Great post, Andy. Refreshing.

A couple of years ago I was cragging next to a guy who took a nasty ground fall (VERY lucky as injuries weren't life-changing or ending, but he was knocked out, bleeding and in bad shape). His partner has just finished a Wilderness First Responder course the week prior and after the fall went into full first aid algorithm mode. The partner was borderline panicked but did a fine job and we all helped stabilize the guy and roll him off of his harness full of cams.

I was on a mountain rescue team for 10 years and in my experience, there's basically nothing you can do without ALS, advanced kit and drugs. You simply have to wait for rescue. I tried to calm the partner down, explained he was doing great, and that we just had to wait. Once rescue arrived there was a doctor who took control of medical. The partner talked to the doc and said "damn I forgot to check for battle sign" to which the doc said "so what, what could you have done?".

It's really disempowering, but I wish more people understood that accident victims in remote settings are either stable or going to die. In my years on the team we only had three subjects who were truly on the edge. In two cases the only reason they survived is because we immediately had a helicopter that flew us in and the patient out. The third died during transport while we were in brutal conditions at night. Every other victim was either miserable or already dead as it simply takes a long time for help to arrive. It wouldn't surprise me if this story is a bit different in Europe (I'm in the US) where the travel times for helicopters are incredibly short (and therefore fast) and the rescue services are world-class.

Your post has some good points and tools I wasn't aware of, thanks!

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Jun 25, 2023·edited Jun 25, 2023

My experience of codeine is that it is completely useless for stopping pain (opposite to the highly effective co-proxamol which really did stop pain nicely - before some medical genius banned it and replaced with the useless codeine-paracetamol "cocodamol") - however it causes massive constipation (which GPs always seem to fail to warn their patients about, thereby needlessly burdening NHS with longterm haemorrhoid and anal tear patients) - however this does make it a useful anti diarrhoea drug. Tramadol is a separate chemical - supposed to be a stage heavier duty. But for many people it still doesn't do much for pain, while also causing nausea. At the high end, Oxycodone is highly effective, and has some capability to stop extreme pain from severe injuries, but no UK doctors will give it to you (even when you do have a severe injury - unless maybe if you are dying from cancer or something). I might have saved a few from a severe back injury and kept in my mountain kit, and might have given one to my mate when he decided his ankle hurt too much to walk off Snowden horseshoe years ago - and 5 mins later I might have been unable to keep up with him as he ran down the mountain singing... ;-)

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