Fall at Frenchman Coulee--

[catbirdseat]

[Marc]

Unfortunately the odds say you are many times more likely to contract a disease performing cpr than doing any good at all. Not to say it's not worth doing, but it is pathetic in terms of helping somebody live.

 

Iain: I think your attitude here is is naive and wrongheaded. If you are really concerned about contracting a disease, then you should bring gloves and a breathing barrier with you whenever engaged in risky activity, namely, living life.

 

Here is another anecdote for you: about 10 years ago I and another individual performed CPR on an 81 year old man for 20 minutes. When we began, his face was nearly the color of a Concord grape. He lived. We didn't get sick.

 

 

Edited March 9, 2004 by Marc

[catbirdseat]

Actually the climb was Pumping the Pigeon, a Chossy 5.8 Crack climb. The fall happened closer to 2:30.

Route #8 in the photo

[jon]

Marc, Iain et. al. start enother thread if you want to argue about this, but Marc there is a serious difference between performing CPR on someone who has had a heart attack versus serious trauma, both in likelyhood of survival and disease transmission.

[iain]

Iain: I think your attitude here is is naive and wrongheaded. If you are really concerned about contracting a disease, then you should bring gloves and a breathing barrier with you whenever engaged in risky activity, namely, living life.

 

Are you saying you shouldn't bother with gloves and a mask? I'm not sure what you are trying to say, other than insulting me.

 

Here is another anecdote for you: about 10 years ago I and another individual performed CPR on an 81 year old man for 20 minutes. When we began, his face was nearly the color of a Concord grape. He lived. We didn't get sick.

 

That's great. Did he fall off a cliff with massive trauma as well? My above quote is simply what my medical advisor has advised me, that in ideal conditions in his ER, CPR has a terrible track record of bringing people back. The odds are more likely you will contract a pathogen than you will do any good, the exceptions being lightning or drowning victims. Do what you want, but I'd rather not be called naive since I have put some time and thought into this. And I would perform CPR if I felt it might help, but there is such a thing as obvious fatal injury.

[Doug]

And people who don't buy lotto tickets have a very poor track record in winning the lottery. Personally, I would try CPR with a trauma victim. I'd have a hell of a time living with myself if I didn't at least try. But that's just me.

 

See CPR supplies thread for the precautions I'd take.

[Marc]

Iain:

 

First of all, I apologize for insulting you. I felt defensive about how our group worked on Robert. I was wrong to vent on you and I'm very sorry.

 

I have also been taught that CPR is not employed on trauma victims very often. My wife, who works in medicine and was about the third person at the scene, told me yesterday morning that it was apparent to her that the victim was dead, but she didn't want to be the one to say that CPR would be useless. So all of us worked on him for 40 minutes, with body fluids all over everything, and no protection. I do not think anyone there gave it a second thought.

 

Someone on this thread stated that they will carry PPE with climbing packs; I'm sure that is a good idea. However, emergencies happen anywhere - do you carry PPE with you wherever you go? I'm certainly not going to do that. I once drove by a burning vehicle with person(s) clearly inside (rescue personnel were present). Because of that, I now carry a large pry bar and fire extinguisher in all my vehicles. But I don't carry the PPE because I honestly don't think, in the confusion and rush to do something, that I would remember to use it.

 

I sure, Iain, if you ever come across someone in need -and I hope you don't - that you will do the right thing.

[iain]

Thanks Marc, no problem. It's easy for me to sit on the sidelines and say stuff after the fact. It seems to happen a lot on this site after accidents, unfortunately. Hope you are doing well.

[Norman_Clyde]

As an ER doc I have to decide both when to start CPR and when to call it quits. I agree that a victim of massive trauma, who has no respirations or pulse in the field, is very unlikely to survive. If a medical person at the scene decides to call it quits on CPR, that's fine-- this lifts the burden from all others involved. But if no medical person is present, continuing CPR is the right thing to do, for moral/ethical reasons, not even so much for the well being of the victim, but for the sake of rescuers and family members. No one wants to live with any lingering doubt that they might have made a difference, but chose not to try. Family members will not have to ask if something more could have been done.

 

Hats off to all of you who did your best to save Robert. You will probably sleep better at night because of what you did. The risk of disease transmission was yours to assume, just as you assume risks in climbing, because you decide it is worth it. Don't let anyone tell you that you wasted your efforts-- you didn't.

[NYC007]

How about we just leave it at that. I think we own it to him.

[jon]

I think it should be pointed out here that nobody is questioning the decisions made in this particular accident towards the people trying to save this guy, you guys did what you thought was right and that is all that counts. There are many people who just can't handle situations like this but you guys did all you could and I'm sure everyone is grateful for that. Having been faced with a similar situation myself I know how intense it can get and not knowing what might happen next. In my friends accident, which was similar in that it was a huge fall, while he never went into cardiac arrest, we were faced with the problem of possibly having to perform CPR on someone who likely had spinal injuries if he did go into arrest, as well as moving someone with those injuries. Luckily two of us had significant rescue and first aid experience and we were aided by two people from this board who I will forever be in debt to.

 

For the people who were there, I would suggest seeking out some people who have been through all of this and can offer you some support. Witnessing something like this is VERY troubling, as well as humbling, and it's not fair to yourself to let these thoughts fester in your mind any longer then they should.

[offwidthclimber]

dude, this fucking sucks.

 

first, my condolences to robert's family. secondly, kudos to those involved who went above and beyond to give him the most optimal chance possible at surviving.

 

shitty...

[kmurray]

While I have had many experiences in stopping CPR in people, and declaring them dead, I think there is a real problem with people doing things that have no value.

 

For example, in a victim of traumatic full arrest, one of the few procedures that might save a life in a very small percentage of cases, would be opening the chest, and searching for a repairable tear. Dr. Clyde and I both have the skills to do that, but I venture that neither of us would, because we would be lacking the vast amount of equipment that is neccessary to make such a venture worthwhile.

 

My point in posting is that with a person suffering a traumatic full arrest, there is nothing that you can do that will save their life in the field, and you should feel no guilt because you have not undertaken futile things.

 

I, for one, would not want my last conscious thought to be of someone breaking my ribs, attempting to do effective, but fruitless CPR.

 

A book that touches on this issue is "Dark Shadows Falling", by Joe Simpson, in which he discusses at length, the issue of being with a dying person in the wilderness, and the issues involved.

 

I am not one to be overly morbid, but one of the reasons that we tend to be so unprepared for exposure to such things, is that we tend not to talk about it, and work through the issues. It is good to talk about it at length, both for the people involved, and for the people who may some day be involved. Also, in their death, those who pass give something to the rest of us, which is an ultimate tribute to them...

[kmurray]

A copy of current EMT protocols:

http://www.med.wright.edu/em/gmvemsc/2004AdultBasic-FRmanual.pdf

On page 73, 3.1.5 #3, it talks about when CPR will NOT be started, and it says: they will NOT start CPR on a victim of traumatic full arrest, unless they can get the patient to an ER within FIVE minutes, or the cause is suspected to be from a reversible cause, such as a heart attack, or focused trauma to the chest (getting hit by a baseball, for example)

 

I don't post this advocating that people not do CPR in this situation, but rather to demonstrate that professionals do not consider this to be of value for the victim. The issue of doing it to make the family or rescuer feel better is another thing.

 

I have often seen paramedics perform CPR that could have no beneficial effect (one-handed CPR with a light touch), only so that it can be said that CPR was done, and make people feel better.

 

If we are talking about futile care, why not do useless things that do not put the rescuer at risk, rather than useless things that DO put them to some risk?

[Bad[lasma]

Its has always been told that once CPR is started on an incident like that, that only a paramedic or the cornor can say to stop. My heart felt sorrow goes out to the Family of Robert. I know everybody that was there the first people to him and the Fire department and EMS people did there jobs well.

At least I havent heard anybody slamming them this time.

[chelle]

Actually as long as a WFR is on the scene and is the person with the highest training CPR can be called after 30 minutes. While you may not think of Vantage as a wilderness, it fits the legal definition of wilderness and calling CPR is within their protocol.

 

Practically speaking though, most people will not stop CPR if more rescue personnel are on their way. It's a tough call to make.

 

Anyone of the MDs out there know if there is any benefit to continuing CPR when the person is not revivable and some form of transport is on the way, just in case they are an organ donor?

[Norman_Clyde]

Don't continue CPR out of any hope for organ donation. In these cases, CPR is useless to perfuse vital organs for the same reason it's useless to revive the person, i.e. massive internal bleeding and disrupted circulation. Organs not dependent on circulation, such as the cornea, can still be harvested later and do not depend on CPR. However, there is a time limit on harvest for these as well, in the range of hours I believe, making organ preservation for any wilderness victim a real longshot.

[klenke]

Thanks for the info, Barry. Good to know.

 

Question: is "harvest" the standard medical term used for organ donation/extraction? Reads kind of strange.

[richard_noggin]

I think we are getting way off topic. I have been checking this tread daily because I ran accross Robert at the crag in the past and he seemed to be on top of things. Just for my information I would like to know what happened, so I can avoid a similar mistake.

Questions: Did he rig his own rope, did he pull too much from one end , could he not see the ends from his stance,

Was he useing a bucket(atc, sherrif ect.)that could not be locked off if he saw the end coming.

The last couple of years there has been way too many accidents from going off the end of the rope, lets talk about it.

CPR is post accident lets talk pre accident.

[sobo]

I think we are getting way off topic. I have been checking this tread daily because I ran accross Robert at the crag in the past and he seemed to be on top of things. Just for my information I would like to know what happened, so I can avoid a similar mistake.

Questions: Did he rig his own rope, did he pull too much from one end , could he not see the ends from his stance,

Was he useing a bucket(atc, sherrif ect.)that could not be locked off if he saw the end coming.

The last couple of years there has been way too many accidents from going off the end of the rope, lets talk about it.

CPR is post accident lets talk pre accident.

 

FYI, Central Washington Mountain Rescue (CWMR) conducted a reenactment of the accident this past weekend at the very scene of the incident, based upon information provided by Robert's partner, another very close friend, and several witnesses (many from this board). Additionally, we tried to perform a rescue of the rappeller, given the equipment that we've been told was available at the top of the chains at the time of the accident. CWMR is currently compiling our findings and will be releasing a report to the AAI for inclusion in the next edition of ANAM. When the information is finalized and cleared for public consumption, I'm sure that we'll be posting it here. Thanks.

 

Paul E. Soboleski

CWMR

[Tony_Peruchini]

Hello Scrambler: I'm Tony Peruchini, the brother of Robert Peruchini, and I read on the climbers website that you were there that day, and took photo's etc. It was the worst day ever when I got that call that my brother had died from his climbing adventure that day. If there is any information you can share with me, or photo's of that day, I'd really appreciate any thing you have for me.

Please respond back, and I'll send you my mailing address. I live in Everett Washington.

Did you know my brother personally?

[james_e]

Well, i can give you guys the real cause. In the July edition of Rock and Ice there was a very informative short article on it. The man and his partner had a 200 foot rope, with no middle mark on it. They dealt out half of the rope down the cliff, so that it was touching the ground. They figured they could just throw the other half of the rope down and it would be the right length. It was a very windy day at the coulee, and what they didn't notice was that the wind had actually pulled more of the rope through the chains, leaving just 12 feet at one end. The man began his rappel, but the rope quickly shot through his rappel device. He grabbed the end of the rope before it got out of reach, but slipped within seconds.

Great apologies to you, and kudos to those who tried to help him.

[Crackbolter]

Hello Tony,

 

I was there at the time of the incident as well as my roommate Dave Yount and his girlfriend Cheri Dunham. We were climbing close by and heard the commotion. I made an effort to help the EMT's in any way possible but they had everything under control.

 

Let me know if you need anything.

 

Sincerely,

Tony Bentley

tony (at sign) featheredfriends.com