"You Only Live Twice Mr Bond"
Posted by Jeremy Windsor on Dec 22, 2023
In this post, members of the Keswick Mountain Rescue Team describe how a young fell runner developed hypothermia during a descent of Blencathra and subsequently triggered an extraordinary rescue effort. Here’s their story…
Callout Date: 06/01/2022
Callout Time: 5:23 pm
Agencies Involved: Keswick MRT, Coast Guard Helicopter and Penrith MRT
Just before Keswick team’s scheduled weekly training evening we received a callout from a fell runner reporting his companion had a ‘delirious episode’ whilst descending Hall’s Fell on Blencathra and was unable to continue down to the valley. With no mobile phone, he left his companion in a bivi bag in order to descend to summon help. Keswick team responded quickly, climbed up to the casualty, assessed and provided medical attention. A Coast Guard helicopter was requested for speed due to likely risk of hypothermia. Many thanks to Rescue 936 from Caernarfon who attended and winched the casualty from the ridge for onward transport to hospital. Many thanks also to Penrith MRT for responding in support.
24 Keswick team members, 2 Penrith MRT – 3 hours 8 minutes
POST SCRIPT – You only live twice Mr Bond!
We are absolutely delighted to be able to give the full story of Keswick’s second callout of the year on the 6th of January on Hall’s Fell, Blencathra. The initial incident report was kept deliberately scant of detail as at that stage nobody knew what the outcome would be. Here is the full story:
The team were called to a 26 year old fell runner who, near the end of leg one of a Bob Graham Round training run, was unable to continue the relatively short remaining descent down Hall’s Fell to Threlkeld village. The temperature all day had been around freezing point with strong winds, snow and sleet showers. His friend helped him into an emergency survival bag before he ran down to raise the alarm.
The 66 mile Bob Graham Round is made up of 5 sections. When taken in the clockwise direction, the 13 mile Keswick to Threlkeld section typically takes 4-5 hours, crossing the summits of Skiddaw, Great Calva and Blencathra before descending Great Hall's Fell
Two team members formed an advance party and went to investigate armed with warm clothes and snacks to deal with what was expected to be a hypoglycaemic (low blood sugar) and cold fell runner. Around 20 minutes up Hall’s Fell the two discovered the survival bag empty but folded up with stones piled on top, and no casualty in sight. They continued on and discovered the casualty a little further up the trail lying face down and with no signs of life. Despite the fact that to all appearances the man was lifeless, current medical guidelines and our team training tells us that a casualty is not dead until they are warm and dead. To that end the casualty is treated as if he were still alive.
Whilst one team member started an assessment of the casualty the other reported the situation by radio and the urgent requirement for a helicopter evacuation. When the initial careful assessment showed no signs of life CPR was commenced with the two team members rotating at regular intervals to maintain good chest compressions.
A few minutes later the medical bag with defibrillator arrived on scene. The pads were placed on the man’s chest and shocks given but with no effect. As more team members, and reassuringly one of the team’s doctors, arrived with various bits of kit the man’s evacuation plan was put into action, all the time with CPR in progress.
An Autopulse is a battery-powered machine that performs chest compressions allowing the casualty to be transported on a stretcher. When this arrived on scene the man was loaded onto the stretcher in preparation for the arrival of Coast Guard Rescue 936 helicopter arriving from Caernarfon.
In very blustery and showery conditions the man was expertly winched from Hall’s Fell ridge into the helicopter along with a team doctor who accompanied the casualty to A&E at the RVI Hospital in Newcastle.
Battery powered mechanical devices such as the Autopulse are now widely used for prolonged periods of cardiopulmonary resuscitation (CPR)
On arrival at hospital the casualty’s core temperature was found to be 18.8 degrees. A specialist ECMO team arrived from the Freeman Hospital to ‘plug’ the casualty into an ECMO machine. This is a device that removes blood from the patient, warms and oxygenates it before circulating the blood back into the body. In this way the casualty’s body was re-warmed gradually.
There followed a number of very tense days with the casualty in an induced coma. Snippets of positive news received from the consultants in the hospital on the man’s progress were greeted with amazement from those who had seen him on the hill, incredulous that he could possibly be alive. After 5 days the man ‘woke up’ and was asking what on earth had happened as well as wanting a coke!
Five months on and the man who miraculously cheated death is making a very good recovery and has even managed some decent runs. This was one of the lowest body temperatures from which someone has survived – a truly remarkable survival story and a testament to the professionalism of all involved.
It is normal for fell runners to travel light, rapid movement creates heat that doesn’t need much in the way of clothing – this is fine when things go right. Let’s hope the story of our survivor is a wake up call for those who venture ‘lightweight’ into the hills. Spare clothing and a survival bag doesn’t weigh much but could make the difference between life and death.
To find out more about the use of ECMO in hypothermic cardiac arrest take a look at this.
More on the long term effects of hypothermic cardiac arrest can be found here.
Our thanks to Keswick Mountain Rescue Team for giving permission to reproduce their article. Why not make a donation?
Thanks for reading this post. If this is your thing why don't you take a look at other posts on the blog? Better still, why not join the British Mountain Medicine Society? More information can be found here.
For more information about the University of Central Lancashire's Diploma in Mountain Medicine (DiMM) take a look at this.
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22/12/2023 @ 10:34:39 Paul Newby (Alpine Club and Thames Hare & Hounds)
Both salutary and inspiring for a lifelong mountain runner (now aged 79 and blessed still to be able to do it, without so far needing rescue).
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