Complex alpine extrication: case report of mountain and speleological rescue cooperation.
Mountain sporting activities are an increasingly popular practice that exposes mountaineers to a high risk of adverse events. This report describes a unique case of recovery in an austere environment that involved explosives. In June 2012, a 52-year-old man ascended a cliff tower in the Eastern Alps, Italy. A landslide occurred, and a boulder crushed the climber against a large stone located farther down the cliff, causing compression of the lower limbs and the pelvis with consequent severe musculoskeletal trauma. The National Alpine and Cave Rescue Unit (NACRU) arrived and proceeded with stabilization of the injured climber, which took 6 hours and involved a difficult extrication supported by the Cave Rescue division of NACRU. Unfortunately, during transport to the trauma center of Borgo Trento, Verona, the patient exhibited signs of progressive traumatic shock because of crush syndrome, hypovolemia, and acidosis, which led to cardiac arrest and death. Based on an extensive literature review, this report was determined to be the only one of a mountain rescue using explosives for the extrication of a victim in the Northeast Italian Alps. This case describes how a rescue in austere environments can represent a high-risk situation, and it shows how improvisation and cooperation between rescue teams are crucial for a successful recovery.
Intensive Care Unit (Dr Sette).
Piersandro
P
Sette
Department of Emergency and Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata (Dr Carlini).
Mauro
M
Carlini
Department of Public Health and Community Medicine, Hygiene and Environmental Occupational Preventive Medicine Division (Drs Berti, Rucci, Marchiori, Tardivo).
Damiano
D
Berti
Department of Public Health and Community Medicine, Hygiene and Environmental Occupational Preventive Medicine Division (Drs Berti, Rucci, Marchiori, Tardivo).
Igor
I
Rucci
Department of Public Health and Community Medicine, Hygiene and Environmental Occupational Preventive Medicine Division (Drs Berti, Rucci, Marchiori, Tardivo). Electronic address: framarchiori@gmail.com.
Francesco
F
Marchiori
Helicopter Emergency Service (Dr Toffali), Department of Emergency, G. Fracastoro Hospital, San Bonifacio, Italy.
Fausto
F
Toffali
Emergency Medical Service of Verona (Dr Schonsberg), Verona, Italy.
Alberto
A
Schonsberg
Toxicology Unit, Emergency Department, University of Verona (Dr Ricci).
Giorgio
G
Ricci
Department of Public Health and Community Medicine, Hygiene and Environmental Occupational Preventive Medicine Division (Drs Berti, Rucci, Marchiori, Tardivo).
Stefano
S
Tardivo
D000059:Accidents; D003444:Crush Syndrome; D017809:Fatal Outcome; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009051:Mountaineering; D018635:Rescue Work
explosive; landslide; mountain; rescue; shock; trauma