Each year since 1941 the National Speleological Society has held an annual conference to bring members together to discuss cave science, exploration, conservation, rescue, art and many other related topics. The 2011 convention was held in Glenwood Springs, Colorado and seven of our members were present to support this week-long event. The conference features lectures, seminars, workshops, exhibits, contests and field trips and is rounded out by parties, banquets, awards presentations and concerts, which featured the Chris Daniels and Kings band and the Terminal Syphons.
Almost 1300 cavers from across the United States and beyond attended the conference, raising the population of Glenwood Springs by 15% with most of these people spending the week in an area not more than 0.1 square mile in size. This influx, in addition to the regular summer tourists visiting this resort community, visibly strained the local resources and the convention organizers needed to workout the logistics of the conference to make the event flow smoothly. It should be pointed out that the local merchants were thrilled to have the NSS 2011 convention in town.
O.M.E.G.A. provided a number of logistical support functions, ranging from communications support to credentialing to organizing and managing a number of events throughout the week. Communications was perhaps our greatest challenge. We needed to connect staff and attendees across the Roaring Fork Valley, the three canyons accessing it and the surrounding areas of the Rocky Mountains where many of the attendees ventured to explore local caves. To accomplish this we brought in three repeaters for the week and set them up on Iron Mountain, 1400 feet above the Colorado and Roaring Fork Rivers. A VHF repeater was used as a talk-in and informational frequency for the attendees, many of whom were licensed amateur radio operators. A UHF repeater was set up for staff communications. Many of the staff members were already amateur license holders or obtained their license in the months leading up to the conference. The repeaters easily covered the Roaring Fork Valley and reached deep into the surrounding canyons, as well as to the top of the White River National Forest Plateau. The supplemental communications for the field trips was managed over the established Colorado Connection, Roaring Fork Amateur Repeater Cooperative and Grand Mesa Repeater Association networks. With a lot of early planning and preparation communications came off as a great success and, for the most part, the NSS 2-meter business band radio cache was left unused.
On Monday night we were presented with an unexpected challenge of needing to support the transportation of the convention attendees from the base camp at Glenwood Springs High School to the Iron Mountain tram base and then up to the Glenwood Caverns Adventure Park at the top of Iron Mountain. Steve and Jeanne Beckley, owners of Glenwood Caverns, closed the cave and surrounding recreational attractions to the public early in favor of hosting the convention attendees. The transportation involved the convention attendees riding school buses from the Glenwood Springs High School to the tram base and then taking either the aerial tram or different buses from tram base to the top of the mountain. The school buses could not be used to take the cavers up to the cave because they were too large to comfortably fit on the winding Transfer Trail Road leading up to the cave. The transportation managers wanted to efficiently load the buses at the high school and rapidly move people to the tram base where they would be transferred for the second leg of their trip, rather than using cell phones. We organized eight communications staff to perform the task and deployed them accordingly to support the transportation function. Our goal was to move about 1300 people a distance of about four and a half miles with an elevation gain of some 1400 feet. And it needed to be done in about two hours. Piece of cake. We even maintained full confidence in our ability to do this when gusty winds forced Glenwood Caverns Adventure Park to shut down the aerial tram, cutting our capacity by about 300 people per hour. Everyone needed to get up the mountain in time to get dinner and see Chris Daniels and the Kings begin to play.
Then a second incident reared its head.
It was about half way through the transport process and I was one of two communicators left behind at the high school with much of the convention staff already either at tram base or up at Glenwood Caverns Adventure Park when one of the cavers ran into the building yelling for a medic. There was an ironic dilemma here. The convention did have its own volunteer medical crew of fourteen individuals, most EMTs and paramedics, led by an emergency room doctor. We could handle a lot of problems. Except the medics had already leaned forward and the vast majority were either up on Iron Mountain or still straggling behind at the tram base. The school was beginning to look deserted.
“What happened?” I asked.
Needless to say, with no medics around, this turned out to be our biggest medical emergency since convention attendees started arriving on Friday. Because bats east of the Mississippi are going through an epidemic known as White Nose Syndrome, the U.S. Forest Service had asked us to provide a decontamination station to restrict cross contamination between caves that conference visitors attended. Cavers were required to decontaminate their gear after each cave trip and the process included bleaching chemicals and high pressure washers. One of the decontamination crew volunteers was the victim. She had lost her balance and grabbed the first thing she could to maintain it and that item just happened to be the heated exhaust manifold of one of the pressure washers. She had a burn on the palm of her hand.
Burns are a scary thing. Mild burns hurt, but do little more then serve as a reminder not to touch hot items. Moderate burns will affect the dermal layer and leave behind blisters that can lead to scaring and significant infection. Severe burns destroy skin, going all the way down to the subcutaneous layer. These often require skin grafts. When distant extremities such as the hand or the foot are affected, the loss of circulation can lead to the loss of the limb. Rapid treatment is critical and I already knew that I was not the medic for this sort of thing. I hit the microphone on my radio, accessing the staff UHF frequency.
“I have a medical emergency at the decontamination area,” I reported. “I need a medic now!”
I wasn’t sure what I was going to do, but my feet were already moving towards the building’s front door. As I exited the building, I came across a school employee who was working the concession area for the conference. I grabbed hold of her.
“I have a person with a severe burn. I need you to bring me ice to the decontamination area.” In retrospect, she probably had no idea that we had a decontamination area or what we were decontaminating, but I was pointing to the grassy field at the front of the school and having received a bewildered nod, I was off.
Someone on the radio was responding that the medics were already up at the top of the mountain. Getting one down would be a good half hour. I repeated my demand for a medic, then, for good measure, restated it into the NSS business band radio. Someone else would have to figure out how to find a medic. I had an emergency to handle and I had no idea how I would go about it.
Finding the patient at the decontamination area was not hard. She was sitting in the grass, holding down the pressure washer, dousing her arm and hand with a pressurized stream of water. Cold water is good. It takes the heat out. The pressurized stream was bad, especially if skin was burned off. The fact that she was in pain gave me a little hope. Burns reaching the subcutaneous layer destroy nerves, leaving a numb sensation. The fact that she felt pain meant that not all of the tissue was destroyed. The one thing that made me hesitate was that this was not some anonymous conference attendee. It was a caver who I knew personally and treating severe injuries on people you know personally is always a bad idea. You’re automatically emotionally involved.
I grabbed a bucket of water, intending that my patient use it to cool the burn, but one of the decontamination volunteers pulled it back from me. “This has bleach in it.”
“I need a clean bucket with clean water!” I said. This was a pretty complicated demand. While they were scrambling to find me a clean bucket, I took the pressure washer away. “I don’t want you tearing your skin with a pressurized spray,” I said. “Show me your hand.”
The heel of the palm was red and puffy, but I did not see destroyed skin. My initial thought was that the burn was not severe. I was thinking that I saw the initial signs of blistering. I needed to cool it fast. A bucket was slid in front of me. I filled it with water from the pressure washer. “Hold your hand in this.” I stood up to scan the area for a coming medic. Instead I saw the concession worker with a bag of ice. I dumped the ice in the bucket. It was not a lot and it would melt fairly quickly, but it was ice and it would make the water cooler.
I keyed the microphone again. “Where is that medic? I have a second degree burn at decon. I need a medic now!” Somebody was answering me, but I spotted the convention’s chief of security headed for me and for a moment salvation was at hand.
Mike is a pretty experienced caver. There have been legends about his exploits drifting around for years. He’s a veteran of many conventions and has worked a number of them in security. No medical skills, but invaluable operational experience.
“I was heading up to tram base when I heard the call,” he told me. “I’ve got people at the campsite looking if any of the medics are still there and if not, one is taking my truck up to tram base to pick up a medic. What do you need?”
What did I need? “A medic.”
Mike’s calmness and confidence did not falter. “I’ll get you one.” I wanted him to be wired up and energized like I was, but all I got back was calmness. “Stay here. Stay on the radio,” he told me. How could he be so calm? He knew her, like I did. We were all Colorado cavers.
Mike left to find help. I was left behind with my patient and a crowd of spectators, none of who could do anything to help. How ironic is it that as a first aid instructor I was the senior medical person present? I did not feel qualified.
On a second scan of the grounds I spotted Don and his wife Theresa walking towards the bus loading area, no doubt heading for the evening festivities. I met Don over the weekend. He was a firefighter and an EMT from Missouri and his wife was a nurse. Don was one of the medical crew volunteers and for some reason he was still at the high school. I really did not care what that reason was.
“DON!” I yelled loudly enough that the circle of people around me parted, leaving a path open for Don to come in.
“What happened?” he asked.
“She grabbed the exhaust manifold,” I said. “She burned her hand.”
“Do you know where the school’s first aid kit is?” he asked me.
I did, but it was in the athletic office, clear on the other side of the building. I didn’t even know if the office was open. Then a moment of clarity struck me. One of the medics left his pack at registration because he did not want to lug the heavy bag with him. I had no idea what it would have for burns, but it was a medical kit and probably a better one than what the school had.
I ran back to the building, into the registration office, leaping over people and furniture. The large faded orange bag sat in the back room against the desk. I grabbed it and dashed back to the decontamination area, unzipping it as I ran.
Taking the bag from me, Don unceremoniously dumped its contents on the grass, then dug through the gauze pads and bandage rolls until he found a square plastic packet about four inches on the side. “Water gel,” he said. “This will work. Get me a dressing.”
While I looked for the puffy sterile packet, he shook the water gel and tore the envelope open. He pulled our patient’s hand out of the water as I handed the dressing to him and he used it to dry the skin. The pain was obvious on the young woman’s face.
“I promise, this will make it better,” he said. I think everyone assumed he meant the pain, but in retrospect that was not the case. He put the gauze pad from the water gel envelope across the burn, then poured out the remaining liquid in the envelope across the gauze pad.
While Don was securing the gauze pad with a bandage, I keyed the microphone on my radio. “I have a medic,” I said. “Don is here. We’re working with the patient. We do not need another medic.” That was good timing. They had tracked down a medic at the tram base and were waiting to put him on the first available vehicle to go back to the high school. This was a case where two medics probably would not be better than one.
Other convention staff had arrived at the decontamination field by now, including Dave, who was the convention chair. I took the time to brief him about what happened and what we were doing. Don declared the first aid to be completed, but stated that the next step was a visit to the emergency room. The wound still needed to be examined and treated. We arranged for transportation to the hospital and things were slowly getting back to normal. The decontamination area was being shut down. The last of the attendees were being loaded on the buses. I helped Don clean up the mess we made in the grass. We replaced all of the medical supplies in the bag.
“How bad is that burn?” I asked him as we worked.
“That ice water probably took it from third degree to second degree,” he said. “ER will need to deal with the blisters, but you did the right thing fast. Water gel is better and we got lucky it was in the pack. Not everyone has it. Good job.”
That made me feel better. The adrenaline was burning off and I felt the energy crashing coming on. No matter. We got the job done. Don and Theresa boarded the next bus. I stayed behind until the last bus of the day was heading up to tram base. It was full of convention staff and a handful of attendees who were running late. For the rest of the night staff who overheard the radio traffic were asking me the details as to what had happened.
The good news was that we responded quickly and our patient arrived at the hospital less than an hour after her accident, having already been treated. The doctors did not hold on to her for long, although they rewrapped her hand and gave her medication. I again saw Don and Theresa the following day and received an update. Don had followed up on the injury and said that the hospital doctor was happy with our rapid response. Between the ice water and the water gel, the heat was removed from the burn long before the emergency room doctors looked at the injury. The burn was considered minor. It would blister and peel, but it was not as bad as it could have been if left untreated. Don told me I did good. From listening to him, I got the impression that I was the calm methodical professional. I certainly did not feel that way when I was responding to the call for help, but I guess that the bystanders saw something different.
Compared to Monday night, the rest of the conference was quiet and calm. We had other medical issues, all of which were relatively minor, and a handful of security related events. At the Friday night banquet the NSS officials were saying that 2011 was one of the best conventions in their collective memory positive reviews and letters continued coming in for several weeks after the conference. Our burn victim was able to go back to caving much sooner than anyone had anticipated and for me personally, there was a change to my medical kit. Now I have a container of water gel included among the other supplies that I regularly carry.