Mt Whitney Zone
Posted By: hikin_jim Six Day Ordeal in the Sierra - 07/16/14 07:35 PM
This article is worth a read for anyone who travels in the back country.
Six Day Ordeal in the Sierra

It looks like he:
a) did not leave a detailed itinerary with anyone and
b) did not have any signalling devices with him

That's not to try to rip him to shreds (he did a danged good job with what he had; I'd probably be dead right now), but rather to encourage people to think about safety.

Waiting THREE DAYS for someone to even notice you're not back yet is no fun. A PLB (Personal Locator Beacon) works anywhere in the world and notifies Search and Rescue that you're in distress immediately. It also takes the "Search" out of "Search and Rescue". A tremendous amount of resources are expended just looking for someone. The article states that 80 people were out looking for him. A PLB sends out both your GPS coordinates *and* sends out a homing beacon. Search and Rescue can proceed to your location directly and little time is spent looking for the victim.

HJ
Posted By: saltydog Re: Six Day Ordeal in the Sierra - 07/17/14 05:14 AM
HJ: Excellent observations all around. No worries about ripping the guy; he has done that enough himself, and anyone who doesn't get that has not listened to him on that subject.

Anyone who does rip this guy is missing much more important things:

He did not leave a perfect track, he knows that, but he left more than most and enough for SAR to fly over his position several times before he was rescued. These things are ALWAYS matters of probability.

What he did know and did do made the difference between his being rescued and otherwise.

In his very early recovery, he has given interviews making the important points of what he did right and what he did wrong.

Criticize it if you will; I call this progress. we are all better informed for his story, as was he from those who went before him.
Posted By: Ken Re: Six Day Ordeal in the Sierra - 07/17/14 06:48 AM
Ironically, he was only about 1 mile from the JMT. Could probably have gotten 1/2 way there and gotten attention.
Posted By: Harvey Lankford Re: Six Day Ordeal in the Sierra - 07/17/14 01:57 PM
Ken, that mile or two as the crow flies is through Sixty Lakes Basin to the JMT. With a broken leg and that terrain off trail, one mile is a 1,000. He mentioned Davis Lake - I don't know where that is. Someone please help us out.

He also intended to go (that day???) to Blayney Hot Springs/Muir Trail Ranch on the JMT north of Evolution- a long ways from Sixty Lakes Basin - must be 70 miles
Posted By: Glenn Re: Six Day Ordeal in the Sierra - 07/17/14 02:34 PM
Harvey,

He was on Mt Goddard - you might be thinking Mt Gardiner. Davis Lake is just west of Wanda Lake. Still, 1000 miles if you're crawling.
Posted By: wbtravis Re: Six Day Ordeal in the Sierra - 07/17/14 04:15 PM
To all the noobs here...

Read this and learn from it. This, if anything, is a cautionary tale.

I always read these this and try to learn. Mr. Hein pointed out his mistakes...well off trail by himself, no signal mirror and he left his pack. Nothing is said about the contents of his first aid kit but using a tourniquet says he could not stop the bleeding with what was in his first aid kit.

Many think this will not happen to them...it does and it has happened to me but not to this extent and I was hiking a x-country route with a friend. I stepped on a loose rock a year ago and thought I torn my Achilles deep in a canyon with one block I had to work to get around get out on what turned out to be a severely sprained ankle. With the help of my friend I got out but did not hike for about six weeks because of the injury.
Posted By: Harvey Lankford Re: Six Day Ordeal in the Sierra - 07/17/14 04:17 PM
Originally Posted By: Glenn
Harvey, He was on Mt Goddard - you might be thinking Mt Gardiner. Davis Lake is just west of Wanda Lake.

duh
Posted By: Ken Re: Six Day Ordeal in the Sierra - 07/17/14 05:17 PM
Originally Posted By: Harvey Lankford
Ken, that mile or two as the crow flies is through Sixty Lakes Basin to the JMT. With a broken leg and that terrain off trail, one mile is a 1,000. He mentioned Davis Lake - I don't know where that is. Someone please help us out.

He also intended to go (that day???) to Blayney Hot Springs/Muir Trail Ranch on the JMT north of Evolution- a long ways from Sixty Lakes Basin - must be 70 miles


so you know.

As reported in the piece, he crawled a total of 2 miles to get to where he was. In another direction, in one mile, he'd have been on the JMT. I don't mean that as a criticism, but how simple decisions can become complex in the situation.

Also, he made a common, but incorrect decision WRT bleeding. it is now the standard to apply a tourniquet to stop bleeding that cannot be stopped by direct pressure. This can be life saving. Because of the incorrect fear of loss of limb, he exposed himself to the risk of bleeding to death....for no benefit.

Much of this was determined by the military, as is true of much of what we know about trauma care:

[url= http://www.thefreelibrary.com/Manage+mass+casualties+with+SAGGY+PRIDE%3A+when+situation+overwhelms...-a0139312209]Do you have SAGGY PRIDE?[/url]

I'm reminded of my acquaintance, Leroy Petry:
---------------------

For conspicuous gallantry and intrepidity at the risk of his life above and beyond the call of duty:

Staff Sergeant Leroy A. Petry distinguished himself by acts of gallantry and intrepidity at the risk of his life above and beyond the call of duty in action with an armed enemy in the vicinity of Paktya Province, Afghanistan, on 26 May 2008. As a Weapons Squad Leader with D Company, 2nd Battalion, 75th Ranger Regiment, Staff Sergeant Petry moved to clear the courtyard of a house that potentially contained high-value combatants. While crossing the courtyard, Staff Sergeant Petry and another Ranger were engaged and wounded by automatic weapons fire from enemy fighters. Still under enemy fire, and wounded in both legs, Staff Sergeant Petry led the other Ranger to cover. He then reported the situation and engaged the enemy with a hand grenade, providing suppression as another Ranger moved to his position. The enemy quickly responded by maneuvering closer and throwing grenades. The first grenade explosion knocked his two fellow Rangers to the ground and wounded both with shrapnel. A second grenade then landed only a few feet away from them.
Instantly realizing the danger, Staff Sergeant Petry, unhesitatingly and with complete disregard for his safety, deliberately and selflessly moved forward, picked up the grenade, and in an effort to clear the immediate threat, threw the grenade away from his fellow Rangers. As he was releasing the grenade it detonated, amputating his right hand at the wrist and further injuring him with multiple shrapnel wounds. Although picking up and throwing the live grenade grievously wounded Staff Sergeant Petry, his gallant act undeniably saved his fellow Rangers from being severely wounded or killed. Despite the severity of his wounds, Staff Sergeant Petry continued to maintain the presence of mind to place a tourniquet on his right wrist before communicating the situation by radio in order to coordinate support for himself and his fellow wounded Rangers. Staff Sergeant Petry's extraordinary heroism and devotion to duty are in keeping with the highest traditions of military service, and reflect great credit upon himself, 75th Ranger Regiment, and the United States Army.
Posted By: Harvey Lankford Re: Six Day Ordeal in the Sierra - 07/17/14 06:27 PM
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.
Posted By: Chicagocwright Re: Six Day Ordeal in the Sierra - 07/17/14 07:32 PM
I'd like to make sure I understand your post regarding the tourniquet. As I've understood from the article, he believed he had a choice between applying a tourniquet, which guarantees the loss of the limb, and not applying the tourniquet but potentially bleeding to death.

Perhaps it all depends on how bad the bleeding was but it seems as though he made the correct decision? Am I at least understanding correctly that the decision saved his leg?

It seems as though the Leroy Petry story is significantly different in that the limb (or the hand) was already lost. In other words, Petry was not faced with the same decision and it was obvious that he needed to apply the tourniquet.

I'm very interested in your thoughts and want to make sure I understand why you said "he exposed himself to the risk of bleeding to death...for no benefit".
Posted By: Harvey Lankford Re: Six Day Ordeal in the Sierra - 07/17/14 10:14 PM
Chicago - I will answer for Ken since I'm here

he said
incorrect fear of loss of limb

you said
guarantees the loss of the limb,

so the rest of his statement is correct as written. I had to read it twice. Maybe Ken can clarify
Posted By: Chicagocwright Re: Six Day Ordeal in the Sierra - 07/18/14 12:32 AM
Originally Posted By: Harvey Lankford
Chicago - I will answer for Ken since I'm here

he said
incorrect fear of loss of limb

you said
guarantees the loss of the limb,

so the rest of his statement is correct as written. I had to read it twice. Maybe Ken can clarify


That is actually a big part of my question because I am wondering if my understanding of tourniquets is correct. My assumption is that tourniquets "guarantees" the loss of the limb. I'm hoping I'm wrong in case I ever need a tourniquet!
Posted By: Ken Re: Six Day Ordeal in the Sierra - 07/18/14 03:45 AM
Originally Posted By: Chicagocwright
I'd like to make sure I understand your post regarding the tourniquet. As I've understood from the article, he believed he had a choice between applying a tourniquet, which guarantees the loss of the limb, and not applying the tourniquet but potentially bleeding to death.

Perhaps it all depends on how bad the bleeding was but it seems as though he made the correct decision? Am I at least understanding correctly that the decision saved his leg?

It seems as though the Leroy Petry story is significantly different in that the limb (or the hand) was already lost. In other words, Petry was not faced with the same decision and it was obvious that he needed to apply the tourniquet.

I'm very interested in your thoughts and want to make sure I understand why you said "he exposed himself to the risk of bleeding to death...for no benefit".


Harvey and I think alike, as we often do. smile

The problem with bleeding is that it is a one way street, in a wilderness setting. You cannot really replace the oxygen carrying capacity in any way. Even I or a paramedic (sans blood transfusions) cannot really do much about blood loss. You get into things like Trendelenburg positions, but the effect only buys a little time.

So stopping significant bleeding is one of the most important first aid priorities.

For a long time, the "conventional wisdom" has taught in first aid that application of a tourniquet "guarantees" the loss of a limb. I think this was implied so that people would not abandon direct pressure, which works an astonishing amount of time, if done right. In fact, it does no such thing. Tourniquets have to be used correctly, though. I vaguely remember the way they were taught was to apply them, AND NEVER RELEASE THEM.

In the case being discussed, that would have been SIX DAYS.

NOT GOOD.

As Harvey stated, "Bleeding always stops"--one of the rules of surgery (and an inside joke). GENERALLY, bleeding does, as arteries constrict, as blood clots form, etc. If you can slow the deluge down while that happens---and also apply direct pressure where possible---it will almost always stop. Once it has stopped, no more need for the tourniquet.

Note that that process actually happened in this hiker (except that he lost quite a bit of blood (?) until it stopped.)
Posted By: Bee Re: Six Day Ordeal in the Sierra - 07/18/14 04:36 AM
Military medicine is a topic near and dear to me (I was at a medical base during my short service)

Best hiking buddy to have when you break a major blood vessel: a trained medic!

I had a major boo-boo out on the trail and promptly had my life saved by a combat medic (he tied that pressure bandage so tight that it might as well have been a turny....but on my head??)

The surgeon complimented my buddy on his excellent application of a proper bandage (most people do not tie a pressure bandage tight enough....we were taught using a penny; the penny should stay glued to your skin after you remove the bandage if it's tight enough)
Posted By: Harvey Lankford Re: Six Day Ordeal in the Sierra - 07/18/14 12:43 PM
Originally Posted By: Bee
(he tied that pressure bandage so tight that it might as well have been a turny....but on my head??)

The surgeon complimented my buddy on his excellent application of a proper bandage (most people do not tie a pressure bandage tight enough....we were taught using a penny; the penny should stay glued to your skin after you remove the bandage if it's tight enough)

Hence, Bee, tight enough against your skull and thus is the origin of the phrase "a penny for your thoughts" :-)
Posted By: wbtravis Re: Six Day Ordeal in the Sierra - 07/18/14 03:36 PM
Originally Posted By: Bee


Best hiking buddy to have when you break a major blood vessel: a trained medic!


I was trained...in 1970 by the army, by the navy would have been much better.

I know more than the average person but that was 44 years ago. Because of this, I carry a bigger first aid kit than most,and it has come in handy over the years usually for people other than me.

I have been in a group where a dozen people did not have a useful first aid kit for stopping heavy bleeding. They all had the $13.50 per packaged REI specials.

This is one of the many reasons I stopped counting grams.
Posted By: 63ChevyII.com Re: Six Day Ordeal in the Sierra - 07/18/14 04:03 PM
Originally Posted By: wbtravis

I have been in a group where a dozen people did not have a useful first aid kit for stopping heavy bleeding.


I recently added one of these to my first aid kit. Has anyone ever used on 'in the field?'

http://www.amazon.com/QUICK-CLOT-HOME-Health-Beauty/dp/B003FBTXQ8
Posted By: RickG Re: Six Day Ordeal in the Sierra - 07/18/14 05:35 PM
Interesting development:

http://www.dailymail.co.uk/sciencetech/a...attlefield.html

I just went through First Aid training 3 weeks ago for Boy Scouts run by the American Red Cross. They still do not recommend tourniquets unless there is the loss of a limb, or that limb is expected to be lost. Damage to the tissue under the tourniquet as well as the loss of blood flow are the main reason. Mainly, I think it's because people don't learn how to apply a tourniquet properly that they discourage it.
Posted By: wbtravis Re: Six Day Ordeal in the Sierra - 07/18/14 08:39 PM
Hmmm...I took it a year ago and they did recommend their use.
Posted By: SoCalGirl Re: Six Day Ordeal in the Sierra - 07/18/14 09:53 PM
Originally Posted By: 63ChevyII.com
I recently added one of these to my first aid kit. Has anyone ever used on 'in the field?'

http://www.amazon.com/QUICK-CLOT-HOME-Health-Beauty/dp/B003FBTXQ8


If you count a wrestling tourney as "in the field". My son got smacked and had a real good bleed going on.... we used a similar product to that one to swipe around the inside of his nose and it stopped the bleed real quick.

In regards to tourniquets... I was always taught that after it's applied, if it's going to be there for awhile, that you're supposed to loosen it every 15 minutes to help with blood flow so that while it's helping to stop the major bleeding, complete circulation isn't cut off from the limb.
Posted By: Bee Re: Six Day Ordeal in the Sierra - 07/18/14 10:28 PM
Originally Posted By: wbtravis


I have been in a group where a dozen people did not have a useful first aid kit for stopping heavy bleeding.


My medic was indeed trained by the Navy.

I actually carry a large first aid kit in my car (required for work) and one of the least available item was what we used to call a "battle dress", ie, a thick absorbant badage used for punctures, et al. None of the commercially stocked kits had them. I bought several boxes of female sanitary napkins, decided on the best one, and stocked all of the kits with them (along with wide stretch gauze rolls for finishing out the 'battle dress' bandage)

It is common theory in military circles that most wounds will be deep puncture, so this is the wound to be most ready for. In reading hiking accident statistics, I find that a majority of notable accidents involve the same types of wounds, so this is what I pack for (after all, a large bandage can be downsized for smaller incidents, but not so much in the reverse)
Posted By: Akichow Re: Six Day Ordeal in the Sierra - 07/19/14 01:52 AM
I took WFA a few months ago, and they only recommended use of a tourniquet as necessary to save a life at the possible cost of the limb.

The WFA class was consistent with this excerpt from the NOLS Wilderness Medicine Book.

Note that the excerpt acknowledges that the issue of tourniquet release in wilderness medicine is the subject of "ongoing arguments," meaning nothing is definitive.

By the way, this book is available for Kindle (and therefore readable on on iPhone). I just downloaded a copy of the NOLS book from Amazon for myself. Nice to have a Wilderness Medicine Guide at your finger tips in the wilderness.
Posted By: wbtravis Re: Six Day Ordeal in the Sierra - 07/19/14 03:47 PM
Originally Posted By: SoCalGirl
In regards to tourniquets... I was always taught that after it's applied, if it's going to be there for awhile, that you're supposed to loosen it every 15 minutes to help with blood flow so that while it's helping to stop the major bleeding, complete circulation isn't cut off from the limb.


That is what I was taught originally but the doctor who taught the first aid course said it suppose to be left in place.
Posted By: Fishmonger Re: Six Day Ordeal in the Sierra - 07/28/14 12:21 AM
We were on Black Giant when half the world was looking for him. Choppers all around the mountain (below and above us), and rangers everywhere on the trails in the area converging on the search area, asking everyone if they saw something or saw his name in the summit register. Lots of resources were spent to locate the guy.

It is really rough terrain out there in the Ionian - going in alone without a PLB or sat phone seems a little crazy in this day and age.
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