Oxford University Cave Club

Expedition: "Gustuteru 1996"


Medical Officer's Report

Tim Guilford

Medical Incidents

It is a credit to this year's expedition that there are few incidents to report here, and none of them actually serious. However, most potentially serious of these involved a caver being hit on the head by falling rocks whilst prussiking, and I will report it here in some detail since lessons may be learned from it. Other minor incidents are also reported.

On 22nd July 1996, Martin Smith, an experienced caver, was exiting Torca del Vasco behind Geoff Newton. When Geoff cleared the top rebelay on the notoriously loose 4th pitch he announced this to Martin below who started up the bottom section. This was despite an earlier warning from Nathaniel Mumford who had insisted that no one else be on the upper sections of the pitch until he was entirely clear of the bottom. However, this was Martin and Geoff's first trip into the cave, and their decision to double the pitch between rebelays would not be considered unusual in ordinary circumstances. Geoff accidentally dislodged rocks on the upper section of the pitch with his tackle bag, and shouted "below" to Martin, who, wearing thick gloves, promptly covered his face. A cascade of rocks lasting several seconds hit his helmet. The helmet absorbed the shock adequately, but forced the plastic cradle onto his nose causing both internal and external bleeding. Martin shouted that he was alright, and asked if it was safe to continue. He received a positive reply, started prussiking again, but more rocks followed. One hit the back of his knee, and gave him a dead leg (though only bruising later). At this point Martin took evasive action and pendulumed to the far side of the pitch and wedged himself away from the line of fire until Geoff was clear of the pitch head.

On the surface Pauline Rigby and Michael Playford examined Martin, cleaned his face wounds, and stayed with him until they were satisfied that he was suffering no deeper injury. Martin slept, took a day off caving, and was then fit to cave the following day.

The pitch was properly gardened on the next visit. However, the incident emphasises the importance of warning others of any perceived dangers, even if the recipients of the information are more experienced cavers than the donor, and points out the inherent risks associated with multiple prussiking on pitches.

Martin was wearing a Protex Helmet, and although his face was cut by the cradle he believes that the force of the impact of a cascade of rocks on his head was adequately absorbed by it.

Six other medical incidents were reported. The most unusual happened to Pauline Rigby on 7th July when, after a strenuous carry up to Top Camp, it snowed. Pauline became very cold, and her feet went numb. Later, she complained of pain in her toes, and lost sensation in her two big toes. She later lost the nail from both big toes, and it is possible that she suffered mild frostbite. Her toes have now recovered nervous function, although they don't look very nice.

Not at all unusual were two incidents of thumbs damaged by hammers (Nathaniel Mumford and Tim Guilford). Tim had forgotten his gloves, and was hammering with his left hand, so the injury was not unexpected. Wearing gloves would greatly reduce the consequences of hitting yourself (or, I suppose, of someone else hitting you).

Joanne Whistler returned the only reported case of dehydration, probably caused by walking up the hill from Covadonga. She was administered rehydration salts. Expeditioners seem to have become gratifyingly more conscious of the dangers of dehydration during carries in recent years, restricting walks to the cooler parts of the day (or night) and carrying sufficient water.

There were no recorded cases of stomach upset, common on earlier expeditions, indicating that the dettol hand wash system after defecating and before handling food works well.

Medical Logistics

The first aid kits this year were modelled on the system I used two years ago, with a main kit at top and base camps, and independent trauma and deep rescue kits maintained at top camp ready for immediate carriage underground in an emergency. Tables kept in the kits logged contents and whereabouts of additional supplies. This year however, sterile units were kept in a separate kit because of the soiling caused by regular use of the main kit at top camp.

This year for the first time we carried both a SKED rescue stretcher and back-splint stretcher at top camp. Neither were used, although many of the expedition members have now had training in the use of the SKED in rescue practices in UK. The callout system at Top Camp seems to work efficiently. Two callouts were made this year, both when cavers were overdue. On 13th July, an exploration party in Torca del Vasco failed to emerge before callout, and a rescue was initiated at exactly callout time. Two cavers carrying extra light, food, and a rescue kit kitted up and headed for the entrance, whilst food for others, and a second team were prepared. The overdue cavers were met soon on entering the system. Alex, who had already used up three of his nine lives on last year's expedition, had forgotten his prussiking gear, proceeded down the cave, and had been forced to use knots. In a second incident, Geoff Newton and Bob Kynaston were slow exiting from Torca del Regallón, but delivered an agreed whistle signal as rescuers were being dispatched to the entrance.