Wilderness Medicine Case Study 27

Your friend is leading a chossy traverse on the third pitch of a new route on Heavy Runner just outside Glacier National Park. She is about forty-five feet out with poor protection when a section of the wall breaks loose and she falls. Her protection pops and she swings into the left-facing wall below you. Fortunately your belay is secure and you are able to arrest her fall. Looking down, she appears to be unresponsive, hanging in her harness against the wall. When you finally reach her some fifteen minutes later, she is awake and complaining of a mild pain in her left side. Her helmet is damaged and there is a shallow cut on her cheek that has stopped bleeding. Two rappels and an hour and a half later, you are both safely on the ground.

Once on the ground, Tiana—26, athletic, and in good health—reports sharp pain when she tries to take a deep breath. She is nauseous, with a mild headache and a sore, stiff neck; she cannot remember her fall. The ribs on her lower left side are very tender; Tiana winces and has trouble catching her breath when you touch them. Her pulse rate is 88 and regular, her respiratory rate is 22 and easy and her skin is slightly pale underneath her tan.

What is wrong with Tiana and what should you do about it? Click here to find out.
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