Came across an injured Canyoneer in Imlay (what would you do)

[Deathcricket]

If you do the reading, O Cricket of Death, you would discover that I took great umbrage at the Park Service's 11th hour change of Pristine Zone group size from 12 to 6.

I think you are deliberately missing the point. The Park has a rule. If the Canyoneering Community wants to be a player in the managing the park game (and we do), if we want a seat at the table, we probably need to be considered a "rule-conforming-to community" by the Park Service. Each time a GROUP gets caught breaking the rule, we, as a community, lose credence with the Park Service.

(a separate debate could ensue as to whether we have any credence in the first place - side issue!)

The group's plan changed so they chose not conform to the rules. Then they frakked up and broke TWO ankles, requiring a helicopter rescue. They were not smart enough to go out the Sneak Route, or to break their group up, or otherwise come back into conformance with the rules.

So, DC, I agree the rule is BS. But the citation is not. The rule exists. Breaking the rule, then drawing attention to yourselves by demonstrating gross incompetence yields a citation. No big surprise. Take the citation and say "thank you sir". Or go before the magistrate and argue that the rule is BS. But don't complain about the CITATION being BS. Please.

Tom

Good post! I do agree and I probably didn't explain my position well. I do agree they broke the rules, however I don't feel they blatantly broke the rules and perhaps it was just ignorance (although we know that's not an excuse). They got permits for everyone in their group and it's a simple mistake to not understand that even though they did get permits, forming a supergroup of 7 is a violation. So IMO it's a completely different scenario than me and 7 of my friends sneaking into Mystery canyon this Saturday July 30th at 7:30AM without permits. In one case you have a person trying to do the right thing and maybe misunderstanding a simple context, and on the other you have a person like me thumbing his nose at authority and perhaps getting caught in the process, or perhaps not.

Further, when the NPS reached the parties, there were two in the canyon in one section up top needing rescue, 4 in the narrows, and one at the buses having called them out. Which matches their permits exactly. If you had medical training and ran across a separate group, would you not stay with them to aid while your group then went to get help? Would you accept a fine for leaving your group in an emergency situation to aid another human being? If there are only 2 people in a group and one gets hurt, is the other person not allowed to go and get help with another group, because of a single permit? How does the NPS prove they were even all part of the same group to issue a citation? They didn't catch them "red handed". The only reason is they probably admitted it.

So yes I agree they made a mistake (another of many that day), but their intentions were to do the right thing, and as near as I can tell they did not try to decieve the NPS when push came to shove. So the charge is BS IMO. I'm not advocating breaking the rules, I just like to understand people intentions and motives in the spirit of the law. No damage was done to the canyon, no extra people went through above the canyon limit that day. And we do both agree that 7 people vs 6 isn't a huge transgression. So the only conclusion is that slapping them with a $1000 fine is purely a vindictive move to cover the huge amount of rescues this party generated.

Anyways kinda out of our hands, but I think mercy is in order for this situation. Good thing I'm not a judge, I would be too "all over the board" on my rulings.


Edit: But yeah I think the permit system is stupid, the rules are stupid, and generally thumb my nose at authority anyways. I think we don't have any "chips" to bargain with and they (nps canyoneering rule makers) really don't care about us, they will do what they want anyways, screw NPS. So i admit I'm biased in the first place. I just think to issue a citation you have to conclusively prove a violation and that was not done in this case. The party probably admitted guilt but that could be retracted because they were under duress almost seeing their friend die, yadda yadda yadda blah blah...

[ratagonia]

Edit: But yeah I think the permit system is stupid, the rules are stupid, and generally thumb my nose at authority anyways. I think we don't have any "chips" to bargain with and they (nps canyoneering rule makers) really don't care about us, they will do what they want anyways, screw NPS. So i admit I'm biased in the first place. I just think to issue a citation you have to conclusively prove a violation and that was not done in this case. The party probably admitted guilt but that could be retracted because they were under duress almost seeing their friend die, yadda yadda yadda blah blah...

A lot to be agreed with, DC.

To issue a citation, they don't need much of anything. Very few citations are contested. And I'm kinda thinking the magistrate rules in their favor, a LOT.

I don't have a permit with me, but I think it says "don't combine groups" right on the permit, as one of the checked conditions. So, I ain't buying the "we thought we could combine into a supergroup of 7, no problem".

Please realize that the Park Service is a bureaucracy. The RULES are what count, catching people breaking the rules, making sure people know the rules, investigating people who might be breaking the rules. The goals and purposes for which the rules were created in the first place - no longer important.

Tom

p.s. I think we have beaten this one to death, CricketMaster.

[jman]

I am not advocating breaking the rules, I just like to understand people intentions and motives in the spirit of the law.

IMO it's a completely different scenario than me and 7 of my friends sneaking into Mystery canyon this Saturday July 30th at 7:30AM without permits.

Lol...ya sure you are not advocating breaking the rules?? Oh, cricket, so funny.

[Deathcricket]

To issue a citation, they don't need much of anything. Very few citations are contested. And I'm kinda thinking the magistrate rules in their favor, a LOT.

Yeah this horse was dead by page 3, hehe. I just enjoy arguing with you. Since James left I have no one to take me up on random topics.

Lol...ya sure you are not advocating breaking the rules?? Oh, cricket, so funny.

Well I was just using that as a "hypothetical" situation, ya know.




I'll have a trip report on Monday

[bshwakr]

__

[mmac]

Back to the original topic, I think DC did everything correctly considering the situation. Way to keep your cool!

The first responder however should have stayed with the gal until park service SAR personnel arrived. It would have broken up the group, but once you start patient care, you can't stop until someone of an equal or higher level of training takes over. It's abandonment, and can be a potential legal mess. Good samaritan laws don't protect you if you leave the scene.

I'm glad to hear that everyone made it out safely! What an experience!

[Deathcricket]

The first responder however should have stayed with the gal until park service SAR personnel arrived. It would have broken up the group, but once you start patient care, you can't stop until someone of an equal or higher level of training takes over. It's abandonment, and can be a potential legal mess. Good samaritan laws don't protect you if you leave the scene.

Good post, and had not heard of this before. I don't think a person should be "required" to stay with a victim if his own life/well being is threatened. And our party cruzing down orderville had no wetsuits to brave the cold that was coming that night. And we gave our emergency blanket to her. So him sitting there with shorts and a t-shirt would not be pleasant at all in freezing cold water after dark and very dangerous for him. Yes the rescue crews did get them out of there later that night, was it 12:00AM? But we were not sure they would even get there that night to see her. All we knew was it was getting dark soon and we would be screwed. Further, we left her in good condition and good spirits, besides the extreme cold coming, there was no imminent danger to her.


I'm hoping you're wrong on that sir.

[ratagonia]

Good post, and had not heard of this before. I don't think a person should be "required" to stay with a victim if his own life/well being is threatened. And our party cruzing down orderville had no wetsuits to brave the cold that was coming that night. And we gave our emergency blanket to her. So him sitting there with shorts and a t-shirt would not be pleasant at all in freezing cold water after dark and very dangerous for him. Yes the rescue crews did get them out of there later that night, was it 12:00AM? But we were not sure they would even get there that night to see her. All we knew was it was getting dark soon and we would be screwed. Further, we left her in good condition and good spirits, besides the extreme cold coming, there was no imminent danger to her.

I'm hoping you're wrong on that sir.

Well, that is the general rule. Much less applicable to a WFR than an MD, though legally probably similar.

Coming from another party though, with the situation under control etc... My first choice as WFR would be to find a way to manage the situation and the various players, and stay with the victim until handoff. (But get as many of the other persons out of there, while retaining all useful resources). There was some concern about internal injuries that might suddenly cause her vitals to go south (though, as a WFR, not much you could do about it other than rescue breathing). But, that requires the other people present to allow themselves to be managed - which may not have happened in this circumstance. Unuseful people standing around until well after dark == more victims.

Tom

[middlefork]

There are few doctors or nurses out there that unless they are trained in Trama response, would not give control to the first person that came up and said "Hi I'm ...... and I have been trained in EMT, WFR, OEC, Advanced Red Cross First Aid or any other credential that gives them the feeling that you are trained to respond to emergency situations.

They just want to get away from it as soon as possible. They are not trained to deal with trauma.

Bottom line get the knowlege to deal with emergency situations and with that knowlege you can take control of the scene.

And yes people standing around doing nothing need to leave.

[spinesnaper]

There are few doctors or nurses out there that unless they are trained in Trama response, would not give control to the first person that came up and said "Hi I'm ...... and I have been trained in EMT, WFR, OEC, Advanced Red Cross First Aid or any other credential that gives them the feeling that you are trained to respond to emergency situations.

They just want to get away from it as soon as possible. They are not trained to deal with trauma.

Bottom line get the knowlege to deal with emergency situations and with that knowlege you can take control of the scene.

And yes people standing around doing nothing need to leave.

Was that a doctor bash? The flip side is that it is the responsibility of SAR responders to take command of the scene. Generally that also means thanking bystander rescuers for their help and then giving them permission to go unless assistance is needed. Even then, most professional first responders I have encountered would much rather have their SAR colleagues assisting them than bystanders and that includes any doctor who might be on the scene. Especially when doctors are opinionated and not so helpful. In the couple of situations I have been involved with, I stoodby until is is clear that my assistance no longer needed.

Regarding legal requirements, these vary sometwhat by State. A few States do require physicians to render emergency care to a stranger found in an emergency condition. Most states encourage but do not mandate this provision of care with Good Samaritan laws. These provide limited liability for physicians who choose to render care in these circumstances. In many cases, without the specialized supplies that a SAR Paramedic will have with them, there is often little that a responding physician can do other that providing reassurance, organizing the scene, and providing limited first aid. Most physicians I know who are active in the back country do not shy away from this sort of involvement. Still, as comforting as a neurologist who happens to be doing the narrows when you fall the bulk of the last rappel out of Imlay might be, the person you really want to see is the SAR team and all the resources they bring.

Ken

[mmac]

Here's a link to the AZ Good Samaritan law and an overview of it's implications. These laws generally vary state by state, but they tend to be pretty similar. A person acting in good faith to help out is protected from liability from harm caused by the actions or inactions of that person on scene unless they are grossly negligent.

Your personal safety is the primary concern on any emergency scene, and your welfare is more important than the patient's at the moment. It sounds kinda harsh, but the reality is that you don't want to create any additional patients. If you get hurt, you can't help anyone. It increases the level of complexity and the necessary resources required to resolve the situation.

Bystanders are some of the most valuable resources on scene. Especially in the backcountry where those precious resources are limited, individuals with medical training are particularly useful. I'm always happy to utilize people if they're knowledgeable, calm, and can follow directions. In my experience, doctors are some of the first people to step up and help in an emergency. In general though, I would rather work with an EMT, Paramedic, Flight/ER Nurse bystander because their training and experience is more relevant to the scenario at hand.

As several others have said, training is what it's all about. If you think you might want to help someone out, get the training and experience to do it effectively. CPR/First Aid is the first step, but I think that everyone who participates in activities like canyoneering should seek out WFR training. It could save somebody's life, or maybe just brighten their day. Either way, you can make a difference.

[spinesnaper]

As several others have said, training is what it's all about. If you think you might want to help someone out, get the training and experience to do it effectively. CPR/First Aid is the first step, but I think that everyone who participates in activities like canyoneering should seek out WFR training. It could save somebody's life, or maybe just brighten their day. Either way, you can make a difference.

If you really want to make a difference, you might also consider carrying a personal locator beacon. They are not useful in very spot in the canyon but with a little sky, they are going to summon help. Not sure it would have made a bit of difference for Aron Ralston.

I find it interesting how EMT's and other field personal like to bash the usefulness of medical doctors (especially when there are no doctors around). Generally, I think this is because they have a need to feel important. However if you are a paramedic or EMT, it is the ER doc at the base who is calling the shots.

Generally, in an emergency situation the best resource will be the responding emergency personal and you will be greatful for their professionalism and training. Sure if the flight nurse is standing there you are as good as home. In the absence of these professionals on the scene, a physician on the scene of an emergency is likely to take charge. If I had a twisted ankle in the backcountry and had to choose between an EMT and an orthopedic surgeon to apply my SAM splint, boy tough call there. In general though there is seldom going to be any medical personnel around in the backcountry.

Having some first aid training is good and more training and supplies are better. However, flipping open and activating that personal locator beacon is now the best first aid supply you can carry. The one I carry only weighs 5.3 ounces (McMurdo Fast Find 210). I believe that ACR is out with one also that only weighs 4.9 ounces. Hard to go wrong with either option.

Ken

[JONBOYLEMON]

Wow, this is the energizer of threads.

[spinesnaper]

Wow, this is the energizer of threads.

When we get to 1600 posts, then we will have something.

[mmac]

I find it interesting how EMT's and other field personal like to bash the usefulness of medical doctors (especially when there are no doctors around). Generally, I think this is because they have a need to feel important. However if you are a paramedic or EMT, it is the ER doc at the base who is calling the shots.

I don't mean to "bash" Doctors by any means. They are ultimately the people who are going to have the greatest ability to help a patient over the long run. My concern is that MDs are generally specialists, and there are many, many different kinds. An ortho-surgeon would be awesome to have available to assess and stabilize an ortho-wound. The understanding of a particular procedure is likely greater, but I would suggest that the effective application of the procedure wouldn't be much different if performed by an experienced prehospital provider. It's not like the surgeon could actually perform surgery in the backcountry. When someone identifies themselves as an EMT or Paramedic, I know exactly what they should be able to do. When somebody says "I'm a Doctor." You have to wonder... a Doctor of what? A urologist likely wouldn't be much help stabilizing a femur fracture. I would rather have someone trained in prehospital life support for the multi-system trauma patient (as described at the beginning of this thread) than a random MD.

I think that everyone needs to feel important. If you can't feel like you've made a difference in some way, then what's the point of doing any job? We should all appreciate the importance of everyone in the medical chain, from dispatchers to first responders, to doctors, nurses, and technicians. Everyone contributes to the outcome of a patient, and no one should be put down for trying to help.

[spinesnaper]

A urologist likely wouldn't be much help stabilizing a femur fracture. I would rather have someone trained in prehospital life support for the multi-system trauma patient (as described at the beginning of this thread) than a random MD.

That urologist will have a detailed working knowledge of fluid balance, shock management, and hypothermia, plus they tend to have a wicked sense of humor. I would be pretty happy if a urologist was on scene in a backcountry medical situation. I assisted a dermatologist reduce a dislocated shoulder in the Sierras a number of years ago. So my advice is keep an open mind on this issue. Before medical school I work as an EMT in Oakland. Sure I could bandage a wound but EMTs are not physicians.

Everyone contributes to the outcome of a patient, and no one should be put down for trying to help.

This would precisely be my point. A physician backcountry traveler coming a upon a scene requiring medical assistance is not such a bad thing. It is not a substitute for the actual SAR response.

Ken

[Upstream]

I can certainly understand your desire to get the subject to safety, but I think you did the right thing. I'm a member of a SAR technical rescue team, and we would rather see injured people stay where they are to reduce the chance of further trauma, and help prevent possible injury to those who are assisting. Sometimes we can get to a subject fairly quickly by helicopter which allows us to determine the extent of any injuries and make a transport plan based on that information.
If at least one member of your group has a Personal Locator Beacon that uses NOAA SAR satellite tracking and you can get high enough for it to properly transmit, help may come much sooner. We also recommend everyone carry the ten essentials:

1. Navigation (map and compass)
2. Sun protection (sunglasses and sunscreen)
3. Insulation (extra clothing)
4. Illumination (headlamp/flashlight)
5. First-aid supplies
6. Fire (waterproof matches/lighter/candles)
7. Repair kit and tools
8. Nutrition (extra food)
9. Hydration (extra water)
10. Emergency shelter

Be safe and have fun out there!

[ratagonia]

I can certainly understand your desire to get the subject to safety, but I think you did the right thing. I'm a member of a SAR technical rescue team, and we would rather see injured people stay where they are to reduce the chance of further trauma, and help prevent possible injury to those who are assisting. Sometimes we can get to a subject fairly quickly by helicopter which allows us to determine the extent of any injuries and make a transport plan based on that information.
If at least one member of your group has a Personal Locator Beacon that uses NOAA SAR satellite tracking and you can get high enough for it to properly transmit, help may come much sooner. We also recommend everyone carry the ten essentials:

1. Navigation (map and compass)
2. Sun protection (sunglasses and sunscreen)
3. Insulation (extra clothing)
4. Illumination (headlamp/flashlight)
5. First-aid supplies
6. Fire (waterproof matches/lighter/candles)
7. Repair kit and tools
8. Nutrition (extra food)
9. Hydration (extra water)
10. Emergency shelter

Be safe and have fun out there!

Thank you, Upstream, and welcome to the group!!!

Tom

[Deathcricket]

Interesting, I actually got an update from the group about a week ago... I wasn't going to revive the thread but it seems that has happened anyways. I don't think she would mind me posting this. Wraps up the story nicely.

Checking In

Hi,
Just wanted to check in to let you know that our group from Imlay is all mending well. Neither of the 2 injured people have recovered enough yet to get into a canyon but everyone is close. The gal that you guys stopped to help no longer needs a cane for walking and is back to hiking. I think her boyfriend suffered the most from the PTSD. She put her PhD program on hold for a year while she focused on her recovery.

I'm in the middle of a WFR course now...it's very intense but I'm already thankful for all that I've learned and feel like a better canyon partner. I have a heightened awareness of all that you guys did when you made the choice to help. It still means a lot. I hope to return to the favor to someone some day but have my fingers crossed that it won't be necessary.

Best Wishes and safe travels.

[ratagonia]

Interesting, I actually got an update from the group about a week ago... i don't think she would mind me posting this. Wraps up the story nicely.

Thanks DC. Was there ever a report on the actual injuries? "PHD program on hold for a year" sounds a lot more serious than the broken ankle my brain remembers as the most serious injury.

Tom