Ken,
I was stupid for not reading the name of the mt properly. I must have subliminally thought of where I had been.
He probably found crawling the least path of resistance his (only) choice. Who knows what any of us would have done.
Thanks for posting the story about Leroy.
This will get us off track from typical self-Rx of a leg wound in the Sierra, but at last year's Exp Med conference a military provider spoke. He said
(1) thanks to armor, most chest and abdominal wounds are no longer as fatal. That leaves head wounds and arm/leg wounds. They are focusing on the latter because they cannot do much more about the former's lethality (even with helmet). So tourniquets are back in vogue, in part for the reason #2 below
(2)more emphasis is now placed on the patient (shot soldier) to be his own first responder by helping himself rather than exposing a medic team to fire. So if the surviving wounded person (again, nowadays more likely an arm/leg wound) can place a tourniquet, crawl to a safer place, radio to direct more hot lead, then the medics can come in after the area is neutralized.
(3) Surprisingly, they have reduced the replacement of IV fluids. All bleeding stops (one way or the other) but they feel that restoring circulating volume just speeds up the blood loss. So if they sometimes let the patient stay relatively hypotensive, then seemingly paradoxically the survival (sometimes) increases because the bleeding
(sometimes) slows. It obviously depends on the size of the leak, and takes some guesswork all the while the clock is ticking and adrenaline flowing.
None of this decision making is available to a solo cross country hiker who is in extremis. Wow, what a story.
