You and your climbing partner are six pitches up on Goat Wall in Mazama, WA when a sudden lightning storm moves in with heavy rain and lightning. Abandoning the climb you begin to simultaneously rappell off (an advanced—and somewhat risky—climbing technique where two climbers rappel at the same time on the same rope counterbalancing one another). On the last rappell, you neglected to tie a knot on your side of the rope and misjudged the distance to the ground, and rappelled of the end of the rope a few feet above the ground. Unfortunately, your climbing partner, Jessie was roughly 20 feet above you when you fell. With the loss of your counterbalanced weight, the rope pulled through the anchor and Jessie fell to the ground landing on her right side and head in the talus.
When you reach her, Jessie is unresponsive and bleeding from her nose and ears; some of the fluid appears to be a light yellow and her helmet is cracked. A quick physical exam reveals a soft spot on her skull behind her right ear and crepitus in multiple ribs on her right side. Her pulse rate is 168 and regular; her respiratory rate is 26 and slightly irregular; her skin is pale.
What is wrong with Jessie and what should you do? Click here to find out.
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.
Our public YouTube channel has educational and reference videos for many of the skills taught during our courses. Check it out!