Tuesday 12th May 2020 (Day 49 of Lockdown)
My friend and fellow blogger Bowland Climber has posted this and has quite rightly asked for it to be circulated as much as possible. Obviously I agree with the message and have had no intention of travelling further than a couple of miles from home. But I have to say it has made me think because I have been walking on albeit well established limestone paths in my area I realise there is hardly anybody about and I could be almost as much a nuisance as the example in the scenario described below if I had an accident preventing me from getting out to a road. I will be even more cautious now.
Conrad R.
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From BC:
This is a copy of a Facebook page for Coniston Mountain Rescue today.
It is worth reading in full and disseminating widely in the outdoor community.
Hello All,
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.
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:-
1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. Normally the Team would mobilise within 10-15 minutes of this type of call, due to all the pre-checks, personnel checks etc., the time elapsed thus far is 45 minutes.
11. 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.
12. 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…
13. 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.
14. 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.
15. 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.
16. 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 metres wide, usually it takes 8 people to carry a loaded stretcher, they cannot socially distance.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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 an MRT member for over 30 years with probably around 1000 incidents under my belt, I know, accidents happen.
1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. Normally the Team would mobilise within 10-15 minutes of this type of call, due to all the pre-checks, personnel checks etc., the time elapsed thus far is 45 minutes.
11. 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.
12. 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…
13. 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.
14. 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.
15. 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.
16. 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 metres wide, usually it takes 8 people to carry a loaded stretcher, they cannot socially distance.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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 an MRT member for over 30 years with probably around 1000 incidents under my belt, I know, accidents happen.
The BMC have issued a very sensible and balanced newsletter which covers the issues raised here in calmer, more balanced language but covering the same and other very relevant points more comprehensively.
ReplyDeleteMost of the people who will or might read this much prefer to be given neutral advice and to be expected to use sensible judgement: I suspect that this deliberately lurid post by the Coniston MRC is coloured by their having to deal with the stiletto heel brigade too often - who would never read it anyway - and so is aimed at the wrong targets: the obvious thing to do is to sign up all carparks and entrances to popular footpaths and trails with the same or similar sort of notices that are used to warn of fire and other existential risks - and indeed Foot and Mouth disease, although that was statutory - except the message would be 'don't take risks, there are no rescues, no help of any kind available' - maybe adding in small print a more lurid warning of the possibly fatal consequences of ignoring it. This would give visitors no excuse, such as not having seen such narrowly circulated encomia ( 'Stay Alert' must be added to the notice, of course).
It has never been specifically forbidden to go into the hills or to climb, so the new guidance does not alter the actual legal situation, which the MRT post seems to miss.
I saw this on facebook. Sadly, as ever with this sort of thing, it probably won't reach exactly those people who it ought to, either because they don't read your blog, belong to the right forums etc or because they choose to ignore it anyway. None the less, its a timely reminder.
ReplyDeletegimmer and Mark - that is fair comment and I do respect the BMC, but every little helps (I hope.)
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