UKC

Brave Dave documents an incident in which he was involved in March. Very lucky. Think about the use of ice axes on steep icy ground where a slip potentially has serious consequences  

youtube.com/watch?v=CRf7CnhOzXY&

Something I've noticed is that people often seem to have quite unrealistic expectations around using an ice axe to self arrest. On hard snow/ice or very steep ground the chances of making an effective arrest are quite small.

This is horribly reminiscent of an accident that happened to me in January 1973 - a long slide resulting in serious injuries, but seen from the perspective of the people who were there. I found it terribly moving - I was in tears at one point. 

That's what happened to me - I think my axe snagged on something - a protruding rock or harder ice, and I lost my grip on it. 

Scary stuff, shows how quickly things can go bad. Also shows the value of carrying a bothy bag and/or survival bag.

From a first aid point of view I think they did pretty well, focused on the priority of keeping the casualty warm, without moving him unnecessarily. And most importantly rang mountain rescue straight away, and presumably managed to describe their location sufficiently accurately.

Forget about an ice axe in these conditions, the essential kit is a gopro, selfiestick and youtube channel...

Yes. I did wonder where the survival bags and/or bivvy bag was. I have a two man shelter that would have got them out of the wind. 
 

He said he’d used the app to text their location. 
 

Good use of whistles too. Maybe consider blowing them straightaway? 

It's so easy for that or things like it to happen but I've often heard people talking about self arrest as if it were some sort of dead cert. I slid once approaching Glover's Chimney, I was bang on it and got that axe in straight away with a textbook arrest. I still slid for over 50ft and realised afterwards that had there been anything at all that slowed or interfered with my response there would have been no chance of stopping before the bottom.

I’ve only practiced on snow but if it’s in your hand rather than on your backpack you might get a chance, the trick is to stop your fall before you pick up speed.

But really should be already using it as a thrird leg on the upward side of the slope. 

That was horrible to watch.

Good that the guy went through the process of setting up donations to Mountain Rescue at the end of it. 

Time to set up a monthly donation. If I halve what I spend on caffeine I won't even notice it.

looked like he may have slipped on steep grass and his slippery waterproofs took him away ? walking poles would have been useful..

my first encounter with loosing control in this situation was on a school trip, all the students had practised that day all had had previous experience and the teachers were all instructors/mountain rescue team members. One of the students slipped on the descent down Glyder Fach, Myself and one of the teachers followed down the fall route finding the ice axe, a trail of mittens and gloves and a hat and finally the pupil with a fractured leg and much bruising.

A sobering experience on the limitations of the ice axe.

The question is: were those paying clients, and did the conditions of the day fall outside the remit of a summer mountain leader?

The answer is no. They were a separate pair. 

Announcing "F*ck, I think we're dealing with a dead man", right at the start of trying to locate a fallen mate, perhaps isn't the best method of keeping everyone calm and focussed. And in those conditions, on icy ground, wearing wet slippery waterproofs with no poles or axes, that particular descent route is bloody lethal.

After viewing previous video offerings, I don't think there was much doubt Dave would be calling out MRT sooner rather than later.

It is something I don't really hear it talked about, but an ice axe in hand is something that can be extremely useful on terrain other than snow and ice. An ice axe is a super useful tool to use on such steep grassy slopes, not sure it would be much use for arrest as people seem so fixated on with axes, but improves balance and stability so much on a slope like this, and makes proper use of effective footwork so much easier. It also acts as a first line of defence to prevent a slip developing into a full on slide in a similar way to on snow.

I have been known to use an ice axe in this way on completely snow free slopes, it is surprising how much it adds to the ability to move confidently and securely on those steep grassy slopes. I wouldn't go as far as to advocate carrying one specifically for this purpose, but if you are carrying it anyway why not?

What about the chap with DD, who it could have just as easily happened to? It sounds like he's talking to him like a client. 

He dealt with the situation reasonably well but when there's a load of comments saying he saved that guys life, what a hero etc. you have to ask. They don't look like summer conditions in Snowdonia to me. 

Good of him to continue to film though, I assume to gather evidence for the Coroner rather than get the 'like and subscribes' numbers up.

I was on Snowdon on the Monday before the  incident. I’m struggling to remember if temperatures rose significantly that week, but when I went up, it was certainly winter conditions for the summit and a few hundred feet below. Ice axe and crampons were certainly advisable. I delayed putting crampons on a little too long and ended up on my arse as a consequence, no damage but a warning against complacency.

I must say I hate steep wet grass, and although an ice axe seems like overkill I've toyed with the idea of keeping some kind of sharp implement in my sack for such situations. 

yes but my point was that if he slipped on wet grass in summer he wouldn't have had an axe..

Yep agreed.

yes, and cheap walking boots with soft soles are a recipe for disaster, but thankfully most walkers stick to the paths..

He does refer to him as his mate at the start of the video, so to be fair unless he's trying to hide something I read that as two mates having a day out together rather than a client relationship. He does take charge a little bit, but giving him the benefit of the doubt I reckon might just be because he's more experienced in the mountains than Rory.

And I know in hindsight his immediate reaction of commenting that he thought they had a dead man on their hands might not be the most helpful thing in the world, but I don't think you can judge people too harshly when something like that has just happened given the amount of adrenaline that will have been pumping through his veins.

At the end of the day they didn't do a perfect job, but they did their best to help the guy, and saved his life. I'm a bit more pro-video than some in these situations too. Can't imagine it took him long to clip his go pro on his chest strap or whatever, and we ended up with a valuable illustration of what can go wrong in the mountains. There are all sorts of disastrous / tragic scenarios which are much easier to analyse and understand due to video/photos being available, and which probably resonate much more strongly with people than a description of the event after the fact. Hopefully the result of this is that everyone who sees the video is a bit more careful having been reminded of the risks, and maybe mrts getting some more support. 

I've just realised who he is... much is explained. 

There's a known history of this, most notably a terrible incident in May 1991 when a very experienced (multiple Munro rounds etc) 80-year-old man named Matthew Moulton died after slipping on steep grass on Stob Dubh, the Corbett above Glen Etive. His companion reported that he was wearing full waterproofs, and that was a factor in what happened. I've seen a (thankfully lesser) version of this first-hand, with a friend on steep grass in the Borders about 25 years ago. It was a wet day and my friend was in full waterproofs. He slipped and managed to stop himself unhurt after maybe 10-15 metres - but the speed he picked up over that distance was alarming to see. I've never worn waterproof leggings on steep wet grass from that day to this.

Re GerM's point about using an axe on snowless ground, I've done this too. Studded fell running shoes (rather than boots) are also useful on steep wet grass, but they're more of an acquired taste whereas an axe is a much simpler thing to have.

Yep.

Many years ago I was on the Ben in icy conditions and saw someone emerge at great speed from No. 4 gully. They were on neve, lying on their chest. Their arrest technique was perfect but they couldn't penetrate the neve far enough to slow down, there was a plume of it going over their head. After several hundred feet they hit a patch of softer stuff and came to a halt.

About thirty feet short of the boulder field.

Best not to trip in the the first place.

Fair enough, a fair point to make.

I was making a point only vaguely related to yours, which is why I replied to your message.

The reason I went on to talk about ice axes was it is also something that could have helped prevent this incident, more as a general point than any particular criticism, stuff happens. It was certainly the type of day where carrying an ice axe would be advisable, as at least some (maybe all) of those in the video were. Conditions shown in that video don't reflect the wintryness of that particular week this year, by that point it was largely snow free on Crib Goch, but that was mainly due to the rapid thaw of that day (and day before?), two days earlier it was certainly full winter conditions in the area, although cover was thin on Crib Goch itself.

They weren't using ice axes on that slope though, and as I suggested maybe it is a situation many wouldn't really think of using an ice axe, despite the usefulness of the tool in such a situation. Just thought I'd try to spread the message of how useful I've found an ice axe in situations some people wouldn't consider getting it out of the bag.

That's it decided then, all next year's outdoor gear catalogues to feature the latest range of the revolutionary 'Grass Axe' and hobnailed grass scrambling boot.

All fair points, but in my eyes he loses a lot of respect with his "all's well that ends well" conclusion, with zero acknowledgement of his own poor route choice on the day and zero reflection on what he could have done better, equipment choice, lack of helmets or if it was advisable to take a relatively inexperienced mate out in such poor conditions. The only positive that can be gained in being involved in the near death of one of your companions is if you learn from it. In Dave's case he appears to have learnt nothing.

Those would be great. There's also the thing I've seen pictures of related to very steep sheep-cropped grass on islands such as Boreary and the ones south of Barra: wearing crampons in summer.

Actually, re the axe-on-grass thing, do you think people generally don't do it because it's seen as a bit stupid-looking or something? I don't care what I look like, and can think of loads of occasions when I've got below the main snowline and kept the axe in hand, but it is a pretty rare thing to see. Maybe the rise in pole-use in the past 30 years has made it less likely - but on that kind of ground give me a solid axe (with a pointy bit if required) rather than a lightweight pole any day.

My thoughts entirely. I guess the use of poles would also serve the same purpose. Ice axes were talked about in this situation on my course. 

The big advantage of poles on such ground is that you can carefully spread your weight and maintain 3 points of contact. If you're just trusting your feet then you're purely depending on one point of contact and your ability to arrest quickly if you slip.

Seems that we're in agreement on this one then. I'm afraid I'm going to have to draw the line at mention of crampons though, a bit of a pet hate of mine seeing people put crampons on at the first sight of snow, and consequently ripping any vegetation within boot reach to shreds, while arguably increasing rather than reducing risk to themselves by adding a trip hazard where loss of traction is pretty minimal.

Yes. And if you have an ice axe with you - it can be used in the same way. 

What were they wearing on their feet? It looked like trainers.

Only time I used an axe to self-arrest in a real situation I wasn't wearing gloves and the snow abraded all the skin off my knuckles, both hands. It stopped me though.

A sobering watch.

Perhaps the thing that stood out most for me was Dangerous Dave's route selection, before anyone had fallen. He could have opted for the long way down - continue on towards Snowdon until he hit the PyG, but decided he was familiar with the summer "escape route" which they all duly trooped down.

That part of decision making, right or wrong, was I think logical given conditions on the day. I am trying to refrain from making sweeping crticisms, because there is much to commend concerning this video, but that is exactly what I'm likely to end up doing. Regarding that particular point of why take this route, the weather conditions on the day I think played a big part in that. There is maybe more of a question of whether it was a particularly good idea to be up there at all given the weather forecast, but there is nothing fundementally wrong with going out in bad weather. As I recall forecast that day was wet and windy in the morning, and wet and VERY windy in the afternoon. I assume their thinking was a quick hit and get down before the weather got worse. What happened is they got caught up in the deteriorating conditions, which is why I think they came down the shorter, less exposed, but unfortunately super slippery way from Bwlch Coch rather than continue the longer more exposed traverse of Crib y Ddysgl.

I haven't watched much of Brave Dave's stuff, but from what I have seen a lot of it smacks of a lack of substantive experience. He seems to be out there doing stuff, but feels like there is a certain lack of judgement grounded in time spent making prudent decisions. Give him another 5 to 10 years and he may be a much more rounded hill goer.

The standout 'Is that really a good idea?' moment was him scooting along on his bum down the slope that one person had already slid down, telling his mate to be careful.

Things that are positive though were a readiness to change plans given conditions on the day, a willingness and determination to help out a fellow walker in trouble, an early call for external assistance and a proactive approach to try to manage the situation. The publication of the video is also I belive a positive step even if part of the motivation is self promotion. I also belive part of the motivation is so that others may benefit from the expericence, and maybe lead to some learning from the situation. The promotion of mountain rescue funding was also done in a positive way (although he neglects to mention other teams involved, as mentioned in the Llanberis facebook post that appears momentarily on the video). I have taken the 'Brave Dave' moniker as seriously hyperbolic before, but think it a pretty brave move to put this video out there, open to over analysis and criticism from all and sundry, and that it offers a rarely seen insight into how these situatuions happen.

That is a good point actually, thinking about it I agree it would have been good to have some reflection from him on what happened and what lessons were learned at the end of the video.

Maybe he'll find this thread one day... I've certainly found this thread useful to hear people's thoughts on what could / should have been done differently. 

I was out on Snowdon the day of this incident, doing Watkin / South ridge. IIRC there had been some winter conditions that week (I seem to recall parsley fern getting a few ascents) but a thaw had set in on Sat morning. I wonder if the lure of possible Saturday winter conditions was a contributory factor to being up there in high winds?

Is this the same 'Brave Dave' I recall being derided as something of a chancer when it comes to safe practice...?

This also happened on Sgor na h-Ulaidh c.1990. A couple on holiday slipped on waterlogged grass and were killed. I had met and chatted with them a few days before, lovely people, retired doctors from what I recall. Really sad. Fingers were pointed at round-heeled boots which were very popular at the time, Scarpa's Trionic being the best known example.
I have it in my head that someone else died on Sgor na h-Ulaidh in similar circumstances around this time. I may be wrong though, it's possible I'm thinking of your man on Stop Dubh. Davy Gunn will know if he looks at this thread.

Yes I think that's quite likely

I don't believe that Dave chose the route for the two guys he met on the hill, they'd made their own decision hadn't they?

He made the call to get out of the wind, which seems fair, and I don't know the hill well enough to say whether there were any alternatives other than reversing Crib Goch?

I agree with others that walking poles would be ideal in such circs and that grippy boots are a must (not that many boots would grip on that sort of slope, one of the reasons I like stiff boots even in summer is that one can edge on steep grass- slower  but safer). 

Having read the last keyboard war that erupted about Brave Dave I thought I knew what I might see on this video, perhaps nudged by the slightly naughty disingenuous thread title, but I was wrong.

Sure in hindsight he'd probably say the route choice was incorrect, but he gets kudos from me for showing us all how quickly sh*t can go south, and how you can then find yourself looking at a guy you'd just met who is now half naked, bleeding from a head-wound and with probable broken bones, lying in snow whilst the wind roars around you miles from help.  Looked like he took control of the situation and had the answers for everyone else who seemed pretty shell-shocked (of course could just be self-serving editing).  Had he not gone from the casualty to summon extra help from passing walkers then things may well have not turned out so well. He also does a good job at the end of soliciting donations for MR.  I think he'll have added a bothy bag to his standard kit carry now, as I hope will some others who have read this thread.

So well done Brave Dave from me.  I think UKH would do well to promote this to a wider audience, not as textbook but as "This just happened to you - what would you do, are you prepared, do you have a Bothy Bag, are you on the app?".  It could be helpful.

For starters what is 'the app' 'what three words'?

Yes. I couldn’t really work out a thread title to suit. That was the most direct I could think of without being too Clickbaity. 
 

I assume it’s the mountain rescue SARLOC. You don’t actually have an app. They text you a link and it opens in your browser. 
 

I would have hoped somebody trained in first aid would know the procedure to move a patient with a suspected neck/back injury (multiple person log roll is what I learned in ML  first aid). And the bothy bag I think I saw could have been setup around the patient and hopefully it would be big enough to keep the other pair warm too. Also, don't give tissue injury casualties Ibupfrofen as it can exacerbate internal bleeding and short term healing (and it's not a pain killer). 

Yes, I can remember that. That Sgor na h-Ulaidh slope is a very steep one for a standard walkers' route - there could well be a path on it these days (I haven't been up from that side for a long time), but there wouldn't have been then. I had a couple of pairs of Trionics - they were very comfortable but that incident made me think better of it and I went back to square-heeled boots. And did sloping-heeled boots not also feature in the Beinn an Lochain fatality - mid-1980s, maybe - which ended up in court (and in the papers)? I seem to recall Scarpa or whoever issuing a statement saying their boots were not at all a factor in what happened.

The court case rings a bell, they certainly became very controversial with articles in the papers. Like you, I had a pair of Scarpa Trionics, my first boots actually, with which I did all sorts including winter hills and easy gullies, but with the accidents and the criticism they were receiving I pretty much stopped using them for anything that involved steep grass or snow. 

Obviously during the incident a lot was done to help the casualty and that is to be commended however despite the obvious points about the days objectives I also cant believe his choice of bail route. 

The ground between the crib goch and the pyg track is extremely steep, not a very suitable choice of route even as an experienced party much less with a novice. Yes the wind was bad but if what he said was correct the difficulty was over and they could have continued around to the start of the pyg track.

Although the person who fell was not in his party, dave holds a professional qualification (allegedly since he doesnt use his real name there is no way to verify) and therefore has a duty of care to those around him. The fact that he conversed with the group and encouraged the course of action which led to the accident seems like a bit of a problem to me.

I was once in a somewhat similar situation- approaching an unseen but undoubtedly seriously injured casualty- and could hear someone already with them say to the casualty "stay with us", or words to that effect. Perhaps I was being naïve or just not thinking, but I hadn't considered the possibility of dealing with a fatality while I was trying to get to them. In the time it took to finally get to them I had managed to process that possibility a little, and feel I was more useful on the scene having done that before reaching them. I would have been less clear headed if I'd have had to consider that possibility after having reached them. Again, this may just be me, but "prepare for the worst" does resonate.

That was a fascinating watch; I'm sure I'm not the only one who watched trying to work out, in real time, how I would have responded.

Given the reveal at the end of the video that the casualty had broken bones in both his neck and back, the rolling about trying to get the insulation sorted looks pretty bad!  I'd like to think I'd have given some consideration to the high liklihood of spinal injuries, and used the two extra sets of hands to effect some sort of controlled roll to get him off the ground and into the bag.  And whether leading or not (are we really to believe that Rory isn't a client..?) I'd also like to think I wouldn't have been on Crib Goch in those conditions without a group shelter in my bag...

Have dug out the relevant SMC Journal - the two accidents were less than a week apart:

10-14 October 1989: After a large scale search by Glencoe, Leuchars, SARDA, and RAF Wessex the body of James Rogers (28) was found below steep slabs on the North Face of Sgor na h'Ulaidh. He had been wearing bendy boots with chamfered heels. 444 hours.

15-16 October 1989: Searches by Glencoe, Kinloss and Lochaber MRTs and an RAF Sea King revealed the bodies of Doctor Graham Watson (46) and his wife Jenny (40) below the North Face of Sgor na h'Ulaidh, both wearing bendy boots with chamfered heels. It was noted by teams that the steep terrain of this accident (very close to the previous accident) was very greasy and slippery, thought to be caused by lichen and heavy rain after a dry summer. 438 hours.

Thanks Dave, that brought some memories back. My goodness I had it in my head the couple were both retired, they were actually quite young. Lovely people who were very happy to be in Glencoe. Terrible.

I do remember the unstable wet lichen being mentioned at the time. The date also coincides with a period I remember well as being particularly wet, even by Glencoe in October standards, so the vegetation and underlying soils would have been saturated.

I think "Brave Dave" has made a bit of a rod for his own back given previous videos, seriously wanky stage name and has definitely deserved criticism in the past.

However I think this post (and others) is very unfair

 Given the conditions, what looks like a very inexperienced friend in tow and most likely some feeling of responsibility for causing the whole incident in the first place given the other party seemed to want to follow him, It's not surprising he flapped a bit and forgot some of his training when he unexpectedly had to take control of a serious casualty- he's not doing this sort of thing daily remember.

Many of us have been there.

The guy did his best and it sounds like the casualty is making a recovery from some pretty grim injuries.

There's definitely things he could have done better but you could say this with just about every serious incident!

I think it would be a useful exercise to assess "Brave Dave's" (or indeed our own) performance in light of what Laura McGladrey teaches...

IMHO Laura is "Da woman" when it comes to "emotional" or "psychological" first aid. Youtube:  youtube.com/watch?v=B7xeVBZDQyU& (One I've just pulled up at random...there are others). 

I'd say what she teaches is really useful training for anyone who might need to administer, or who might find themselves in need of, wilderness first aid. 

From the preamble to the webinar:
"Psychological first aid is a modular, tool based approach to support those who experience the psychological trauma of events such as being lost, avalanche, falls, or watching significant injury occur or almost occur to loved ones. While physical injuries have been traditionally recognized and supported on scene, psychological injuries are often deferred to experts. This webinar presents a look at how traumatic stress causes injury, and how it can be mitigated by rescuer interventions on scene and throughout the rescue. Finally, best practice in psychological first aid will be applied to critical incident and near-miss support for the rescuer and the rescue team following impactful events."

And this a podcast interview with her: https://podcasts.apple.com/sg/podcast/psychological-first-aid-ep-34/id10800...

Mmm.  He has received professional training to deal with exactly this situation.  They will have gone over this scenario again and again.  Getting this right is quite literally part of his job.

Given his keenness to go way beyond remit in the past, you'd think he might find struggling with a core part of the training a little embarrassing.  There is no hint of following a DRABC type checklist - he's seized upon the hypothermia threat and dealt with it to the exclusion of all other concerns.

I don't know how well I would have reacted - I've never managed an incident that serious - but if that'd been me I'd still be kicking myself today.

Yes I would be kicking myself aswell given years of medical training of diffent forms.

However being excessively critical isn't overly helpful here. I would say there were significant human factors at play.  I would hope Dave would learn from this and improve his skills, as any professional would. 

Were Dave's (I refuse to keep using "brave dave") of detriment to the patient? 

I’ve done plenty of First Aid training, Jan 2019 was my last refresher and that’s the first time I’ve seen the DR prefix.  
 

However, the first thing has always been look for immediate danger and check for a response, but the immediate danger was exposure and getting shelter was key as the casualty was conscious and talking. He checked for bleeding and asked about pain and loss of feeling. At no point did he physically move the patient anymore than necessary to get some insulation under. 
 

I’m really surprised no one had a survival bag. That’s always in my pack, summer or winter and winter I’ll take the two man emergency shelter with me as well. Note to self - remember to take it out and practice and check. 
 

The title of the thread could have been a lot worse and probably steered the arguments in a negative way, on the whole I think the thread has been well balanced to now. 

Very sobering footage, and well done his companions keeping their heads and giving priority to keeping him warm. Interesting that the the guy's clothes where mostly ripped off during the slide. I've arrived at the scene of two different fatal accidents which were the result of sliding and tumbling for a long way down steep rocky hillsides just like that in this film. In both cases the badly broken bodies pretty well stripped naked. I think that in was in Scrambles Amongst the Alps that Whymper describes the Zermatt guides finding and recovering the bodies after the first ascent accident on the Matterhorn? He wrote that they were in a terrible state, again clothes had been ripped off.

This appears to be a common factor in longs falls/slides and as this film demonstrates, results in the victim rapidly losing body heat which will greatly increase the risk of hypothermia, even if they survive the fall.

This may be a factor to consider when choosing winter mountaineering and skiing clothing where salopettes or one piece suits may be better than two pieces split in the middle?

Laura McGladrey...another one on psychological first aid: https://www.outdoored.com/file/video/summit-laura-mcgladrey-anxiety-panic-a...

Well he kind of did up to C

Danger - Analysed on the way, risk of falling, risk of stuff falling down
Response - Alert (Responding to voice and not slurry)
Airway - Well he is talking so that is all good
Breathing - Well he is talking, and doesn't sound like he is struggling for breath, panting etc
Circulation - This is where things have gone iffy and he gets distracted by environment.

Hard to tell how people are going to react in such a situation until you are there, and doing a 2 day first aid course every 3 years leads for easy skill fade. Lessons to be learnt, for sure (there always are), did his best in the situation, also for sure.

He got the others to call 999 as soon as the casualty was found (if not before?): S. The casualty was conscious and talking: that's pretty much your RABC. So we're into BBBBB. He assessed the bleeding head and back wounds, and considered them superficial. He asked about neck or spine pain, and established the leg pain.

His focus on preventing hypothermia was correct; there's little you can do for broken bones or internal injuries in the field.

I remember how poorly I performed in the scenarios in my first aid courses, and those were just make up. I've done a bit better in recent incidents where I've had to assess a casualty in the street, but, given the stress of the situation, I don't think he did that badly. Yes, the handling could have been improved, and the provision of coverage and warmth (for casualty and rescuers); as suggested above, he may now consider adding a group shelter. 

Really? It's been in the courses I've done, and in books. These days, DRSABC if often taught

Danger, Response, Shout, ABC.

Yes. I think there’s a danger in ending up with a huge long acronym that people start to forget.

I seem to remember that C is no longer circulation (certainly not checking for bleeding!) but is now Compressions. 
 

Ultimately, we can discuss classroom teaching and roadside accidents ad finitem, if you’re on the side of a hill where rescue maybe an hour or two away, whatever you do won’t be wrong.

DR(s)ABC(de) has been used in one form or another for at least the last three or four courses I've done - but exactly how it's used does seem to vary quite a bit from provider to provider, so maybe you've not met it yet.

I guess that a par score is handing the casualty on to the professionals alive, and he did that - and it's very clear that without his interventions they'd have died from exposure pretty quickly.  Someone coming out with the 'we mustn't move him because of the chances of spinal injury' fallacy would have had a dead casualty on their hands.  So yes, I'm not saying he did a bad job.  

Perhaps I'm being overly harsh - on his performance, and also on my own performance whenever I practise this sort of thing.  But you are specifically trained in how to deal with exactly this situation - how to talk two untrained helpers through log-rolling to protect the spine. It seems there were not any negative repercussions - the casualty is recovering - but that might not have been the case.

Edit: I think I am being too harsh.  But when someone shouts as long and loud as 'brave' Dave does about their abilities then they're setting themselves up for criticism!

I can see where all this started with the ABC thing, but with every addition I think this acronym is becoming a less useful way of remembering the right order of how to do things, especially with the addition of another C, which comes just before A, obviously!

Reminds me of this:

youtube.com/watch?v=RD5M7ZczriI&

Not far off 40 years ago I contrived to go about 200m down a summer snowfield on the east side of Braeriach at high speed - one of the hottest days of the year (mid-June), no axe, young and stupid. Stayed conscious - which saved me as I eventually got my feet dug in and stopped just short of the boulderfield, as with the No.4 Gully incident mentioned upthread. It ended with a Wessex ride to Ninewells, as although I was mainly just scraped and bruised, I'd hit a band of protruding rocks halfway down and got a puncture wound just above my waist (could see into my guts, which was interesting).

Anyhow, I too had the clothing-damage thing - it was in the days when people often wore ordinary cotton checked shirts on the hill, and my one ended up looking like it had been through a cheese grater.

I use the acronyms only as a short form here. I prefer to remember the actual words (although 'doctors ABC' works quite well). So the BBBBB is breathing, bleeding, brain, burns, bones.

DRSABC is a triage process; assess the danger to yourself and other rescuers, check for response; call for help if necessary; if no response, check they have an airway, check if they are breathing, check if their heart is beating. Those are flowchart y/n checks.

Well yes. Hence my comments on making a rod for his own back and I'm sure there were plenty of us waiting to lay it on thick.

However with all the first aid and medical training in the world there are definitely times when algorithms/ acronyms/standard procedures just go completely out the window. He did his best in the circumstances I think. 

I just hope the video was posted as a learning exercise for others. 

The video provides a whole host of opportunities for 'hill judgement discussions':

Was the route appropriate for the wind 

Was there sufficient time contingency to complete before the weather got worse

Did he know his companion and route well enough to accurately answer the first two questions.

If the answer to any of the first three was wrong were the escape options suitability placed, appropriate, and straight forward

Did he know his companion well enough that should he become the injured party they could act independently.

If no to the above was a party of two appropriate for the route choice.

Was the thaw complete enough not to carry axe and crampons on the route - could he be certain

Was the the thaw complete enough not to carry axe and crampons if the route was diverged from - could he be certain

How well was he/his companion moving on the ground, balance, confidence, security.

Once he gained hangers-on how good were their movement skills, foot-work and foot-wear.

At the escape point the judgement about the whole parties movement skills versus the steepness and the wetness of the ground became critical, versus continued exposure to the wind.

Given he had only just met his hangers-on, did he have time to accurately assess movement skills versus the longer walk to shelter, did he assess

Given the hangers-on were already preturbed was the escape appropriate.

Prior to the descent did he assess if he could maintain group control to ensure the party avoided the worst fall-lines, or if it would become a free for all - a particularly hard one to achieve. I've never seen a party outside of a 1:1 or 1:2 guide situation actually achieve it well, I've seen lots of ML try and often struggle to do it without coming over authoritarian, and most groups of friends will act at will (nothing wrong with that; horses for courses). 

We have all ended up on steep ground like that regularly as individuals, and sometimes it comes down to luck, the slimey rock hidden by grass, a foot 2" either side and nothing happens, when does individual acceptance, migrate into a collective responsibility for each other, when does it evolve into a de facto leadership judgement.

Post isn't meant as a slag-off Brave Dave, this sort of ground and decision/judgment is a regular occurrence. Many people will do it subconsciously, how often do we actually get it wrong (albeit in Dave's case in IMHO wrong repeatedly on the same day...he has after all set himself up as a learning excercise), but get away with it versus actually assess it?

How many of us can honestly say we haven't broken all of them when young keen and green like Dave.

Except from what I remember of my course, the C is now pretty much redundant. If they’re breathing then their heart will be beating. If their airway is clear but they’re not breathing you just get on with compressions.
 

As I say, this is all well and good in the classroom but instinct will take over and most of these things will be obvious. The main thing is to try and call for help before you start doing anything - with obviously a few caveats because the hills are completely different environment, not usually covered in normal first aid courses, and calling for help could significantly delay ABC. 
 

I would imagine for most of us, first aid incidents have been pretty obvious on what to tackle first. What the cause was and what the injuries were and how to address them. 
 

I mention it not just as a small criticism of BD but also as a note as it hadn't been mentioned previously. i.e. for those who haven't been on a first aid course and want to know best practice, it's worth mentioning. I could have put it more diplomatically but as someone who has a serious back injury made worse because of a situation like this (close to paraplegic) then I figured it was pertinent. 

I just watched it but I did skip through a few bits. There is plenty of learning from this....

I hope Dave gets the opportunity for de-brief and review of practice, training, learning needs and so on.

He did ok in some aspects but at best it was ok not good. His immediate approach to the casualty was stressed, disorganised and not reassuring for the injured guy....I appreciate its not easy but doing regular drills of this helps a lot.

He did step up which  is fair play but there was just so much that one could comment on...

That's an excellent post!

That escape route wasn't an enviable choice. Given that he had his camera and selfie stick with him, I would have loved to have seen how the decision to escape was made, and what considerations were made. 

I would also love to see some reflective contributions from his friend - would the less-experienced member of the party do that route in those conditions again? 

I think the last couple of courses I have done they didn't even teach log rolling anymore as it's very difficult with lots of people in classroom conditions, I think they got to the point Dave was at  - don't move them if you can help it but if something else is going to kill them because you didn't move them then you've got no choice, even if it exacerbates a neck/back injury.

I've never tried going down to the Pyg Track that way, but from the col I have gone down the other way north toward the Llanberis Pass. I've only done it under heavy winter conditions, and we were traversing around to a do a route on the North Face of Crib Goch, but at least on Google Earth there appears to be a zig zag track going down there. It looks a lot more like scree rather than the grass on south side that seemed to lead to their problems - Brave Dave himself falls quite a long way early on in the video.

For people who know Snowdonia well, is descending North any better idea than descending south from Bwlch Coch if you are trying to escape the ridge? A few winters ago when we were heading over the ridge to get to our climb we came across a couple in totally inappropriate gear, the woman looked terrified although the bloke was sure they were fine. With my partner we talked after about whether we should have tried to rope them off the ridge, but it struck me I didn't know what the escapes were like in either direction from the col.

I did check subsequently and fortunately there were no accidents reported that weekend so they must have got off OK somehow! 

This video is very distressing. It's difficult to watch but I am glad he posted it. 

Yesterday I set up a direct debit to Glencoe MRT after watching it.

But I won't be judging him. If level of risk is to be debated then the majority of the population would have a field day with the climbing community as a whole. 

It was on my last requalification, a couple of months ago.  But first aid courses are really surprisingly variable between providers, so it's perfectly possible that it wasn't on yours!  I seem to be told that the 'C' of DRsABCDE stands for something different every time...

Absolutely.  There is no doubt whatsoever that this casualty needed to be moved to get insulation in.

In reply to abr1966:

I'm quite grateful to Dave for posting it; I found it really useful as an exercise in seeing how (I think) I'd have reacted.  Easily as good as doing a simulated scenario whilst on a training course.

One can hope. 

In normal circumstances I'd rather go into Cwm Glas, but as its more of a gully and NE facing it can hold snow for longer, so may have been a no go option.

Going down the way he did is grim but doable. I'd like to have nice stiff boots on for digging my feet in the crappy terrain, and a stick too.

My memory of the subtlety's of Welsh slopes is 30 years rusty (gulp) so can't advise, this sort of incident and party dynamic has been often been featured in MR reports......whats unusual is for it to be caught on camera.

It is clear that Dave has a very high opinion of himself, and so I wouldn't like to speculate on his motivation for posting this video. I would ordinarily commend anyone else on putting this video up in the face of potential constructive criticism, but actually I think Dave thrives on negative feedback and uses it to build an 'outsider' reputation with his viewer base. Nonetheless, I think he made some reasonable decisions after he had reached the casualty which helped to save his life.

However, I think this accident could have easily been avoided. Although the wind was dramatic at Bwlch Coch, the risk placed by it (overbalancing during high-consequence movements) was clearly much diminished now they had already navigated the narrowest section of the ridge. I think the decision to descend directly was not justified here, and it happened for two reasons. Firstly, it seems that no-one brought up (or even realised?) the risks posed by the direct route down to the Pyg track. This route, being a steep grassy slope with crags, was particularly dangerous for this party, because (from what I can see) at least two of them were wearing trainers.  Secondly, I think the risk from continuing along the ridge was overestimated, directly because they were overwhelmed by being in bad weather in the mountains ("This is jacket-ripping wind"). 

I don't think these two mistakes would have been made as readily by a more experienced party. I think other signs of inexperience also showed in that, after Ed had slipped, all three of them began running down the hill and then unexpectedly slipped themselves too. I don't think the point has been made that this was extremely close to being a 2+ casualty incident.

Overall I think it is very good that this video is in the public domain. The viewer can watch through the set-up, the accident and the response and work out exactly what went wrong, in a way that wouldn't be possible from a MRT report. It also drums home the point that in the hills, anyone is only a couple of poor decisions away from being in a very bad way indeed.

As with ScraggyGoat my knowledge of Welsh slopes is somewhat dated (and limited). What is that slope equivalent to Scottish terms - eg is it like trying to get down off the side of the Devil's Ridge?

As others have said, this feels like a valuable video to have in terms of the raw immediacy of such situations rarely being seen. However the coda jarred a bit for me - good that he's trying to boost funds for the MRT, but the tone of it is a bit too perky/jaunty for my liking, given the context of what's happened, and it felt like I was watching some strange outtake of the Pub Landlord.

OK fair enough Tim, not really sure what to say to that other than I'm sorry to hear about your accident and events following.

And as I said at the time, my post wasn't solely aimed at you.

The C that I now teach is for circulation - check the casualty for blood loss as part of your overall checks.

I've heard that others have CPR, something I'd not promote.

It’s no longer taught like that now. 
Airway and then if breathing isn’t strong straight into compressions. No rescue breaths, and not even 15:1 or whatever. 

A sobering wee film this. Was that orange thing he stuffed under the casualty’s back & then wrapped round his waist, was that not a bivi bag?Certainly appeared to have a wee window in it. If it was, he’d have been better using is as intended, getting in it beside the casualty and keeping the wind properly off him. It’s surprising how comfy it gets temperature wise inside the bag, I once whiled away 90 minutes waiting for the chopper with a casualty who had fallen off Ledge Route and for whom we had real fears (unfounded in fact) about a spinal injury. He was on snow, and we didn’t manage to do much about that. He was uncomfortable, but he wasn’t hypothermic when the chopper came.

My action points from this - update my first aid certification ASAP and set up a DD for Glencoe MRT. And if I meet Brave Dave on the hill I’ll be heading off to the other hill....

Best comment so far 🤣

But does it come before or after A and B? Getting air into the lungs doesn't help if there is no blood left to distibute oxygen around the body.

Is DD in trainers?

Again

I think this must be taught differently by different organisations. I have current first aid training and we still do 30:2 compressions:breaths (although temporarily no breaths at the moment due to covid). I remember hearing that if on the phone to 999 they will tell you to do compressions only, but that's only to make sure someone that doesn't know what they're doing doesn't waste too much time trying to do breaths, as there is a bit of a technique to it and keeping compressions going is the most important thing.

And even with the same organisation there have been disagreements about whether C stands for circulation or CPR, but I think circulation is the official answer at the moment and makes the most sense to me. 

My understanding was that C stood for catastrophic bleeding

Danger, response

Catastrophic bleeding

Airway, Breathing, Circulation

Disability, Exposure

If you don’t identify catastrophic bleeding initially then the casualty will become a fatality in a matter of minutes

That's another one where even from the same first aid organisation there has been confusion on different training courses that I've been on. Sometimes they leave catastrophic bleeding out of the primary survey entirely and it's just DRSABC, sometimes it's DCRSABC (on the basis it's more important to go straight to the blood fountain than to see if the casualty responds to stimulus), and sometimes it's DRCSABC (can't remember what the rationale for that one was), with D and E tacked on the end at random.

The correct answer seems to change every year! Maybe not all first aid training is so haphazard though. 

It's also based on the idea that most calls will be urban, and therefore in the (somewhat hopeful) 8 minute average ambulance response time.

Outdoor first aid courses still teach breathing (well, mine did...). But then CPR in a remote environment is probably even more hopeful...

Catastrophic bleeding and heart failure with a single first aider? 
 

On my wilderness fist aid course the ambulance paramedic said “Despite your best efforts, sometimes people die.”

Yes - no doubt some people will die - hopefully having at least some first aid knowledge and the skills to use it will go some way in preventing that.

I don't recall implying both catastrophic bleeding and heart failure - merely that this may be the order you would assess the casualty

You're pretty quick to judge aren't you, how do you know what lessons were learned. I can't see video proof of you doing better and tbh they could have done a lot worse. Are you just bitter that you aren't getting clapped on Thursdays anymore? I guess you're right though, you've got to be...

Right! Massive haemorrhaging  is your number one, of course. If anybody leaves that out, well, they are teaching it wrong. Another thing to consider is waterproofs. They are usually blood-proof, even from the inside out, better check...

CABC and keep it simple. Danger is there always, no need for another acronym, you should consider Danger at every first aid situation and have it absolutely ingrained as the very first thing, even in a city or car accident situation. Same for Shout. No need for convoluted acronyms that just muddle things up. As everybody can see from this very thread and all the different responses to it, multiple acronyms don't help. Training helps...

North leads into to a remote upper cwm, down over a series of ledges to a difficult to find exit to a lower cwm next to a stream, then down to the road. South you cross the Pyg track by default but you need to circle right to avoid a craggier area I think this fall might have occurred in.

I think there is also a path starting a little further along on the the south side that contours around onto the Pyg track much higher up, but I'm not sure.

A most enlightening video.  It brings home just how quickly things can change in the mountains and how important it is to have the right kit and make the right decisions when they do. 

The go pro proved useful too.

Pick an acronym or whatever method that works for you, to help you remember the training.

I don't generally like mnemonic acronyms, because they're usually convoluted, and I can't remember them. But DRSABC works for me, and reminds me to take care of myself first, rather than getting stuck in immediately. It's easy to forget that in the desire to help.

Practice helps me more than anything; repetition reduces the stress of the new situation.

In response to the confusion regarding chest compression:breath ratio, the Resus Council is usually the best place to start-

https://www.resus.org.uk/resuscitation-guidelines/adult-basic-life-support-...

There is of course more up to date COVID-19 guidelines on the same website

Read “Compression only CPR” section 8. 

I think so.

What a t**t of a post that is....!

The north descent is easier, on a scree trod into the upper cwm but, as jezb1 points out, could well have been snow-covered and it is also steep. Photo here:
https://www.flickr.com/photos/mikepeacock/50040090887 
Escape from the upper cwm is easy (and there are paths) but, again, only if you know it. Without knowledge of this area it's complex and confusing terrain. I've never done the route from Bwlch Coch to the Pyg Track as it always looks steep and unpleasant.

The north descent is easy enough, on a scree trod into the upper cwm but, as jezb1 points out, could well have been snow-covered and it is also steep. Photo here:
https://www.flickr.com/photos/mikepeacock/50040090887 
Escape from the upper cwm is easy (and there are paths) but, again, only if you know it. Without knowledge of this area it's complex and confusing terrain. I've never done the route from Bwlch Coch to the Pyg Track as it always looks steep and unpleasant.

Sorry for handing you your arse in our previous clash Plainly Simple, but I'm getting old and can only handle feuding with one cockalorum at a time. Perhaps I could pencil you in for later in the year?

it would be good to post this on utube. he says he's going to do a follow up video to answer questions.

I'd be amazed if he had the maturity of introspective thought to admit his judgement was borderline throughout the day, and as result it contributed to a chain of events where somebody was seriously injured, though granted this was not a certain outcome & probably all of us at some-point have had a day out with similar borderline decisions (but in most cases without the casualty).

But my ghast might yet be flabbered!

It’s common for people who have lucky escapes to believe it to be their skill that saves them. 
 

Talk to any driver who has had multiple near misses and they will attribute the reason they didn’t crash to their advanced skill, rather than their hopeless ability to drive that keeps putting them into near miss situations.

Ultimately both parties went out for adventure and to push their limits. It’s what we all do. If it was 100% safe and no one ever was injured then a great deal of the attraction would be lost.

Criticising someone for falling off a dangerous route seems a bit pointless. 

I'd be the first to defend our right to take risks/kill ourselves, even to the extent, for example of soloing a hard winter route on a remote crag in a hoolie.

But there is a difference between a tragedy of someones personality leading them to their demise, despite experience, knowledge and skill, taken by risks which they were well aware of.

Compared to what could have been the tragic outcome, of a party member dying, due to unwittingly being at greater risk than they thought, when there was a safer option close to hand, and that risk wasn't the assumed risk related to the fundamental challenge of the day (granted they had accept the overall risk by being on the hill).  At that point they were escaping, trying to reduce rather than accept more risk, the fine line between fun and fear crossed, turning for home. By their very actions this party was no longer embracing risk but wishing to reduce their exposure to it.

You don’t get to chose when the fun stops. In that case you’re just pretending to embrace the risk. 

think you're right if his response to 'tom butel' in the comments is anything to go by- just a freak accident..

There are two very important points, for me, that I don't think have been properly discussed in this thread. They so very nearly converted a single casualty accident into a multiple casualty accident in their haste to find and get to the injured party. Our very first responsibility is to our own safety – and obviously we all know that, but it's only useful advice if you don't forget it in the heat of the moment. Which is something I suspect many of us might be at risk of when surprised by such a stressful turn of events, and is perhaps something we should all give serious thought to after seeing this video.

On the subject of spinal injuries, the moment that had me shouting at the laptop was at 11:40. Prop his head up a bit!?

I think part of this is a mindset thing. If you've visualised yourself in this possible situation before and routinely double checked the 'bad things' that might happen, then you the beginnings of an internal script to play. This might be the biggest service the video delivers, a chance to consider and plan your own script for events such as this. Positivity and 'brave'ness can be a positive thing if checked by some self-reflection and humility. 

OK????

Anyway. Thankfully it didn't come to this for Dave and his pals.

As far as I'm aware, compression only CPR was first instituted after research showed that a substantial portion of the public weren't attempting basic life support as they were so put off at the thought of the mouth to mouth element on strangers. Compressions only was considered good enough to give the casualty a fighting chance for the minutes it would typically take before trained medical staff were able to respond.

In a mountain rescue scenario, that response time is going to be considerably longer. In such a situation the only likely benefit of compression only CPR is that it'd help keep the first aider warm.

I think this is the case..... there seemed a bit of confusion over what to do and I was trying to point them in the right direction...

I hope things are improving on your side Stichtplate

No complaints here thanks mate, the last couple of weeks have seemed to have been more about mental health than covid (patient's not mine ). Hope SAS is treating you well. You on the road now or studying online?

Bit of both........We're out on the road as Care assistants with PTS. Not really had much to do with COVID patients thankfully, just been keeping the renal/cancer/elderly patients going and it's paid work so I can't complain!

Good to be doing something but keen to get back on the A&E side of things, especially as we're 2/3 through the course now ha!

It's all good stuff, as you know PTS is vital work and all that experience has a very direct relevance to PES. 2/3 of the way through! honestly, it'll fly by. Stay safe.

I did a five day first aid course last summer run by a paramedic. The guy was advocating chest compressions only in the absence of O2. His reasoning was that the compression of the lungs during the chest compressions actually got more oxygen into them compared to mouth to mouth as there is reduced oxygen in your exhaled breath.

I'd be interested in your opinion, would you say that this is the guidance changing, or was this advice always wrong?

There's very little good quality evidence as it's hardly ethical to with hold pulmonary resuscitation from one cohort and provide full cardio pulmonary to another, then compare results.

As I understand it from a purely physiological point of view, chest compressions alone will promote very little gaseous exchange within the lung tissue. The point of chest compressions it to continue perfusing the body's tissues with blood that is pre oxygenated from normal function prior to arrest.

Edit: I should add that I've personally watched a defib monitor during resuscitations many times. As soon as bagging the patient is interrupted (to upgrade the airway management for example) end tidal co2 monitoring clearly shows a huge reduction in effective gaseous exchange, regardless of the fact the compressions are uninterrupted.

Thanks, good to get the opinion of a professional on this.

Good point about the difficulty doing a fair trial!

Spend a thread keyboard warrior shit talking someone and you get it back. Guy is an arse who must be right and can't learn, suffers from another personality flaw which is not conducive to safe adventures in the mountains.

Inhaled oxygen is around 20% by volume, exhaled is about 16%. So we only use about 5% of the oxygen we inhale.  This means a casualty can still make good use of mouth to mouth air transfer.

I've done a few different tickets and while I've certainly been taught about compression only CPR, at no point has anyone suggested it has any benefit in oxygen transfer.

Although I have no basis for proving it, I struggle to believe compressions achieve much at all with regards to getting oxygen to the right places in the lungs.

It's just the internet mate...take it as it comes...its opinion...plenty of them around...!

Go on then, I've just come off nights and I'm bored.

That was months ago! You've been stewing all this time, and that was the best come back you could manage? Awww, bless.

Not at all, when I'm wrong I'm quite happy to stick my hand up, apologise and retract. Jimtitt received exactly this sort of apology from me on here just a couple of weeks ago. Plus my thanks for the info and an assurance that I'd alter my practice forthwith. (just to clarify, when I wrote "Not at all", I meant about admitting when I'm wrong. I'm well aware that I'm often an arse. Most people are from time to time, you'd have to be totally up you're own arse not to realise this).

In your case you made a load of bullshit claims about paramedics, UK Helicopter Emergency Medical Service crews and UK special forces all couched in hints at your acquaintance with loads of "badged" SF medics from "The Regiment". All bollocks and frankly you came across as a total Walt. 

Oh, and nice sweatshirt in the photo where you're staring manfully into the distance. Does it come in adult sizes too?

Edit: here you go:

In reply to jimtitt: 5th June

Apologies, I stand corrected. While vented ffp3s are still being issued they've recently (May 15th) been flagged up as a possible cause of concern by one British clinical body. 

https://www.baoms.org.uk/_userfiles/pages/files/professionals/covid_19/baom... 2

One of the big manufacturers you mentioned are currently conducting trials to see if they present a risk to patients, but a close examination of one of my own respirators shows that sharply exhaled breath does indeed result in unfiltered air escaping. Thanks for the info and I shall alter my own usage accordingly.

See? dead easy to apologise, learn from your mistake and move on. Once you've grown up you really should try it.

For reference the shit talking was about this thread, not the one two months ago.

Your welcome to keep calling me a Walt, carry on.

i simply stated something which is evidenced photographically in a publicly accessible forum which you deny.

https://www.instagram.com/p/BqrL-EMhwj3/?igshid=kfjnn8ni53vb

 As you previously confirmed they don't take passengers for rides and the person in question has made a big deal out of his, very linear, career progression. 

As for the jumper I'll ask my pal but I hear they don't make them in sizes big enough to fit your piss tank old timer, may even be a protected title, you know about them apparently. 

OK. Instead of just calling me names you could actually reference what you took issue with and why and we could have a discussion about it. You know. Like proper grown ups?

Not what I said at all. What I said was you have to be a registered clinician to be HEMS crew. I've got a good mate with an almost identical photograph, orange jumpsuit and everything. He was a HEMS dispatcher at the time working out of Broughton and got to spend an observer day with them. You're right though, they let him help on a couple of jobs. He performed the role of drip stand like a trooper.

Yep, I know about some stuff and I'll stick my two pence worth in. Someone comes along who knows better and I'll thank them for putting me straight. You, on the other hand, spout shite on an epic scale and then take it as an insult on your manhood if someone dares to differ.  

Lets look at my very first post in reply to you back in April:

That was all it took to flip you into full on rant mode. Did Mummy not give you enough hugs or something?

Surely if the chap in the middle of that Instagram photo was special forces his face would be all pixelated out like when they appear on Top Gear?

Yes I remember that thread. Have a read of your own posts. Stones and greenhouses. Also the "Keyboard Warrior" bit doesn't quite work given the subject..........

And both of you come on, we were somehow keeping to a fairly sensible discussion around mountain first aid and learning from your mistakes/reflective practice.

Which is a bleeding miracle given who the subject is.

He was in the Ghurkas then attached to the SBS (SF part of the Royal Marines) as a winter warfare specialist apparently. Left in 2018 at the rank of Lance Corporal. Important distinction as in the army every paramedic holds the minimum rank of Corporal. No paramedics in the Royal Marines either, which I know because I had a placement with SARS (there's some photos on my FB page if you scroll down) where I shadowed an ex RAF paramedic who'd left RM so he could access a paramedic training program. 

Nirmal Purja is a total legend but he's not a paramedic as Plainly Simple keeps insisting.

You're absolutely right and I'm well aware that I should have the strength of character simply not to engage.... but, UKC very occasionally throws up a total cockwomble that I can unleash my sarcasm on. Wonderful stress reliever and it saves me being a dick to the wife and kids.

Yes. Advice seems a bit sketchy read in isolation. I guess trainers are are trained and the advice they’re given may not be updated as regularly as it should be, or as they’re only human, unless they’re reading from a prepared script, their message may not come across. 
 

But I’d still argue that long mnemonics tend to get confusing. Maybe they’re just there as a training aid and once you come across a casualty, you’ve had the training and don’t try and remember them. 
 

I’ve only come across two unconscious people, in both cases the danger was obvious and was dealt with first. In the first case the casualty was obviously breathing and I just put them in the recovery position and waited for help to arrive. Bystanders called for ambulance. In the second case the casualty wasn’t breathing but was wearing a motorbike helmet, that started alarm bells ringing straightaway, but as I opened the visor he took a massive deep breath and opened his eyes. 
 

All the other hundreds of first aid scenarios I’ve been in have been minor burns, cuts and abrasions. A few have required hospital treatment. 
 

The more incidents you get involved in, the more you realise keeping the casualty calm and comfortable is the most important. Especially with children. 

Oh God, I find myself stepping in with another minor quibble but I honestly think it's a very important one. Children have a different physiology from adults, they aren't just adults in miniature. Typically they will maintain and maintain good observations (blood pressure etc) right up until their observations take a sudden and very dramatic nose dive. Very often the biggest early sign that a kid is in a seriously bad way is that they are totally inconsolable. If you get a kid like this you need to pay very close attention indeed. 

My guess is you only ever see worst case scenarios. The rest of the time the first aiders in the community have put a band aid on the cut, or ice on the bruise and the kid is back out playing. 

No, we attend everything. I’ve been called out for a paper cut, a bad dream, and to change a battery in a hearing aid. And I’ll never take anything for granted if the patient is a child.

Ok. Maybe not ONLY EVER SEE, but I’d suggest that the vast majority of cases you never get to see. When my son gashed his head open, I drove him to A&E myself while he held pressure on his head via a towel. 
 

The problem is, if people aren’t trained in first aid, they reach for 999 at the first sight of blood. And in my experience people seem to have a very low pain threshold nowadays (which has been proved to be psychologically due to not experiencing pain very often) and will think they’ve broken a bone if they stub their toe. 

Not at all. I haven't even finished the training yet and attended grazed knees, slightly twisted ankles and the like.

I know that one of the issues when reading UKC is sorting the wheat from the chaff.  A bit like when Jim Titt or rgold comment on ropework, or beardymike talks about gear design, I generally find that when Lemming or Stichtplate discuss first aid, it's worth listening to what they say!

I've seen kids 'crash' like that a couple of times, in my old job as a teacher in charge of outdoor ed. Once I sort of saw it coming; the other took me utterly by surprise. 

I’m not saying they don’t. I’m saying it’s extremely rare. You must have seen thousands of injuries. 

Morever I’m saying you need to reassure the casualty to reduce the likelihood of shock. 
 

I feel the Internet has a way of conjuring up serious problems in people’s minds and then placing them into every scenario. Yes it does happen and yes you should be wary of it but it’s not something that happens for no reason. 

If I kid falls over and grazes their knee, you don’t need to tell them to lie still and call and ambulance while monitoring their vital signs. In fact I’d go as far as to say that’s going to cause worse problems and guarantee you give them a psychosomatic issue and send them into shock.

So let’s not ‘step in on every minor quibble’, there’s a balance to be had. Credit people with a modicum of intelligence. 

I assume you have seen "Doc Hollywood"...

Nah, any good???

There’s just so many things in this post to take issue with that I’m not even going to start. Either take what I said earlier at face value or don’t.

I think there is a problem somewhere if you are taking children who’ve had bad dreams to hospital for observation. 
 

I think we all know children hold up well for a long time before crashing. But think we should probably take the history of the accident or illness into consideration before dialling 999. 
 

I thought a&e was already stressed without being called out for spurious paper cuts and grazes. 

Worth considering that the parents won't necessarily have called 999.

Quite likely that they've dialled 111 for advice (like they're told) and an ambulance has been sent for whatever reason. 

I saw it as a teenager, I can’t see the relevance of the only scene I can really remember!

No, the general public are largely entirely ignorant of the differences between adult and paediatric physiology beyond size.

Yes it is

So it’s not even relevant! 

Come on now. Can we show a little bit of sense here? Thousands of children fall over and graze their knees every day. 

I was correcting your statement “my guess is you only ever see worse case scenarios”. you guessed entirely wrong. In fact my typical shift often involves no “worst case scenarios” at all.

If you’ve been called out to a child that’s fallen over and grazed their knee and you don’t know what you’re doing you’ll be complacent (which is what I was warning you of in the first place) and go “oh look, it’s only a grazed knee”

If, on the other hand, you’re competently trained a series of questions will start running through your head:

There must be more to it if I’ve been called out?

What caused the fall in the first place? Simple trip or underlying condition?

Is the knee graze a distracting injury masking something else?

etc, etc...

You get the idea now? All I’m saying is that you can’t afford to be at all complacent when dealing with kids because it can all go to shit very, very quickly.

Why don't you start a separate thread where people tell you what their job is and you tell them how to do it properly?

There are always some people who will make a drama out of a crisis. 
 

I would suggest that the vast majority of people who’ve seen a child fall over will help them up and brush them down and not make a fuss. 
 

No need to call 111, 999 or go into huge drama about what other injuries they could have sustained. 
 

I’m not telling anyone how to do their job. I’m suggesting that some people will have a strong bias based on their experiences. If most of what you see is the aftermath of serious accidents and you have to piece together pieces of a puzzle using unreliable eyewitness accounts. Often from people trying to be even more dramatic, and maybe from people who have a different agenda for getting an ambulance to attend. Then you will have one viewpoint. 
 

If you spend your life watching children run around playgrounds and tripping over, you probably have an entirely different viewpoint. 
 

If you are on mountain rescue you’ll see a lot of one type of injury, read the reports, you won’t see all the hundreds of thousands of people safely walking the hills. 
 

If you’re not careful you’ll confuse your relatively few bad experiences with the hundreds of thousands of good experiences and start to believe the hills and school playgrounds are full of people with broken necks and brain injuries. 
 

A sense of balance is required. Or we will all disappear up ourselves. 

I think you're completely missing the point of Stichtplate's posts, but fine.

I may well be. Possibly the way they’re being written. 

Except that "the aftermath of serious accidents" is not "most of what you see" as a working paramedic.  As you would know if you weren't refusing to listen to the working paramedic who's been trying to tell you that.

Someone doing a particular job doesn't have their specialist knowledge instead of your 'common sense' everyday experience of life, they have it as well as that.

See also mountain rescue.  They're at least as well aware of "all the hundreds of thousands of people safely walking the hills" as you, perhaps more so since active members are exclusively recruited from those who live in the area and are enthusiastic about spending a lot of time in the hills themselves.

Now there I am willing to concede you may have a unique insight.

Not since the restraining order I don't.

What worries me is that paramedics are being called mostly to trivial incidents. 
 

We seem to be reinforcing a cotton wool society. 
 

This is probably evidenced in the last few months where a&e has been practically empty if the reports are to be believed. 
 

The general public don’t seem to be able to differentiate between what constitutes an emergency and what doesn’t. 

Now then I think this thread has gone far enough.  The only acceptable next step is to have a livestream where we ask Brave Dave to respond to the following questions:

1) Would you reconsider your descent route in light of the events that took place?
2) Why did you prop his head up?  Would you do it again?
3) Trainers? Really?
4) Was 'Rory' a client or a mate?
5) Do YOU get to choose when the fun stops?
6) What's your stance on chest compressions/breaths whilst conducting CPR Dave?
7) Do you have to be a registered clinician to be HEMS crew?
8) Have YOU ever been HEMS crew?
9) Have you ever fought a Para?
10) Have you ever fought Walty McWaltface/Planeandsimple?
11) A child has grazed their knee, can talk us through your plan for their treatment?
12) Have YOU ever treated a grazed knee?
13) Does DancingonRock regret starting this thread?
14) What's the hardest thing you have ever done on Grit?
15) What grade is TPS?
16) Is Kinder in?
17) When's COVID going to be cured?

I'm happy to chair, all proceeds from ticket sales to go to LLanberis MR.

Who's in?

I’m in if Rom is

There's only one scene of that movie a teenager is going to remember, and it doesn't involve medicine...

The scene I had in mind: there's a montage of him dealing with different minor issues on his medical rounds, not all related to medicine.  Parallels to Stichplate:

• Paper cut <> infected finger from fishing hook - both finger injuries
• Repairing hearing aid <> reading the mail to an illiterate family- both related to accessibility and communication
• I'm not sure about the bad dream however!

It's stood up to the decades rather well I think.  Sentimental feel good pap really, but it's in interesting locations different to the Hollywood normal and opens with a classic ear worm from the 80s.

Thats posh. I have a photo somewhere where a couple of blokes at the back are holding a rectangle of cardboard covered in black tape over their eyes. No one, including the photographer, spotted it at the time.

(not particularly to you , but a comment across the board)

From recollection all long courses in first aid are required to assess rescue breaths as well as chest compressions.  Ideally, rescue and breaths and chest compressions should be given according to the syllabus - I have seen a graph of how O2 levels fall if just compressions are done.. However, I can;t recall the source of this atm. Was it based on modelling or real interventions? I can;t remember. Pros - can you help me out?

However, there are three things that tend to mean we should just focus on chest compressions - inability (e.g lack of face opening or face obscured and not trained to move patient); unwilling to give rescue breaths (lack of PPE, Covid-19 scenario); initial training insufficient or skill fade meaning that rescue breaths take too long and hence blood pressure drops (this is nothing against the trainer or candidate, but some skills are harder to get right, or keep right than others *);

The skill fade with first aid is huge. I did some testing with some first aiders and when put into the scenario of an unconscious non-breathing adult, the majority completely failed to complete the protocol of the primary survey and did not get onto doing chest compressions! Most of them had done a 3 days FAW course over one year ago, and had not had any refresher training. Realistically, they would have been no use in the situation until they received instructions from a 999 call handler. Would they have been better to just have tested on compressions only? Good question. I don't have an answer.

I also recognise that its quite easy to give the wrong message to learners, or put in content that is an aside that is taken quite seriously by the candidates. I've done it with things in my classes - based on things I have been taught, and over time as I've learned and increased my knowledge, my candidates get better info too. . 

* E.g. I have been trained in BVM usage, but don't do it often enough to be competent at the moment. Hence, even if I had a BVM with O2 I know I'm not likely to be effective with it, compared to kit i train with more regularly. Its not part of the syllabus I teach and its not part of SLSGB equipment, so I don't get to train with it,. 

Excuse me if i've made errors in this. Please do query things, if you think I've made an error. You may well be right,..

Seems pretty much spot on to me? Only thing I would add is that if you've got a patient in cardiac arrest, then they are essentially dead. Doesn't matter how rusty your technique is, doesn't matter if you've only ever seen CPR done on the telly. There isn't much you can do to the poor bugger that's likely do them further harm, so as long as you're confident that they've not got a pulse, jump on and give it a go.

Ta. 

Agree. With your last comment. 

I wouldn't criticise someone for giving it their best shot...

I've not called you a single name, as you agree you can be an arse, but we all are at the end of the day.

However you were quick to fire some about accusations and try and discern my ID from some photos, good luck.  Maybe I have mocked you insensitively, particularly given the virus situation promoting you to idol and expert Uber all. Guilty as charged.

Feel free to argue some more about semantics, I didn't disagree that you now have a protected title, which I've admitted they do not possess. However certain members are trained by the NHS to deal specifically with trauma because their job role requires a little more depth. You then went on to claim that this function was performed by attached RAMC.

I'm glad you took the time to find some of our previous conversation. It shows investment in the argument thus proving that you are also a fellow cockwomble. 

You've not called me a single name? This was you posting about me last night:

That just you being pleasant then?

You haven't the wit to mock me Walt, the best you've managed is crude insults. Well done.

It isn't semantics. You wrote: " every special forces medic is a fully qualified NHS trained paramedic." Calling yourself a paramedic without HCPC registration is an arrest-able offence, bit like claiming you're a policeman when you're actually a security guard at B&M Bargains. I didn't claim any SF role was performed by attached RAMC, I correctly pointed out that the only paramedics working with UK SF were attached RAMC. (Edit: maybe attached RAF paramedics too?, outside my experience so I don't know).

I see that me repeating your bullshit to you has hurt your feelings, you do appear to be remarkably sensitive. To save you further distress why don't you just hold your hand up, admit you were talking utter shite, apologise and move on? 

I’d say this is completely fair on the streets, but I’m not sure the same applies in the backcountry. Trying to keep effective CPR going is exhausting, particularly with small numbers and can quickly lead to compromising the safety of would-be rescuers. CPR is also only useful in an unbroken chain to definitive care later, starting and stopping is potentially worse than none at all, especially if the casualty is hypothermic. It’s a lot easier to decide to start than to stop. It’s worth working out if you can continue it till likely rescue with the people resources you have. 
I understand that not doing it might be very hard, and others might criticise from a position of inexperience. It might be argued that doing a few cycles for the psychological benefit of the party is worthwhile, but see my point of how hard it is to decide to stop. (I was once part of a group doing CPR for about 3 hours in the Chilean mountains, but we had 30 people plus and a heli on the way, initially told it would be less than an hour.)

 I was more talking about CPR in every day situations with medical assistance minutes away. 99.9% of cardiac arrests in this country fall into this category. As for CPR in remote places, it totally depends on what's caused the arrest, reversible causes, level of bystander training and kit on hand. The situation you describe in Chile sounds extreme, making the decision to stop resus is always hard but someone should have called it, I dread to think what condition the poor casualty's ribcage was in.

Saying all that, conditions allowing, I'd still advise giving CPR a go in the vast majority of situations, even if definitive medical care is going to be a long time coming. At worst you're going to get a bit tired and sweaty, at best you might save a life

As a slightly idle question, if I called 999 and said I had a casualty in cardiac arrest somewhere relatively remote - let's say halfway up Crib Goch - what sort of response time might be achieved?  How many rounds of Stayin' Alive am I looking at singing?

On Crib Goch you're going to get a response from a 160 mph (?) SARS helicopter out of Caernarfon about 15 miles (?) away. Assuming they aren't already tasked, they should be with you with a fully trained paramedic team and full advanced life support kit pretty dammed quick. 

Edit: Sad I know, but one of the things that impressed me most about my SARS placement was discovering that they get issued Scarpa Mantas as their everyday work boots.

 I dread to think what condition the poor casualty's ribcage was in

llong long ago I did first aid course  would the answer be a stove in chest? anyhow no matter.

What a good read this thread is  although it did sidetrack a little, the idea of  putting up your job title so  whoever it was  can tell you when your wrong,  is so true of UKC  a place of  good misguided info and equally subject matter experts, but sorting the oats from the barley is  well you know what !

Lots of take sways and  good gopro  video  a  go to peace on how not to? has it copy right. 

the one thing that stick out is the 3 bum sliding to look for the (body) had the casualty been passed and all 3 had arrived at the pig track what then?   no one had marked the point of last seen wondering back up to look in a shocked and clumsy way could have easily lead to more slips and a wider search and in the wrong place.   may be totally wrong on this trackers apps on phones may do this but I dont have such things  on  

I passed the course , a  work place first aid it was ludicrous 99 percent pass rate or we will get another provider to run the course,   I had answered a  tight dressing was right thing for a head wound, the assessor tried to guide me  A tourniquet ? but i still passed,,,,,,,,,,,,, and if any one has ever witnessed the appointed first aid person going to mush you will know just to what I am refracting 

so yes the guy in the video has some shortcoming  but he did not feint! 

edit I meant to add microspikes 

We would have earlier, but kept getting told the airforce heli was just about to arrive, for about 2 hours! Also, the casualty’s 2 children were somewhere nearby. It might be cold comfort, but at least they could see we tried our hardest. I would also not liked to have been the foreigners that “didn’t try” and declared him dead! The paramedics called it immediately on arrival, which was much preferable. 
This was a drowning, one of the few scenarios that I would always attempt CPR, no matter how far from definitive care, for that chance that it could help alone.

Again though, I’m not sure the worst that can happen is just to get hot and sweaty. You might be too used to being well trained and part of a well equipped team. I can easily imagine a scenario in poor weather and with few people, who perhaps haven’t seen to their own safety and comfort first, creating a second casualty through exhaustion and hypothermia. 

Yes it's been the best one I've been involved in for a while, and I think the misguided sections are simply people not realising just how much they **don't** know. And let's face it, we've all been guilty of that at some point!

I still can't believe that a "Brave Dave" (cringe) thread has resulted in useful discussion. Miracles can happen.....

That sounds absolutely dreadful, I know from experience just how harrowing it can be for those attending to have the casualty's kids on scene. Hope you came out of it OK psychologically as it's stuff like the situation you describe that can often trigger PTSD.

Spot on, presumably otherwise healthy patient with a clear reversible cause so certainly begin CPR. As to when to call it; our own guidelines are up to 90 minutes if the patient has been submerged in icy water, but that's full advanced life support with all kit and drugs on hand. Impossible to say, third hand, what length of CPR would be appropriate in the situation you describe. 30 people is a lot on scene and when there's more than a few there, everyone expects someone else to step up with the decision making. When you hear "is there a Doctor in the house", it's not so much to have yet another person who can perform CPR, it's more so there is someone to take charge.

I totally agree, if you reread my previous reply to you, I wrote "Saying all that, conditions allowing, I'd still advise giving CPR a go in the vast majority of situations,"

After years of hard work and sacrifice to earn it, I did find myself a little annoyed at Walt's insistence that the title paramedic is just "semantics" because there are other medics trained just as highly in dealing with trauma. In this one regard Walt was entirely accurate, but what Walt wasn't aware of (and you will be) is that trauma care is relatively straightforward and makes up a small percentage (<10%) of our training and probably 5% of our jobs. A good rule of thumb about the validity of a poster's argument is if their only "evidence" is a photograph on twitter

Well I can't disagree with that ;p I think I'd just blanked out his posts.

The BMC recommend carrying microspikes when winter hill walking: https://www.thebmc.co.uk/using-micro-crampons-and-mini-spikes-for-winter-hi....  They don't weigh much or take up much space in your sack and work really well in slippy conditions when you'd be wobbling around on full sized crampons.

Reading the article, I'm not sure that's a very accurate summary. What they are saying is that microspikes are better than nothing but on tricky ground, or where a fall would have serious consequences, you really want crampons.

Thanks for the reply, I appreciate the thoughtful comments. I think from working in a similar field to you that my resilience is probably higher than average to such cases, but they do all have a drip effect that can build up. I did try to talk to people in my group after, but probably don't think enough whether any of them are still disturbed by it now years later. I spoke to the 2 children after, via a local translating. Again, I’m not sure I’d it would have helped them much at the time, but I hope that it made a small difference.