since it might involve soloing or rope-soloing to the top and then, all by themselves, rigging and using an improvised raising system (which don't always work regardless of what the self-rescue books proclaim).

In order to get to the top, it seems likely that the injured person would first have to be lowered to and secured at the Death Ledge so that the healthy person could solo or rope-solo up an easier line. In the vicinity of the main rappel, The High Traverse, at 5.5, is the best bet by at least two grades.

Once at the top, its a substantial run back to the MSP parking lot and an even longer haul back to the West Trapps Lot.

Fortunately, a rescue crew can basically drive to the top of Millbrook, but even so, it would be many hours, quite possibly the next day, before a full-on technical rescue could be accomplished.

This brings up the cell-phone issue in a way that, I think, is a little more subtle than Rob's excellent comments. It should be clear from what I've said that a cell-phone could make a tremendous difference, not only in response time, but in the overall safety of the party.

A party that has a cell phone with them on the climb could call for help without one member having to solo to the top somehow. A party that left a cell phone in a pack at the top would still have to get a member back to the pack, but that member would not have to hike out to get help.

Here's where some of the subtlety comes in. Rob says, if you wouldn't go there without a cell phone, then it is irresponsible to go with one. I buy that, I've been to MB many times without a cell phone, much of the time because they hadn't been invented yet. But now that they exist and I own one, it is possible to ask whether it is irresponsible not to bring one, and even whether it is irresponsible not to have it on the climb with you (something I've never done except once when the cell phone was functioning as a camera...).

To emphasize my own potential irresponsibility, I've taken people out to Millbrook who most likely could not do any of the self-rescue tricks needed to get help or even just reach the top. These folks were good enough technical climbers with primarily gym and sport experience who neither knew the intricacies of a complicated self-rescue nor were likely to be capable of finding and rope-soloing a 5.5 route they don't know about.

If something happened to me, we'd both be totally up the creek unless they had a cell phone with them on the climb. This seems to me to be a clear-cut case of irresponsibility on my part according to Rob's standards. We really shouldn't be out there without a cell phone, but with a cell phone the risk seems much less ominous. Is it "wrong" to go out there with cell-phone in hand, or has the cell phone (together with the availability of a competent rescue team) changed the nature of the game?

Since it could be argued that I am, in a certain sense, functioning as a guide in these circumstances, we might ask more broadly about the guided situation. People engage guides precisely because they do not have the skills to handle the enviroment on their own. Should all clients carry cell phones, and is it irresponsible for a guide not to require it?

A non-cell phone solution to getting back to the top that I've never implemented but which I have seen some other parties use is to leave a rope and set of Jumars hanging at the Westward Ha! rap for emergency escape purposes. Of course, this involves lugging that extra weight in. Should I, at the very least, have been doing this with my inexperienced friends?

Talk about being a long way from rescue:

http://www.msnbc.msn.com/id/44904008/ns/us_news-life/

Seth, I would almost assume that the rangers have to call it in, and then things escalate of course. I can say that when I've walked myself out before, part of my reason for doing so was that I didn't want that escalated fuss. It's too bad, in many ways, that stepped responses seem to have disappeared, as everyone passes off liability until you're at the hospital. ,

Rich, and Rob, nicely stated. Another thing about Millbrook - I'd wonder if there exist trained high-angle heli-rescue services around here like you'd see in the Valley or in other steep big-ski areas. I mean, what happens even if you carry the phone and make the call?

I think that risk recognition and acceptance are maybe more subconscious than we're talking about here, though. It seems like it's something that slowly seeps in over time spent outside of that 1-hr safety margin, more slowly in some than others. Do you think there's more we can do about it?

Julie, the Preserve rangers have trained in "high angle" rescue and could certainly perform the requisite raising operations. But since some of Millbrook is on private land, already a very sensitive issue just in terms of climbing, there could be a question about whether Preserve personnel can operate off the Preserve if that's where the accident is.

As for a helicopter pick-off, the NYC police did one under very difficult conditions at Breakneck Ridge, see http://www.nytimes.com/2011/02/21/nyregion/21rescue.html. But those medics and technicians do not have climbing training, so that landing on a small ledge and getting a victim into a stretcher might well be beyond their capabilities---note the decisions in the NY Times account in this regard. Here's how it is supposed to be done:



The Breakneck Ridge incident, by the way, is an example of inexperienced folks with just enough knowledge to get themselves into really bad trouble. Of course, they called for help with their cell phones. Would they have undertaken this "adventure" without those gadgets?

I recently tagged along on a call that Preserve rangers got for a person with a dislocated shoulder at the top of the rock scramble at Bonticou. There was some dialogue about how to get him down but once on scene it was clear that the patient was young and strong and his level of pain, though intense, was manageable enough for him to walk down with some assistance and a bit of short roping. His wife and a friend came and picked him up at the MMH gate house and drove him off to the hospital. There was no attempt by rangers or anybody else to make him get in an ambulance, he made the call and that was it.

Some people don't have the fortitude to go anywhere without potentially needing a rescue...
http://www.cbsnews.com/stories/2011/10/12/earlyshow/living/parenting/main20119180.shtml

Rob,

You ask some of the most intellegent points. The question is how much does the relience on technology (ie: cell phones, SPOT transponders,....) factor into someones risk decision process on either a subliminal or thought out manner. Its stupid to believe that if you have an accident that you could make a 911 call and 15 minutes later trained professionals will save ones A$$. H#!!, in many cases, in climbing accidents 15 minutes is 16 minutes too long, for which anyone doing CPR on an climbing accident victem can attest. In many cases the cell phone will be worthless. In 99.99% of the places I climb there is NO signal from ANY provider.

Take a cell phone, but act as if it won't work.

And next time you see a first responder, thank them for the work they are doing. They probably don't get the thanks they should, and even those that get paid, don't get paid enough for the work they are doing.

I seriously love this discussion. As always, Rich makes some really excellent points. He's right the parameters of the game have been changed with the proliferation of cell phones. They definitely have decreased response time for incidents that require an emergency response. That is a given, and in Rich's Millbrook scenario, I would see nothing wrong with dialing 911 from the middle of the cliff given even a moderate injury.

However, for many people, cell phones have completely replaced the "10 essentials" that people used to take with them in the back country. These essentials are still essential, but people either don't know what they are, or figure they don't need them if you have a cell phone. That's just bad practice.

I have to admit, the technology is getting good. With the built in GPS, and mapping apps, savvy people are now able to locate themselves on a digitized topo map and track themselves on it, and find there way out. It won't be long at all until phones start doing more than just putting a little blue dot on a map. They will basically be GPS devices as well as computer, phone, camera, etc. We'll be able to make tracks, create waypoints, get ETA's to destinations, and all the good stuff a GPS does.

Taking a cell phone is a good idea. Relying on it and neglecting to know the things you should know beforehand is the irresponsible part.

We have had a few...scrapes... doing trailwork, and though the rangers have come with bandages and a lift in the truck, they haven't suggested any particular course of action. In the 3(hey, trailwork is dangerous!) times I am thinking of, all injured partied drove themselves to medical place or had a friend drive them.

In each case, the person injured was fully capable of making rational judgements, of course.

Where have you been? There are many iPhone apps that have had these capabilities for quite some time.

Rob, as president of the UCPLF (United Cell Phone Liberation Front), has presumably not yet dated Siri. http://thisismynext.com/2011/10/12/siri-weird-things-iphone-4s/

(In related news, the president emeritus of the UCPLF's predecessor organization, the UMCGTSRNKRAOSBHCCNGLF -- the United Magnetic Compass, Gore-Tex, Sticky Rubber, Nylon Kernmantle Rope, and All Other Sidewindin' Bushwackin', Hornswogglin', Cracker Croaker Newfangled Gadget Liberation Front -- recently tweeted the release of his latest app, iLuddite, which measures any crack using your phone's camera, and matches your existing inventory of rocks in your pocket to identify the best fitting chockstone to loop your hemp rope slings around.)

Speaking of cell phone 911 rescues...

Familys Corn Maze Fun Ends In 911 Rescue

Rob, do you carry a compass in your cragging pack?

I think I might. I haven't looked in the top lid of that thing in a long time...nor have I seen my compass in a while. Hmmm. As far as phone apps go, check out Ryan's latest blog post. Smartphones

The old days, like 5-6 years ago? I have a friend who got a job with YOSAR that way... there just have to be less painful ways to get a job!

Walk off the north end of the ledge onto the ridge. You couldn't drag a hurt climber off that way but it'd get you to the top where you could start the 3-ring circus on Westward Ha.

I've left that "escape line" on Westward Ha several times after seeing a climber use it to get off the cliff in a thunderstorm. Poor guy got stung by wasps while traversing across from Cruise Control, too...!

I don't know what the answer would be today, but 10 years ago or so HK and I helped carry out a Marine who slipped while leading and broke his ankle flying past a ledge on the rope stretch. Can't quite remember where -- might have been Sixish, or High Corner -- there was minimal talus, but some.

When I say "Marine", I am not talking about your marathon runner Recon Marine type. This guy was at least 300 pounds of mostly muscle. While we were carrying him out we started talking and it turned out he had a job as an electronics repair tech at Stewart and had very little to do all day but lift weights in the gym. It took six of us on the litter to get him down the talus and eight to lift the litter up over the side of the ranger truck because the tailgate was stuck.

He declined the ambulance because he was afraid he'd have a paperwork nightmare if he got treated at Vassar for an injury they could handle at the base clinic. We rode down in the back of the truck with him to the overlook where he was parked and he drove himself back to Newburgh -- in a a beat up Ford Ranger with a stick shift.

I guess if you're gung-ho enough you can persuade them not to call out the rescue squad even if the rangers get involved. :-)

Ooh, driving a stick shift with a broken ankle!
There's one tough ^@*%*^#!

On the other hand, driving an automatic with a bum left ankle.....not a problem!

Yeah, I should have mentioned that, although it is no picnic. You can also rap to the boulder field and traverse that North and then ascend to the ridge. Either option will be time-consuming.

I do not like that sound.

hey, I'm driving a standard with a right leg in a cast. Actually, I broke mine just before I had to leave for the airport to go to a medical conference, so I "ran" through two airports on a broken foot that was not yet in a cast or on crutches. That hurt.