Just leave them there?

[AlanfromOz]

Hypothetical situation... You've got an injured caver with multiple fractures - eg leg, arm and collarbone. The only way out is through an extensive, tight rockpile - no chance of getting them out on a stretcher, and no chance of the patient being able to get through without a stretcher.

If it's bad enough, do you consider leaving the patient in a safe area of the cave and setting up logistics to bring them food, water, heat, light, etc for long enough for them to recover (weeks?)

Has it ever happened?

[Stridergdm]

Hypothetical situation... You've got an injured caver with multiple fractures - eg leg, arm and collarbone. The only way out is through an extensive, tight rockpile - no chance of getting them out on a stretcher, and no chance of the patient being able to get through without a stretcher.

If it's bad enough, do you consider leaving the patient in a safe area of the cave and setting up logistics to bring them food, water, heat, light, etc for long enough for them to recover (weeks?)

Has it ever happened?

I've never heard of a case where that has been the solution. I'm not a Dr. (nor do I play one on TV, nor do I play one in the bedroom ) but with injuries that bad, I suspect that they'd be medically compromised enough that you'd really want to get them to a place with better conditions. In addition, I think the length of time for say a leg to heal that it could support a caver would be measured in months.

That said, I'd suspect that a way would be found to get the person out, lots of drugs, local immobilization, and "hey, this is going to hurt.. this is going to hurt like hell." Worst case, bring in a drill rig and dig a hole large enough to drop a stretcher in. (I suspect there's a few cavers who would crawl through any breakdown, passage, etc, if it meant that much change to the cave.)

[CaveGimp]

Very interesting question. Lets take it a step further and say a neck/spine injury is suspected, so a backboard or some kind and complete immobileization is required. Given that the cave would liekly be "modified." I am thinking of a cave, highly decorated, that was "modified" for the rescue. On what was a smooth slope there are big "steps" dug into the mud, some formations were cut/removed to allow enough room. Its sad to do to a cave, but one couldn't let the caver die. This type of situtation is why cave safety is so important.

To your question about leaving someone in the cave, I would think that would be an all around bad idea. Bad injuries lead to other problems, and when you add a cold wet enviroment things would get worse. Chance of infection would rise, plus just trying to keep the person warm enough and dry. I have had many bad bone breaks (pelvis, leg, arm) and knowing what my recovery was like, sitting in a cave would have made it worse. It sucks enough not being able to walk, get your own glass of water, etc, but to not to go places, see family and friends for 6+ weeks? Drill the hole.

[Ralph E. Powers]

This is why accurate cave maps are a must, particularly to a cave SAR team. There may be an easier way out or a passage that by passes the area where the injured is at or has to go through. No, leaving them there is not an option, it's never an option. It took a while to get Emily Mobley out of Lechuguilla but they made steady progress and from what I recall from one of the rescuers, very little of the cave was damaged in doing so.
Drilling from the surface a 2 foot diameter shaft (just wide enough for a person in a sked to get hauled through) I would think would have to be THE last resort. Even drilling a 300 foot shaft takes a while, not to mention you have to be super accurate in your cave/above ground survey to hit the right passage and cause the least amount of damage.
During my cave SAR training was (1/2) jokingly told if a person was JUST stuck (because they're just too fat) and attempts to pull them out would've caused more harm than good... then a good cracker and water diet is just the ticket. A few days and they come right on out. Provided they're warm enough to stave off hypothermia.

There's always a way.

[Phil Winkler]

Interesting topic. Here are some historic examples from Wikipedia Cave_Rescue:

Historic examples

* Marcel Loubens from Pierre St - Martin Cave in the French Pyrenees in 1952. Loubens died from a fatal plunge down the 1,135-foot (346 m) entrance shaft after a clasp on his harness broke on ascent. Members of Loubens' expedition spent over 24 hours attempting unsuccessfully to haul their friend back to the surface. Despite the efforts of the team doctor, Loubens died 36 hours into his ill-fated rescue attempt. After his passing the remaining members aborted their recovery attempt. Louben's body remained in the cave for two more years before cavers returned him to the surface in 1954. The blood transfusion given to Loubens by the team doctor was likely the first subterranean care of its kind.[4]

* James G. Mitchell from Schroeder's Pants Cave in Manheim, New York in 1965. Mitchell was a 23-year-old chemist whose death made national headlines in February 1965 when he died of hypothermia after becoming stranded on rope in a 75-foot (23 m) pit with a frigid waterfall. Initial efforts to recover Mitchell's body failed. A rescue team was flown from Washington DC on Air Force 2. A subsequent three day effort to retrieve Mitchell was aborted after repeated failures and a collapse. The cave was abandoned and blasted shut, essentially making the cave a tomb. Mitchell's death made headlines again forty-one years later when a group returned to the cave and successfully recovered his remains.[5]

* Emily Davis Mobley from Lechuguilla Cave in New Mexico in 1991. More than seventy people worked over four days to bring her to the surface after her leg was broken. This was the deepest and most remote cave rescue in American history.

* Floyd Collins from Sand Cave in Kentucky in 1925. Likely the first high profile cave rescue in history. Collins' desperate situation in the depths of Sand Cave made headlines across America. Over 10,000 spectators flocked to Sand Cave in the week following the news of Floyd's predicament. The National Guard was called in to control the carnival-like atmosphere surrounding the cave. Despite the heroic efforts of volunteers who attempted to dig a parallel shaft to free Collins, he was found dead, buried to his shoulders in debris. One 25-pound rock had jammed Collin's foot, preventing his escape. Collins remained trapped in Sand Cave for another 2 months until a crew of German engineers finished the digging of the shaft and extracted his body.[6]

* Neil Moss in Peak Cavern, England in 1959. Trapped in a narrow tunnel, he was eventually suffocated by carbon dioxide after prolonged efforts to free him. Rescuers were unable to free Moss and eventually the family asked that his body remain in the cave.

* Gerald Moni from McBrides Cave in Alabama in 1997. Moni and his group entered McBrides Cave in flood stage attempting a pull-down trip to the cave's lower entrance. A flash flood caused the situation in the cave to become extremely hazardous. While attempting to negotiate a pit being inundated with a high flow of water, Gerald mistakenly grabbed only one of two ropes necessary to descend the pit. The resultant fall to a ledge part way down the drop resulted in a broken femur. A few members of the group managed to negotiate the lower stream passage before it sumped and reached the surface. The others remained with Moni until local rescue agencies could mobilize and attempt a rescue. Rescue teams spent hours waiting for the water levels in the cave to recede enough to attempt an extraction. When teams finally reached Moni, he had been exposed to frigid water for over 12 hours. Rescue teams risked drowning themselves and Moni while traversing the flooded lower cave. 18 hours after his fall Gerald was returned to the surface alive.[7]

[Anonymous_Coward]

While this gets talked about a lot, I don't think it is feasible.

However much the caver would like to heal in the cave and prevent extensive passage modification, I don't think it would ever happen. The landowner, managing agency, Washington overseers, news media, patient's family, general public, etc. would not stand for it.

The hole would get drilled.

Even if the cave had to be surveyed and radio-located to determine where to drill, all this would still take less time than waiting for a bone to heal.

It could also be argued that all the supply trips in and out, plus the impact of someone living in the cave that long could equal or possibly exceed the impact of a new entrance.

[Ralph E. Powers]

It could also be argued that all the supply trips in and out, plus the impact of someone living in the cave that long could equal or possibly exceed the impact of a new entrance.

Thank you... one of the things I forgot to mention as well... the logistics of the whole thing.

[AlanfromOz]

I suppose back / neck injuries would be worse... a broken leg will only hurt and cause a much longer recovery - a broken neck could easily kill them without immobilisation.

So there appears to be agreement that any more than a few days is too long to keep them in the cave.


Another sticky question then... assuming they're dead and it's necessary, do you cut the cave or *gulp* the body? (With appropriate approval from police or coroner of course).

[Stridergdm]

I suppose back / neck injuries would be worse... a broken leg will only hurt and cause a much longer recovery - a broken neck could easily kill them without immobilisation.

So there appears to be agreement that any more than a few days is too long to keep them in the cave.


Another sticky question then... assuming they're dead and it's necessary, do you cut the cave or *gulp* the body? (With appropriate approval from police or coroner of course).

Actually, depending on the injury, a broken leg can kill. If you break your femur, there's always the chance of a bone end cutting the femoral artery.

As for the 2nd question, I can not see authorities or family giving permission to cut a body. I can't recall a case where that has been intentionally done. I do know of several (including the above mentioned Schroeder's Pants cave incident) where the person has been left behind and they've ended up removing remains years later.

[Anonymous_Coward]

assuming they're dead and it's necessary, do you cut the cave or *gulp* the body? (With appropriate approval from police or coroner of course).

I'm pretty sure this has been done. The body recovery from Black Cave, AZ comes to mind. Maybe someone who was involved with the recovery could chime in and confirm or deny.

[shibumi]

Here's the deal. You're either going to die of your injuries within a few hours, or you'll survive
enough for some rough handling. Cave rescue is like that.

I'm going to go out on a limb here and say that very, very, very few situations are unrecoverable.
Yes, there are some exceptions, and some I haven't even imagined (and I've done a lot of rescues),
but very few. I've modified a lot of caves and been at some far-out places where if you can't get
yourself out, you aren't getting out.

I've been doing cave rescue for two decades plus now. I've had a hard time imagining a scenario
where "build an OR in the cave and let them heal for a few weeks" would be needed. My professional
opinion is that the situation is not what makes a rescue a success or not, it's the people performing
the rescue.

Re: Body recovery. I am not kidding when I say to people "we'll get you out no matter how many
trips it takes." Me, if it would place anyone in danger to get my carcass out, leave it in.
The general public does not know, nor do they want to know, what it sometimes takes to extract
a corpse from some situations. BTDT (not in cave yet tho...).

[wyandottecaver]

I am pretty sure there is an example from Europe where a injured caver was supported in-cave for a lengthy time to heal injuries. I'll have to try and find the reference.....

[Stridergdm]

I am pretty sure there is an example from Europe where a injured caver was supported in-cave for a lengthy time to heal injuries. I'll have to try and find the reference.....

I'd be interested in reading about that. It must be a unique set of circumstances.

[Ralph E. Powers]

I've mentioned before about a particular cave where there is a handmade sign posted near the entrance of a crawl called "Point Of No Rescue"... having done this crawl several times and having mentally gone through it with the idea of hauling someone out... it's do-able but they would have to be strapped into an OSS only and that would have to be man-handled through out the crawl. The OSS would allow injured person to bend at the waist to negotiate the tight tight turns and twists of said passage.

Thing is... the injured person would have to beforehand resign themselves of possibly being paralyzed due to spinal cord damage (if injury was back related) and agree not to contact their starving lawyer to bring suit against the ones who got them out of the cave alive.
If the injury were a broken limb then a good dose of morphine or other pain killer and a SAM splint (or air splint (wrapped in tear resistant material) would be IMO the best idea to go ahead and negotiate the person through the passage.

For those of you who have been there ... imagine trying to get an injured person through the crawl just before the Rumble Room in Rumbling Falls Cave.