Today was supposed to be a calm and perhaps relaxing day of science. Due to the chain of events of the day and their specialized nature, this update was created by myself, Peter Coppin, the Education and Public Outreach Lead with assistance and text from Ross Donaldson, our expedition physician.

Andy's and Nathalie's respective groups were planning to start the day by going to the Thermales [hotspring] to bathe. While at Thermales, Andy was going to conduct one of his experiments.

I was spending my morning using our Inmarsat satellite phone to uplink our latest Education and Public Outreach update to our Pittsburgh server so that our Pittsburgh team could put our latest updates onto the public www.eventscope.org/highlakes website.

Then, a sudden call came over the radio: a member of a three-person paragliding team, which had summited Licancabur today, had fallen off a cliff when trying to take off and had bashed his head into the rocks below!

In these mountains, the general practice is to help one another when in need. Nathalie immediately set aside her work for the day and put together a team to go to Licancabur and assist the paraglider. Ross, our expedition physician, quickly assembled his gear. Then, Ross, Nathalie, Clay, Macario, another Bolivian guide, and myself, piled into two vehicles to speed to the base of Licancabur.

At the base of Licancabur, we learned, via the radio, that the paraglider was slowly descending the mountain under his own strength and with the aid of his Bolivian guide. We decided to send Nathalie and Macario to ascend towards the injured paraglider, while Ross began assembling a makeshift medical area with the assistance of Clay and myself.



Nathalie and Macario head up the mountain to the injured paraglider

(Note: due to medical discretion, there are no photographs of the injured paraglider.)

Here are some images of the medical area that Ross put together at the base of the mountain:



Clay and Ross begin setting up a medical area.



They find a sheltered area to receive the injured patient.



And begin to set-up.

Some of the medical instruments:



Ross' first aid kit, including trauma materials.



Ross prepares his materials, including a blood pressure cuff and a portable pulse-ox (to measure the level of oxygen in the blood).



Ross prepares intravenous supplies, in case they are necessary due to excessive blood loss.



Oxygen tank and delivery equipment.

As Nathalie and Macario headed up the mountain, Nathalie spoke frequently with the injured paraglider in French. After a while, her tranmission started to break up, probably because some geologic features were blocking the transmission. Clay then headed part way up the mountain to act as a "relay station" for Nathalie's transmissions. (In other words, Nathalie communicated with Clay who was further up the mountain, and then Clay relayed Nathalie's updates to us at the base of the mountain).



Ross getting a status report from Nathalie via Clay.

Ross was able to conduct a great deal of his diagnoses through the radio updates. His injured patient had already passed the first tests of Emergency Medicine (known as the A,B,C's). By being able to respond to the radio requests, Ross knew that the man had an open Airway, was Breathing, and was Circulating blood around his body.

However, Ross was still concerned about the results of trauma to the man's head and also the possibility of shock from the blood loss, which his patient had noted to have difficulty stopping.

Once the injured person was at the base of the mountain, Ross immediately focused on diagnosing injuries that could be quickly fatal. It is worth noting that Ross did not inspect the most obvious head laceration first. He was more concerned about less visible, but more detrimental injuries, that the paraglider could have also sustained with such a significant mechanism of injury.

After giving the man oxygen and placing his neck in a trauma collar, to prevent movement, Ross checked with his stethoscope to see that both of the man's lungs were fully inflated (making sure the patient did not have a collapsed lung from the trauma). He then looked for bleeding in places that could be easily missed, including the abdomen, pelvis, and thighs.

While checking the paraglider's vital signs (blood pressure, heart rate, pulse-ox, and respiratory rate), our expedition doctor then had his patient move all of his extremities and answer some simple questions. After this quick first-line survey, which took only 4-5 minutes, Ross knew that the man was in no immediate danger. He then had time to look over the rest of the paraglider's body, including the deep cut on the forehead, which had stopped bleeding underneath a pressure bandage.

After Ross' secondary survey, he concluded that the man had a low chance of internal head bleeding, since the man had not lost consciousness during the accident and could recall the whole event. The main injury sustained was limited to the head laceration.

After finishing the trauma assessment, Ross, Nathalie and the injured person settled into one vehicle and Clay, myself and the others settled into the other vehicle.

We soon arrived back at the Refuge where Ross, Clay, Melissa, and Victor began setting up two medical areas. The first would be used to clean the head laceration, and the second would be used to stitch it up.

Here is an image of the medical area that would be used to clean the wound:



Ross is setting up a syringe to clean the wound with a jet stream of filtered water.



Ross also prepares Lidocaine (a medication similar to Novacaine) to numb up the paragliders wound before cleaning.

Here is the image of the medical area at the refuge that would be used to stitch the wound:



Ross prepares a cot and gets his suture material ready, wearing a head lamp for better lighting.



Ross has to make due with limited supplies and a suboptimal environment. He does his best to prepare sterile materials.



These pictures show the different kinds of sutures and the Lidocaine.



Overall, three deep sutures (in the muscle) and 16 superficial sutures (to close the skin) are needed to close a 3-4 inch cut extending from inside the hairline to just above the eyebrow. The laceration was very deep and went all the way to the bone, although it did not injure the bone.

Here are some images of Ross coordinating with Victor. Victor would later act as an assistant during the medical procedure.



Victor and Ross prepare for the procedure.



The paraglider recovered well from the procedure and was later back to joking with friends. One tough guy!

Quote of the day:

"I haven't seen blood yet that I can't stop"