Before the responder gets to work, they should take a physical and mental step back and take a deep breath. Only if the responder is in a reasonably calm mental state can they make good decisions. When the first responder takes stock of the overall situation this allows them to recognize objective hazards, judge the accident and consider their next steps.
Your own safety is paramount! In alpine climbing, the rope team will often be in precipitous terrain and at risk of falling rocks or ice and other hazards. You need to ensure your own safety before helping injured people! In a worst-case scenario, if it is too dangerous to help yourself, you should make an emergency call and wait for a professional rescue team.
If there are several people at the site of the accident, the safety of the group must be ensured (particularly during guided climbs). Only then can first responders go to help the accident victim.
The dangerous area should be secured for the protection of yourself and others: For example the accident site can be cordoned off or visibly marked. While securing the accident scene on the rock face is often not possible or necessary, it can be necessary for accidents during ascent or descent in order to prevent further damage.
Is the accident victim in a precipitous location? Is there a risk of falling rocks or ice? If the accident scene is at risk of objective hazards, the individual should be moved out of the dangerous area and taken a short distance to a safe location – as long as this is appropriate for the responders and does not endanger their own safety. In precipitous terrain the first responder must protect themselves and the injured person from further slips or falls. If this is not possible, the responder’s only other option is to make an emergency call and wait for a professional rescue team.
If there is heavy bleeding, this must be treated immediately with a pressure bandage. This is done before speaking to the accident victim and irrespective of whether they are conscious or unconscious.
The first responder should kneel down next to the injured person and speak to them. If the injured person does not react, the first responder should shake them gently and attempt to speak to them again in a louder voice.
Any time someone becomes unconscious it represents an acute risk to life. Here lifesaving emergency measures are always the number one priority!
Stable recovery position
- Kneel down on the valley side of the unconscious person
- Lay their near-side arm at a 90° angle next to them
- Bend their far-side leg and hold in place
- Hold their far-side hand, lay the back of the hand on their cheek (the one facing towards you) and hold in place
- Turn the injured person toward you at the knee
- Carefully pull your own hand out from under the injured person’s head so that they are lying only on the back of their hand
- Tilt their head backward
- Open their mouth slightly. The mouth should be slightly lower than their stomach, so that blood or vomit can run out.
Body check
The accident victim has fallen but is responsive. The first responder checks them from head to foot. The first responder works quickly, systematically and comprehensively. It is particularly important to check for bleeding, swelling, bruising, malposition and pain.
Procedure for the body check:
- Head
- Neck
- Shoulder girdle and ribcage
- Abdomen
- Spinal cord
- Pelvis
- Arms/hands
- Legs/feet
Desired positioning
Is the accident victim sitting or lying comfortably? Positioning the person according to their wishes or as necessitated by the injury:
- Upper body elevated position: Head injuries, difficulty breathing, suspected heart attack / stroke
- Flat position: serious hypothermia, spinal cord / thigh / pelvis injury
- Fetal position: Abdomen pain
- Shock position: dry or heavily bleeding wounds, faintness / circulation problems
Psychological support
One of the most important techniques for the responder is psychological support – i.e. being there for the injured person, speaking and empathizing with them. Gently touching their arm or shoulder helps to ensure the injured person knows they are not alone.
Even for those that are unconscious – but still breathing – psychological support is extremely important. Some senses, such as hearing and feeling, often remain active even when the individual is unconscious. This is why verbal encouragement and physical contact are important.
The person should only be left alone as an absolute last resort, e.g. if there are only two of you and you have no cell reception.
Resuscitation 30: 2
Perform chest compressions and artificial respiration in a ratio of 30:2 until professional help (mountain rescue / emergency doctor) has arrived or you are exhausted.
Performing chest compressions
- Place the heels of your hands on the center of the chest.
- Use your own body weight to push the injured person’s chest down five to six centimeters.
- After applying pressure, release the chest.
- Frequency: 100 x per minute – almost twice a second.
Breathing
- Hold their nose with one hand and place the other on their chin
- Tilt their head backward
- Breathe in normally and then place your lips around the accident victim’s mouth and breathe out normally. You don’t need to breathe in as much air as most people think – you just need to breathe normally as you would at rest.
Instead of mouth-to-mouth resuscitation, you can carry out mouth-to-nose resuscitation. Here the injured person’s mouth is closed and resuscitation is carried out via the nose.
Get help
While in some mountain regions there can be good cell reception even at an altitude of 4,000 meters, in other secluded regions it may be impossible to make an emergency call with a cell phone. Here the alpine distress signal is the means of communication. The distress signal can also be helpful for mountain search and rescue if they are having trouble locating the exact accident site.
If the rescue team comes by air, it provides useful information that makes working with the helicopter easier.
EMERGENCY CALL
Anyone out in alpine terrain must be able to provide first aid in case of an emergency. The important thing is to stay calm and act intelligently. An emergency call must be made immediately depending on the severity of the emergency: Knowing the correct emergency number is essential for every mountaineer.
In the case of insufficient cell service at the site of the accident, the procedure used to be: Turn off your cell phone, turn it back on again (without entering the PIN) and instead type in 112 to place a call to emergency services in Europe. Your phone can now locate sufficient cell service from another network provider.
These days all smartphones have an “emergency call function” that can be accessed without unlocking your cell phone – and is shown even without a roaming signal. If there is still no cell service and it is not possible to make a call using the emergency call function, the only thing that will help is a change of location.
NOTE: Sometimes it is not possible to make an emergency call, but it is possible to send a text message or WhatsApp. It is therefore sensible to inform a contact person before the climb so that you can send them a text/WhatsApp in the event of an accident (“112, site of accident, problem”). The recipient can make the emergency call, pass on the information and answer briefly.
ALPINE DISTRESS SIGNAL
If it is absolutely impossible to make a call by phone, the alpine distress signal can be used to signal a mountain emergency situation. The emergency call is made using light signals, smoke signals or by waving and is recognized throughout the Alps.
Procedure:
- 6 signals, 10 seconds apart / 1 min rest / 6 signals, 10 seconds apart / etc.
The signal can be visual (headlamp, mirror, waving with a jacket or similar) or acoustic (whistle, shouting). The procedure should be repeated until you get an answer.
The answer usually takes the following form:
- 3 3 signals per minute / 1 min rest / 3 signals per minute
The distress signals and the answer do not need to be identical.
