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The Stuck Leader Scenario


rodw

30-Nov-2010
1:01:20 PM

On 30/11/2010 Li wrote:
>Interesting thread. I'm butting in to ask a probably silly question.
>Can someone explain to me the hanging syndrome? I understand it's because
>major arteries may be cut off? If someone became unconcious would they
>flip upside down or just slump? I'm trying to picture it here. What about
>hanging belays? Why doesn't that affect you if you're belaying the leader
>hanging under a roof (like I've seen at Ozy). I would imagine you could
>be there for 20 minutes or more.

The main issue is not moving, when belaying etc your movement of the body decreases the chance of hanging syndrome...once a body becomes inert though, through being knocked unconcious, hypothermia etc the risk increases. When concious, your body gives you pain signals to move....much like when you sleep and your arm goes numb, you roll over to adjust blood flow middle of the night without waking up etc....so even small movemnets while belaying is enough the eleviate the threat....but once the natural reflexes are removed, ie being unconcious through drugs, knocked out etc...this built in safety mechanism fails and it allows the toxics and to build up causing the syndrome.

There are even cases of people so drunk they fall asleep in positions that cause restrictions much like hanging syndrome and people can die from it.


evanbb

30-Nov-2010
1:07:33 PM

On 30/11/2010 One Day Hero wrote:
>Gawd, you see photo's like that and realize there's a group of people who
>think that is what Canberra climbing is about. How sad!

I had a bit of a chuckle at the comments - 'looks like a terrific line'.

Indeed. Bold and direct.

One Day Hero

30-Nov-2010
1:11:01 PM

On 30/11/2010 Li wrote:
>I'm butting in to ask a probably silly question.

There are no silly questions, only silly people :)

>Can someone explain to me the hanging syndrome?

Yeah, blood flow gets restricted, metabolic waste (potassium is one of the bad things) builds up in that bit of your body, restriction is removed, vital bits of the body (eg heart) are flushed with a higher concentration of bad stuff than they can handle.

If someone became unconcious would they
>flip upside down or just slump? I'm trying to picture it here.

Have done some unscientific testing with my rope access crew, falling unconscious in a swing seat without being tethered short results in hanging upside down with your feet stuck in the chair. In a climbing harness, its somewhere between upside down and sprawled backwards. (depending on your body shape)

What about
>hanging belays? Why doesn't that affect you if you're belaying the leader
>hanging under a roof (like I've seen at Ozy).

I've always found hanging belays extremely uncomfortable, and have to wriggle a lot to not lose feeling in my toes. Some of my friends can sit motionless in a harness for an hour without any discomfort, they think I'm soft.

I would imagine you could
>be there for 20 minutes or more.

Try 3 hours for people on their first trip up! Doing an aid route without a chair is loco!

Estey

30-Nov-2010
1:15:05 PM

On 30/11/2010 davidn wrote:
>
>Yes it's amazing how quickly toxins build in the body. Crush injuries
>can kill you when the crush is removed because of the flood of toxins and
>resulting renal failure (of all things). I guess a harness hang is a version
>of that... Hmm.
>
>Time to go bouldering.

I'm not medical but I think crush injuries and harness hang syndrome are different conditions. I remember googling this about 6 months back and there seemed to be a lot of inconsistency in the literature. Either that or I couldn't understand it.

From memory harness hang occurs when not enough oxygen reaches the brain as all the blood stays down in the legs. I'm guessing this would kill an unconscious climber relatively quickly (respiratory failure because the brain stops working?).

Crush injury involves involves impairment of circulation/lympahatic systems. When the load is released toxins flood the body. I'm guessing this does bad things to a number of the body's systems (cardiac, renal etc).

An immobile casualty hanging in a harness is at risk of both. In either case getting the weight of their harness would be the number 1 priority.

Could be totally wrong on all of the above. Any paramedics or emergency doctors out there want to set me straight?


Capt_mulch

30-Nov-2010
1:21:36 PM

>cases of people so drunk they fall asleep in positions
>that cause restrictions much like hanging syndrome and people can die from
>it.

How come Widewetandslippery is still alive then?

One Day Hero

30-Nov-2010
1:23:52 PM

On 30/11/2010 Estey wrote:
>
>I'm not medical but I think crush injuries and harness hang syndrome are
>different conditions. I remember googling this about 6 months back and
>there seemed to be a lot of inconsistency in the literature. Either that
>or I couldn't understand it.
>
>From memory harness hang occurs when not enough oxygen reaches the brain
>as all the blood stays down in the legs.

If this went on for long enough, wouldn't the patient die from exploding legs?

Estey

30-Nov-2010
2:43:10 PM

On 30/11/2010 davidn wrote:
>Estey: that rings a bell. The blood pooling in the legs bit; the other
>words you used were too big for me to follow.
>
>Though presumably if it were the case you'd then have two different effects
>from being hung upside-down and being right-side-up. Cmon you medicos,
>chime in.

I think its pretty hard to breathe if your hanging upside down anyway. A bit like crucifiction? Now I'm really guessing.

widewetandslippery

30-Nov-2010
3:00:18 PM

My bad interpretation is that point pressure from a harness can impead arterial and venal flow. The body uses the oxygen in the blood and saturates it with CO2 due to slower exchange rates. Hence blood becomes toxic. The pressure bit is a large part of the problem. If you're pancaked on the ground you don't suffer such problems if you did we would all die in our sleep. We also wriggle in our sleep. I think the incidents alluded to by rodw are incidents such as falling asleep and being left in a car boot.


rodw

30-Nov-2010
3:14:39 PM

On 30/11/2010 Capt_mulch wrote:
>How come Widewetandslippery is still alive then?

He dosnt sleep long enough due to the need for another beer....that addiction saves him.


ambyeok

30-Nov-2010
4:28:38 PM

On 30/11/2010 widewetandslippery wrote:
>If you're pancaked on the ground you don't suffer such problems if you did we would all die in our sleep.

If your unconcious and pancaked on the ground (on your back) you have a high chance of drowning from your own saliva, stomach contents, or in WWS case, vommit. Thats what they told us on the CPR course.

davepalethorpe

30-Nov-2010
4:30:31 PM

I believe that the cause is as Estey said, blood pooling in the legs. I am assuming this is due to restricted venous return (doesn't take as much pressure to block veins versus arteries). This reduces the available blood volume that circulates around the body resulting essentially in a type of hypovolemic shock (not enough circulating blood to keep the brain and vital organs happy).

hargs

30-Nov-2010
5:21:18 PM

>I believe that the cause is as Estey said, blood pooling in the legs.

Makes sense: recommended treatment if you're first on the scene -- apart from the usual first-aid assessment -- is to get their legs into sitting position using, for example, a sling under the knees.


Macciza

30-Nov-2010
8:42:52 PM

And back to the original question,
First , check you've still got your helmet on? Yep, Good it's probably not your fault then . . So, what could have happened? Given that you are wearing your helmet. . .
Ahh, your spurt climbing 'buddy' has probably climbed out of sight and the first thing he's done is taken his helmet off and had a bloody accident . . .
You call to him, no response; but you've got good reception, maybe he's with another provider, You wonder if a text will be any better?
Ok , don't panic and cut the rope with your knife, they can tell, you'll need a sharp rock and use your squiddy (multipitch stickclip) to pry some off from offline, ok, done , , ,
Thrusting your clenched fist into your groin you smile in the secure knowledge that you can squirm out of your harness then pull your pants back up, thanks fashion you're a lifesaver . . .
Having escaped the belay,you can then head off on the faint path along the ledge, it probably leads to some stairs or something, TrackCare really should do something about this . . .

One Day Hero

2-Dec-2010
1:07:46 AM

Nice one Macca, thats going straight to the pool room :D

dmnz

2-Dec-2010
6:44:28 PM

why would you have double 9mms in the first place? surely you'd go 8mm...
And twin's sub 8mm

And for me I like the Mountaineers publications more (cept FOTH which is not very good) than the Falcons so check this out Ev
http://www.bookdepository.co.uk/book/9780898867725/Climbing-Self-Rescue

Estey

2-Dec-2010
7:40:12 PM

On 2/12/2010 dmnz wrote:
>why would you have double 9mms in the first place? surely you'd go 8mm...
>And twin's sub 8mm
>

Not everyone likes climbing on dental floss.


ajfclark

2-Dec-2010
8:06:12 PM

On 2/12/2010 dmnz wrote:
>And for me I like the Mountaineers publications more (cept FOTH which
>is not very good) than the Falcons so check this out Ev
>http://www.bookdepository.co.uk/book/9780898867725/Climbing-Self-Rescue

Some of this book is on google books. Haven't clicked through the whole thing.

There are 37 messages in this topic.