A 35 year-old climber is hit by falling rock as she belays you on the sixth pitch of a 12-pitch climb. While Joanne was unresponsive for a few minutes immediately after the event, she is awake and groggy by the time you descend and reach her belay station. Her helmet is chipped and cracked, and she is complaining of severe pain (8) in her neck. During your focused spine assessment (FSA) she complains of mid-line tenderness between C-1 and C-3, and stiff; she has no neurological deficit. Her remaining injuries are compatible with self-evacuation; she thinks she is capable of setting rappel anchors. From the base of the climb it is an hour hike over third class terrain to your vehicle and another three hours to the hospital. There is no cell coverage. A front is moving in and high winds, rain, and possibly snow are predicted for the next day. You have no bivy gear with you; however, sleeping bags, shelter, food and water are in your vehicle.
What should you do? Click here to find out. Refer to this blog article for context. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available.
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