Hopefully you’re all managing to stay safe and healthy through the
Covid-19 pandemic.
We know that many of you will be desperate to get back on the fells
and trails, and to get your Lake District “fix”. The relaxation of the
Coronavirus lockdown may have been music to your ears, when the Prime
Minister stated that it is now Ok to drive any distance to take your
exercise. This came as a total surprise to us as a Mountain Rescue
Team (MRT), Cumbria Police, Cumbria Tourist Board, The Lake District
National Park and also The National Trust. Simply, the Lake District
is NOT ready for a large influx of visitors. The hospitality sector
remains closed, some car parks may be re-opening, along with some
toilet facilities, but this is an enforced opening due to this
announcement to cater for those that do decide to come, rather than an
invitation. Why are we, Coniston Mountain Rescue Team, so concerned
about the relaxation of the travel to exercise rules? Maybe if we talk
you through what happens it may explain why we’re worried. Firstly,
we are all volunteers – most of us have day jobs from which we take
time off to deal with incidents during work hours, or time out of the
rest of our lives “out of hours”, and secondly most of us have
families who we need to protect. How a rescue might play out during
the Covid-19 pandemic:-
Paul and Sarah came up from Preston, and have summited the Old Man of Coniston, had their lunch and set off down towards Goats Water.
Paul slips and hears a crack from his left ankle, Sarah tries to help, but Paul can’t put weight on his ankle which is at a funny angle
anyway. Paul is 15 stone and 6ft 2 tall. Sarah is fit but no way
could she help Paul back down.
Sarah dials 999, remembers to ask for Police and then Mountain Rescue, the operator takes the details and asks a lot of questions to
assess the Covid-19 risk posed by both Paul & Sarah to the MRT, and
subsequently to Ambulance and medical staff that will need to treat
Paul.
In the meantime, four groups of people come by, they all say they’d love to help but haven’t got any Personal Protective Equipment (PPE)
and must socially distance themselves by at least 2 metres.
The Police alert Coniston MRT to the incident via SARCALL, and the Duty Team Leader (TL) calls Sarah, having sent her a link by text for
her to click on to confirm their exact position, and asks more
questions, to work out the resources needed.
The TL then calls other members of the Leader Group to discuss the requirements and decides a 10 member group is required on the hill,
and alerts the Team to that requirement.
The Team numbers are depleted anyway, we have a number of people who contribute massively to the Team generally but are over 70 years
old, i.e. higher risk group, we have people who may be shielding a
family member, or at risk themselves due to underlying medical
conditions that normally wouldn’t be an issue. So a team of 10
assemble at the MRT base, plus someone to run the base – this person
is important as it helps with coordination of other services letting
the hill party get on with the job.
All members are briefed regarding the incident, and check all are happy with the unknown invisible risk posed by the incident; the risk
of walking up the fell is taken as read and a baseline anyway. All PPE
is checked.
Team members climb aboard two of the Team’s three vehicles. Why only two when social distancing could be better in 3 vehicles? The
need to decontaminate the vehicles on return probably outweighs the
advantage of social distancing, and it leaves another vehicle able to
respond to any other incidents.
Normally the Team would mobilise within 10-15 minutes of this type of call, due to all the pre-checks, personnel checks etc., time
elapsed thus far is 45 minutes.
The vehicles arrive at the road head, one last check on PPE and kit for the incident, including radios, and the Team sets off for the
casualty site. Walking time to site is around 45-60 minutes.
The Team can’t call on the Air Ambulance for support as they're off-line for this type of incident due to staff being redeployed
elsewhere in the NHS or due to other priorities and risk factors so
cannot support. Similar with Coastguard Helicopters...
On site, one casualty carer and one assistant will approach the casualty with as much PPE on as possible, and may well apply PPE to
the patient before carrying out a full primary survey, in this case
that’s simple, Paul’s ankle is (probably) broken, and there are no
other underlying medical factors like a head injury, multiple other
injuries or catastrophic bleeding.
The casualty carer and helper would normally give Paul some Entonox (pain killing gas) while they straighten his ankle to ensure a
pulse at the foot and also maybe a pain killing injection. The
injection takes 15 mins or so to work, but Entonox is not given
because of the potential risk of contamination. However, the foot
needs straightening ASAP to restore the pulse in Paul’s foot. Paul
screams as the casualty carer re-aligns the foot (it’s called reducing
the injury) to restore circulation and allow for splinting.
Paul’s ankle is splinted and although he’s still in pain, it’s less than it was and the painkilling injection is starting to take
effect. Time elapsed since Paul fell is now 2 hours 15 mins.
The Team moves in and helps Paul on to the stretcher, the stretcher is made of stainless steel and heavy, it is about 2.5 metres
long and maybe 0.6 metre wide, usually it takes 8 people to carry a
loaded stretcher, they cannot socially distance.
The Team carries Paul down to the Walna Scar road, where they’ve asked a North West Ambulance Service land ambulance to meet them to
reduce potential contamination at base. The carry down has taken 2
hours, so now it’s 4 hrs 15 since Paul fell. Paul is transferred to
the Ambulance and taken to Furness General Hospital. Sarah can’t
drive, but can’t go in the Ambulance either. How can the Team get
Sarah re-united with Paul and then how do they both get home to
Preston when Paul is fixed? What happens to their car? In normal
circumstances we can fix these issues, not so easy in the Covid-19
pandemic.
The Team returns to base and starts to decontaminate the stretcher, the vehicles, the non-disposable medical equipment, the
splint and themselves. Jackets and other clothing are all bagged ready
to go in their washing machines when they get home, which takes a
further 1 hour 15 minutes. Total time elapsed 5hrs 30 minutes. Total
man hours 10 folk on the hill plus 1 running base = 60.5 man hours.
Paul is admitted to Furness General Hospital after a wait of 1 hour at A&E. He is taken to cubicles and X Rayed to understand his
ankle injury better. He is also routinely tested for Covid-19. Paul’s
ankle needs an operation to pin it as the break is a bad one.
Paul’s Covid-19 test comes back positive. Oh dear! Paul is asymptomatic, he has the virus but is either naturally immune or has
not yet developed symptoms. The message is passed back to Coniston
MRT, who then have to check the records of those on the incident.
Every one of them, the ten people on the incident and the base
controller, must now self isolate and so must their families, so now
we have maybe 35 people all having to self-isolate. Plus possibly the
Ambulance crew and their families.
Three days later Eric from Essex decides he wants to come to Coniston to do the 7 Wainwrights in the Coniston Fells. He sets off,
and completes Dow Crag, the Old Man, Brim Fell along to Swirl How and
Great Carrs and across to Grey Friar, then on up to Wetherlam. Eric
puts his foot down on a rock, the rock moves and Eric is in a heap on
the floor, his foot is at a funny angle...he gets his phone out and
dials for Mountain Rescue... but there are only three people available
from the Coniston Team now, so the decision needs to be taken by the
Coniston MRT duty leader which Team to call to support, Neighbouring
Teams are Langdale-Ambleside and Duddon & Furness MRT’s. The issue is,
they’re in the same situation as Coniston with people self-isolating
due to potential contamination, or their members are keyworkers in the
NHS and can’t deploy on MRT incidents. So – we’re asking you to think
twice, even three times before you embark upon travelling to the Lake
District for your exercise. The risk, however small, is real, and I
write this as a MRT member for over 30 years with probably around 1000
incidents under my belt, I know, accidents happen.
Sensible advice, but the majority of accidents I’ve seen in the lakes have involved people who don’t appear to be the type to take advice or follow guidelines.
Bit too soon.
Coniston MRT sum it up well.
https://www.facebook.com/176432572398040/posts/3781575878550340/