A low resource response to a mass casualty evacuation in the mountains

At 4270 m, the remote Himalayan village of Pheriche is located on the route up to Everest Base Camp and other popular treks in the region. The significant altitude places trekkers, guides and porters at risk of acute mountain sickness; particularly if safe ascent profiles are not observed. During a busy season volunteering at the remote Himalayan Rescue Association clinic, a small team of three doctors, one photographer and two HRA staff found themselves responding to a major incident in the mountains some eighteen hours after an earthquake had devastated the country of Nepal. Post-earthquake, radio contact was lost between Pheriche and the medical and climbing teams at EBC. The following morning, the first helicopter to reach EBC witnessed the destruction from the earthquake and the subsequent avalanche that was triggered. It landed in Pheriche with two critically injured climbers already triaged and treated at EBC. Without a major incident plan or high visibility equipment, the team were able to identify themselves and direct the large number of local and western volunteers to either record casualty details, provide first aid or assist in stretcher transfer to the helicopters as more casualties arrived. Using a simple triage tool, casualties were either stretchered or assisted onto waiting helicopters with priority given to injuries sustained. During a period of five hours, the team received, re-triaged, treated and safely re-evacuated over 70 injured climbers and porters by helicopter to lower altitude. It was an outstanding effort by all volunteers at a time of great tragedy.

This abstract was presented at the Innovative Solutions in Remote Healthcare - 'Rethinking Remote' conference, 23-24 May 2016, Inverness, Scotland.