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Why we wear helmets... (examples)

Discussion in 'Accidents and Near Misses' started by ratagonia, Jun 22, 2016.

  1. Ram

    Ram

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    That was pretty grim. Thanks for sharing. I so often see folks break out with the helmet only when the rapping starts. Not for down climbs on both sides of the rapping. More rarely still, is using them on scrambling approaches. This choice to wear it on approach saved your life.

    For those that don't know Doug...he is huge. He is strong. He is athletic....now add lucky and smart! Tough? Walks out to go to the ICU? Yeah, that too. Glad you are still with us

    [​IMG]
  2. townsend

    townsend

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    Wow. So thankful that you are still among the living. Thank you for posting -- you were doing the right thing, I'm sure experienced and climbing carefully, this could happen to any of us.

    This real live experience is a clear illustration of how a fall is survivable, but without a helmet, it is not survivable. Think about it. The only organ in the entire body that is encased entirely in bone is the brain (or the skull, AKA cranium in anatomy class). It is so encased because it is delicate and important.

    The brain would die without oxygenated blood flow. So arteries carry blood up to the brain, and veins bring it back down to the heart (where it eventually is shunted over to the lungs and re-oxygenated). Wash, repeat, and rinse.

    Blood is not "loose" in the brain -- it is confined to the circulatory system. When
    1) the skull is fractured, the arterial vessels may be lacerated ("torn"), blood is no longer confined to the circulatory system. A hematoma (pool of blood) develops. This is known as a epidural hematoma.
    2) head trauma can cause a rupture of the bridging veins. The brain floats freely in cerebral spinal fluid, and when the veins are stretched out, they may tear, and again, a hemotoma develops. This is known as a subdural hematoma.

    See this excellent article: http://casemed.case.edu/clerkships/neurology/NeurLrngObjectives/Epidural and Subdural.htm
    subdural hematoma

    Mortality Rate
    1) epidural hematoma: 5-10% if treated w/in the few few hours.
    2) subdural hematoma: 50-90%.

    Remember Liam Neeson's beautiful and talented wife, Natasha Richardson? She fell and sustained a head injury while taking beginner ski lessons in Canada. She died of an epidural hematoma.

    Considering the remote locations where most accidents happen . . . serious brain trauma is a death sentence.

    Wear helmets whenever there is the slightest risk of possible head trauma (not just in the canyon).:moses:
  3. hank moon

    hank moon lovely ligatures

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    http://publications.americanalpineclub.org/articles/13201214389

    Amazing rescue story - which might have been very different w/o the hard hat.

    Leader Fall – Loose Rock, Chopped Rope
    Utah, Indian Creek Canyon, Bridger Jack, Hummingbird Spire

    On November 14, Kelsey Brasseur (29) and I (28) planned to climb all of Indian Creek’s Bridger Jack towers in a day. By 3 p.m. we had dispatched four of the towers and arrived at the base of Hummingbird Spire, where we ran into an acquaintance, Andrew, and his partner. After swapping pleasantries, Kelsey and I started up Hoop Dancer (5.11). Kelsey led the first pitch and I met her at the large belay ledge. Without glancing at the topo or even looking up, I grabbed the rack and took off toward the summit.

    I deemed the rock too loose for any useful protection, so I ran it out up moderate terrain for 15 to 20 feet above the belay. (I later found out I was off route.) Knocking on each loose block before I grabbed it—all of them rang with a hollow sound—I picked the best hold I could find and pulled down. A cooler-size rock dislodged and fell toward the ledge below, with me underneath. The block hit the ledge and exploded on top of me as I bounced off and continued downward, ripping out the anchor piece through which I’d been redirected.

    Twenty feet below the ledge, I jerked to a stop, hanging upside down by the rope around my ankle. I glanced down and saw a six-foot tail of rope coming from my harness. The rope had been cut in the fall. One of the smaller chunks of rock that had rained down with the block had fallen directly into a wide crack on the belay ledge and wedged itself in as a chockstone, somehow catching a section of rope. My foot was caught inside this 10-foot loop, holding me only around the top of my instep. My right arm was clearly broken, as my radius had come through my skin.

    Kelsey removed the Grigri from the lead side of the rope, unburied the rope from the debris on the ledge, and fixed the longest line of undamaged rope to the anchor. She then rappelled about 10 to 15 feet toward me. I asked her to secure the rope holding me, which was somewhat precariously seated around the chockstone and led to my ankle, and to throw down a line for me to secure myself.

    She wrapped the loose section of the snagged rope, above the chockstone, around her right hand, taking as much weight as possible in case the chockstone dislodged. She used her left hand to gather up another length of undamaged rope and lower it with a locking carabiner on a bight. I snatched the rope and pulled it down toward my harness, but it was slightly too short.

    I pulled myself up with my good arm, grabbed the carabiner with my broken arm, and flopped my lifeless arm toward my harness. After several unsuccessful attempts to land the carabiner on my belay loop, I landed it on my left leg loop. Worried I wouldn’t be able to get to my belay loop before my good arm completely gave out, I clipped the leg loop.

    Kelsey was still holding the rope around my ankle. In order for her toreach the anchor and fix the rope I wasnow clipped in to, I needed to get myweight off the rope. After talking with Kelsey, I reached over to the flared chimney on my right, rammed my broken pelvis in as far as I could, and chicken-winged my broken arm to establish myself. Kelsey released the rope around her hand and quickly fixed the rope that was attached to my leg loop. As soon as I weighted the leg loop and swung out, I enchained some cams from the bight in the fixed rope to my belay loop (although I was still hanging off my leg loop).

    Having heard the rockfall, Andrew ran around the corner to the base of Hummingbird. I told him our rope was too damaged to get us down on our own. He raced down the talus to his car and sped toward the Canyonlands National Park ranger station.

    As I hung by my leg loop, Kelsey gathered more rope to lower herself further down and pull me over to a small ledge on my right, where we rigged up a series of slings to stabilize my legs.

    An hour or two later, Andrew returned and let us know that rescue was on the way. It was now dark, but Andrew racked up, climbed the first pitch, and built an anchor above us, planning to lower me to the ground. We had a hard time getting me off the ledge, both because of pain and because we were trying to hold my body still, out of fear of spinal cord injury. After a discussion, I decided it was worth the risk to lower down without a backboard, reasoning that A) it could be a very long time before SAR would be able to rig up a safe lowering setup (if they were able to do this at all); B) further movement would pale in comparison to any movement/ trauma I’d already undergone; and C) although I was not bleeding too much, we were aware of the risk of hypovolemic shock.Andrew did a great job of lowering me slowly and communicating, allowing me

    time to stabilize as I descended. About three hours after the fall, I was back on the ground. Perhaps half an hour after that, a paramedic showed up, then two flight nurses in another half an hour. The flight nurses injected me with a steady dose of ketamine for the long carry down the talus.

    I sustained a broken pelvis (inferior ramus, superior ramus, and acetabulum), broken back (burst L1), a broken sacrum, broken arm (open radial fracture), dislocated wrist, and damage to my sacral nerves. (Source: Craig Gorder.)

    [​IMG]

    ANALYSIS

    Because the two climbers were moving fast to accomplish their linkup, Gorder neglected to check the route topo to see where the line went, and as a result he got off route on rotten rock, but he continued without protection because the terrain was easy for him.

    Gorder was wearing a helmet, which he credits with saving his life, as the helmet had a sizable depression in it and he came away with no head trauma. He had also just taken a wilderness first responder (WFR) course, which allowed him to assess his own injuries, remain calm, and take the lead in decision-making. (Since he was fully conscious and aware, he explained, he didn’t want his partner to be forced to make serious decisions affecting him.) Gorder also said that bringing a SPOT or similar communication device to this isolated cliff could have sped up the arrival of paramedics.

    All of these climbers can be commended for their handling of a shocking and extraordinary accident. (Source: The Editors.)
    Cameron, Rapterman and Kuenn like this.
  4. Cameron

    Cameron Long Tall Texan by birth

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    I was down a rappel when a friend looked over the edge to throw the rope bag. They aimed away from all of us but it randomly bounced and hit a wall then right on top of my head. Total fluke.

    It hurt, bad. I was stunned. It felt like the vertebrae in my neck had compressed. I turned to the corner to chock down tears because it hurt so bad. The rest of the day I was in pain and my neck muscles tightened. Took a few weeks to finally go away.

    If I wasn't wearing a helmet in that random bounce of rope luck......

    which is why I always wear a helmet.
    Tom Collins likes this.
  5. Canyonero

    Canyonero

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    When I was 18, broke, and getting into climbing, I asked my mother to buy me a helmet and promised I'd wear it if she bought it.

    I probably ought to replace it now even though I haven't really used it in the last 24 years despite wearing it every single time.

    She also bought me a rope, which has definitely been replaced many times over.
  6. Canyonero

    Canyonero

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    I've got a few nits to pick here and a small amount of expertise on this topic.

    First, your statement about falls is too broad. There are falls that are survivable with or without a helmet. There are also falls that are not survivable with or without a helmet. And then there is a certain percentage that are survivable with, but not without a helmet. Those are the ones you can make a difference with.

    Second, your subdural mortality rate is bizarre, as is your epidural hematoma data. Many epidurals and subdurals receive no treatment and are survived just fine. Big ones are bad, small ones are less bad. Associated injuries (spine fx, cerebral contusion, subarachnoid hemorrhage etc) are also bad.

    Here is what "UpToDate" (a common medical reference source) says about subdurals:

    Prognostic indicators — Age and neurologic status as assessed with the Glasgow coma scale (GCS) are important prognostic indicators in patients with SDH, as illustrated by the following reports.

    ●In a series of 60 patients treated for acute SDH, the rates of overall mortality and functional recovery were 55 and 30 percent, respectively [3]. An initial GCS score of 3 was associated with a mortality rate of 93 percent, while no patient with GCS score >7 expired [3]. In patients who presented with an initial GCS score of 4 to 6, mortality rates for patients >65 years old compared with patients 19 to 40 years old were 82 and 50 percent, respectively [3].

    ●In a series of 200 adult patients with acute SDH, mortality at three months was significantly higher in patients >50 years old than in patients 10 to 30 years old (25 and 75 percent, respectively) [8].

    The GCS grades coma severity according to three categories of responsiveness: best eye opening, best verbal, and best motor response (table 1). The GCS is scored between 3 and 15, with higher scores indicating better performance.

    The majority of SDH cases requiring surgery are complicated by associated intracranial and/or extracranial injuries [2]. Concurrent brain lesions such as contusions, subarachnoid hemorrhage, and epidural hematoma are likely to have a negative impact on prognosis in patients with SDH. In this regard, a study that prospectively collected data for 33 patients with acute SDH found that brain parenchymal injury underlying an evacuated SDH was associated with a mortality of 53 percent, as compared with a mortality of 9 percent in those without such injury [9].

    In addition, several studies have identified head CT findings that correlate with poor outcome after SDH, including the following:

    ●Hematoma thickness [4,10]

    ●Hematoma volume [11]

    ●Presence and/or degree of midline brain shift [8,10,11]

    ●Reduced patency of the basal cisterns [10]

    However, some studies have not confirmed these relationships [12].

    So, overall mortality may be 55%. But for the young, only 25% and for those over 50, 75%. But even for those with a subdural large enough to get surgery on, if the brain underlying the hematoma wasn't contused, the mortality was only 9%. It's the other injuries that are killing you.

    For the epidural, overall mortality is 10%. But that's a surgical series. So those who didn't live long enough to get to the hospital and get operated on weren't included. As a general rule, however, we worry a lot more about epidurals. Subdurals usually come from rupture of bridging veins but epidurals usually come from a bleeding artery, usually the middle meningeal. So there's potential for serious deterioration in these patients.

    While we're at it, I'll mention one of my medical pet peeves. There's this idea out there to check people's pupils as if that is supposed to somehow determine how bad their head injury is or how they're going to do. The issue is that the pupils tell you nothing about how bad their head injury is UNLESS THEY'RE UNCONSCIOUS, in which case you already know their head injury is bad. There is little reason to check them once, much less serially, in a conscious patient. Even if they're unconscious, there is little sense in checking repeatedly unless you're going to drill a hole in the side of their head right there in the canyon (and I don't recommend that.)

    Finally, the caution to "wear a helmet when there is the slightest risk of head trauma" seems a bit odd. Are you saying you should wear one when going up and down stairs and when riding in the car? Probably not, but that's what people are doing most of the time when they suffer an epidural or subdural.

    At any rate, I agree with your overall premise- a helmet should be worn when canyoneering and it should go on as soon as you leave level terrain or have rocks that could potentially fall on to you.
  7. 2065toyota

    2065toyota

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    There is really no reason to go overly technical about any of this. Why is there any reason to not wear a helmet. Yes, you have the right to not wear one, but that has nothing to do with whether you should or not. It's simple common sense and there is not really any good reasons to not wear one, other than you flat out forgot to bring it.
    Dave Melton and hank moon like this.
  8. moose droppings

    moose droppings

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    I would like to hear from you seasoned veterans, insights into your decision making heuristic methods in recognizing hazardous situations/environments that necessitate, among other things, head protection.

    head protection during ropework is quite obvious too many. However, most all other perceived hazardous situations/environments (including the approach, canyon, and exit) are quite subjective.

    I am conflicted by this and other similar comments posted on this forum when after I read random trip reports here and elsewhere.
    For example, it doesn't take long to see example of contradicction after reading through Ratagonia's "Latest Raves" blog postings.
    most noticeably are the reports of adventures into the inhospitable and unforgiving environment of the Grand Canyon where some, not all, seasoned veterans and ZAC employees(guides?) are pictured: off-trail descending down precarious slopes, climbing over large boulders, down-climbing ledge drops through "non/semi-tech" terrain, all on approach with helmet strap to their heavy packs... only to strap them on when descending the "technical" portion (i.e. ropes). After which, one or two helmets find their way back into the pack for the epic approach out.

    I am not judging.

    again, I would just like to gain insights into your decision making heuristic method(s) in recognizing hazardous situations/environments that necessitate, among other things, head protection, with respect to canyoneering, canyoning, canyon hiking, backpackeneering....

    thanks
  9. ratagonia

    ratagonia

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    I'll send you the AP we run every 5 minutes, to decide when to put the helmets on. iPhone or Android??? (/sarcasm)

    You seem to think this is a rational decision. Uh, no. This is a decision made by human beings.

    Tom
  10. 2065toyota

    2065toyota

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    In my rational, well maybe irrational mind who knows, I don't really understand why anyone would purposely choose to not wear a helmet. The number of rocks that fall during approaches, decents, rappelling, belaying, etc.

    But it is a choice as with a lot of other things in life, like kneeling and anthems, wearing seatbelts, protests. Yes, you have to right to do whatever you want, but if you choose that right, then you better be willing to deal with whatever consequences occur.
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  11. Rapterman

    Rapterman

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    :facepalm:
    From helmets, to seat belts to...
    the First Amendment?
  12. hank moon

    hank moon lovely ligatures

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    Hitler made his boys wear 'em!
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  13. 2065toyota

    2065toyota

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    We are talking about choices in life and the consequences of your choices. How is that a facepalm?
  14. Rapterman

    Rapterman

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    Toyota I completely agree with your position on helmets
    I just don't see how "protests" and "consequences" are related to the topic.
  15. 2065toyota

    2065toyota

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    Wasn't the discussion on why we wear helmets? I guess that doesn't involve the 'consequences' of not wearing one. And I was just trying to relate with other items that people do that don't believe there are or should be consequences. My bad, I won't post anything political on here again as to offend anyone's first ammendment except for mine ;)
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  16. Rapterman

    Rapterman

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    I will do my best to do the same.
    As we (especially in Las Vegas) try to recover from the worst mass shooting in modern US history
    (pretty much everyone knows someone who was affected)
    I am reminded how small our differences are and how many great things we all share.
    While I have very strong political differences with some of my family, friends, and neighbors, those differences
    do not change the fact that I love them.
    Kuenn and 2065toyota like this.
  17. 2065toyota

    2065toyota

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    I didn't know her because it happened right before I was born, but my mom's sister was killed while hiking when a girl hiking up a hill above her dislodged a small rock only about softball size and only about 20' above her and it hit her in the head.

    It doesn't take very much and it doesn't have to be in a canyon for helmets to be worn or be successful in preventing an injury
  18. rick

    rick

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  19. rick

    rick

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    I have had numerous long arguments/discussions about helmets over the past 20 or so years but almost entirely related to the debate in cycling. So I will add my 2 cents for what it is worth.

    " I don't really understand why anyone would purposely choose to not wear a helmet. The number of rocks that fall during approaches, descents, rappelling, belaying, etc. "

    Here is just one example of where there are extenuating circumstances that would justify (for me) not wearing a helmet.

    Just as in cycling, I have experienced numerous times where wearing a helmet added substantially to my body temperature. We all know how much heat can be lost in the winter when you are not wearing any head covering. ~25% of your heat loss can come from your head. When you are wearing a helmet in 80-90+ temps and concurrently involved in high-levels of physical exertion, overheating can be a serious concern. This can be a safety issue in itself and not just a one of comfort and enjoyment. The relatively small likelihood of experiencing a situation where a helmet protected a person from injury needs to be factored into the calculation of overall safety. Helmet use has a cost in my opinion and so it is not as clearcut a decision as some would suggest. Whether I am riding a bike or canyoneering, if I am really hot and sweating I am....1) not enjoying myself as much as If I was cooler 2)not as clearheaded 3) consuming a great deal more water 4) losing energy reserves disproportionately 5) losing mental/emotional reserves disproportionately 5) possibly becoming more impatient, irritable, etc. All this can adversely affect my safety. To ignore the above aspects of wearing a helmet and only site the positive protection it affords is really a disservice to the discussion/debate on helmet use.

    So to answer your question more directly. I factor in the increased safety that would come from wearing a helmet, into a calculation of my overall safety and to a lesser degree my enjoyment. I consider this to be a rational decision.
  20. Tom Collins

    Tom Collins

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    Some good points there about thinking things through and not simply adhering to a dogma, but if it’s that hot outside, maybe it’s too hot to go canyoneering at all that day. Or at least that particular canyon, maybe pick a different one that will have more shade/water and get an earlier start so you do the approach before the heat gets too bad. That way you can still wear the helmet.
    Kuenn likes this.
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