Following on from a recent training note by the Scottish Cave Rescue Organisation printed in the October 1999 edition of the Grampian Speleological Group Bulletin, this article is intended to bring CCC up to date on modern cave rescue practices and recent advances in casualty evacuation. Firstly, a note on rescue equipment.
Rescue Equipment
As a minimum, the following equipment should be considered in any cave rescue tackle store - paracetemol, stretcher, lump hammer, saw, food blender and Fray Bentos shepherds pie mix.
The SCRO possess a Sked stretcher; an ideal cave rescue device, with plenty of loops, straps, grommets, buckles etc. It also has a rolled over front section, making the Sked suitable for snow covered slopes during the winter, when nobody has the inclination to go caving or brush up on their cave rescue techniques.
Preliminaries
In the event of an accident in which self rescue is impractical, everyone should sit tight and await rescue. Following this procedure will ensure a maximum rescue turnout when those on the surface realise that a serious incident must have occurred to prevent any of the cavers from getting out of the cave by their call out time.
Nine times out of ten, the rescue call out will occur well into drinking time after large quantities of putrid ale have been consumed (i.e. Butcombe, Flowers to name but two which landlords seem incapable of keeping). In the early hours of the rescue, the paracetemol will seem like a godsend.
The cave rescue team should always include a 'captain', who overseas the rescue operation, barks orders and gives press releases - such as 'its only a minor incident and we should have them out by teatime'.
After the preliminaries have been completed - setting up telephones between base and the press tent, sending out runners to fetch items of forgotten kit and generally running around like headless chickens, the evacuation team should be in a position to enter the cave.
Casualty Evacuation
The casualty, or victim (depending on who caused the accident) may be hampered not only by obvious injuries, but by more subtle factors such as shock or internal injuries.
The first stage of casualty evacuation is to bring in to play the four 'R's: Rewarm, Rehydrate, Renourish and Ridicule. No one appreciates missing their favourite sitcom to aid a mishap who is obviously only there because of his own incompetence. Calling him or her a few names will certainly relieve the tension in a rescue situation.
On no account should the casualty be encouraged to exit the cave of his own accord. Remember, the national press will probably have been camped outside the cave entrance for the last twelve hours and will be expecting good coverage of a heroic rescue attempt carried out at all odds. If the casualty brushes the concerns of his rescuers aside and attempts a 'self rescue', the lump hammer can be used to bring him to his knees and remind him of his plight.
Once in the stretcher, some time should be spent adjusting the straps, turnbuckles etc. No doubt, this will not have been practised for some time. There is nothing as unprofessional as exiting a cave only to have the casualty fall out of the stretcher in front of the press. To aid casualty alignment, the stretcher can be painted with identification marks, such as 'HEAD HERE' (at the head of the stretcher) and 'UPSIDE DOWN' (on the underside of the stretcher). The last marking is also useful in reducing the risk of drowning the casualty when crossing stretches of water.
It is well known that a number of cave systems present particularly difficult rescue scenarios due to their to tortuous and constricted passages. If the stretcher is of the rigid design, judicious use of the saw should be made to articulate both the stretcher and the casualty. If the casualty's limbs have grown immobile due to swelling or gangrene and progress as a result is being hampered, the saw can be used once again to good affect by removing the offending appendages. Provided the rescue team can make it to the surface in good time, advances in medical science now mean that the limb can be sown back on with a reasonable chance of success. If this fails, the amputated limb should be presented to the casualty, preserved in a jar of formaldehyde, as a memento of their former caving career.
Room should always be made for a food blender in the cave rescue kit. The French have recently demonstrated the practicalities of boring through the hillside to a trapped caver. While the BCRA funds may not extend to a full land based oil-drilling rig with the ability to drill 16" holes through 100m of limestone, for a mere £20,000, a more modest second hand rig can be bought with the capacity to drill holes up to 3" diameter. This will provide sufficient clearance for a 2" tube connected to a vacuum pump to be inserted through the hole to the trapped caver (the benefit of this method is that it does not create artificial entrances, destroying the character of the cave). The food blender can then be used to liquidize the casualty and thus enable his removal through the tube. If the casualty is either unable or unwilling to enter the liquidizer, the lump hammer and saw can be used to aid the process. While the present state of medical science may not allow the reconstruction of a liquidized human body, the casualty can be frozen in stasis at a cryo-bank until such time as medicine has sufficiently advanced. Needless to say, the underground rescuers should not embark on this process of evacuation until they are certain that the over-ground support crew have acquired the necessary drilling and suction equipment and the expertise in how to use it. The idea of the over-ground crew being unable to extract the liquidized caver does not bear thinking about.
Now we move on to the Fray Bentos Shepherds Pie mix…..