A tumble from a great height or a fall on to a root or trekking pole can lead to significant injuries and internal bleeding in the abdominal area. STEP 1: RECOGNIZE SYMPTOMS The circumstances of the accident can give a clue as to whether the stomach has been injured. Bruising and blue flecks are also indicators of a blunt stomach injury. Pain in the stomach and a rigid abdominal wall often only set in later. A significant loss of blood in the abdomen can lead to typical shock symptoms such as cold sweat and paleness, right up to loss of consciousness. A life-threatening situation can ensue if a professional rescue team is not promptly alerted. STEP 2: MAKE AN EMERGENCY CALL IMMEDIATELY Upon recognizing the symptoms, the first priority is an emergency call, because internal bleeding can soon become life-threatening. It is better to alert emergency services one time too many than one time too few. Every minute counts! STEP 3: KEEP THE PATIENT WARM AND TAKE GOOD PSYCHOLOGICAL CARE OF THEM The injured person should be cushioned, kept warm and supported in a relieving posture (usually in the fetal position or on their back with raised knees). Good psychological should be taken of them. It is a difficult situation for a first responder, because it feels as though you can’t do anything for the person and are just helplessly sitting next to them. But just sitting there and treating the injured person sympathetically is a big help in itself. STEP 4: STABLE RECOVERY POSITION AND/OR RESUSCITATION If the injured person loses consciousness, check their breathing. If they are breathing regularly, put them in the stable recovery position. If the injured person is not breathing regularly, resuscitate until the rescue team arrive or until the first responder is exhausted.