Sprains, ligament and joint injuries caused by twisting, stumbling or tripping are among the most common injuries when mountaineering, or during approach and descent on a climbing tour. Most frequently affected are the knee or ankle, where either the joint capsules or ligaments get overstretched or torn. STEP 1: RECOGNIZE SYMPTOMS The affected area is often extremely painful and becomes hot and swollen. A useful aid here is a RICE bandage: This is a compression bandage that also cools. R stands for rest, I stands for ice, C for compression and E for elevation. STEP 2: CONSTRUCT A COLD PACK You can cool the area by making a cold pack out of a disposable glove filled with moist soil or water. To do this, put on a disposable glove, grab some moist soil, and then turn the glove inside out, keeping the soil inside and then tie a knot in it. STEP 3: APPLY “RICE” BANDAGE The injured person can place the improvised cold pack on the most painful area without removing any clothing. The first responder can now fix the cold pack with an elastic bandage. Warning: do not remove the climbing boot under ANY circumstances, THIS SHOULD REMAIN ON! It already provides compression and prevents further swelling. A climbing shoe is the exception to this: This can be taken off, because the pain from its tight fit can become unbearable. STEP 4: EMERGENCY CALL YES OR NO? Compression helps prevent further swelling and the cold pack helps to reduce the pain. Now make a joint decision as to whether descending or rappelling is possible or whether an organized rescue is required. If you have to wait, the patient should be kept warm and be well taken care of.