First Aid for Mountaineers

Experienced climbers strive hard to know their own limitations and because of this the sport enjoys remarkably low accident rates.  Incidents that make news headlines often involve individuals operating in environments for which they were ill-prepared, and this can give a somewhat skewed impression of the dangers involved in the sport.  Many of the ‘climbers’ reported in the media as having been involved in accidents, died or got lost in mountainous areas are not dedicated climbers.  Often they are tourists who have gone out walking or people who don’t have much experience in the mountains.  Therefore some of the tragedies that hit the headlines may reflect poorly on dedicated mountaineers who are more likely to be better prepared and not as likely to require mountain rescue.

While mountain climbing can be one of the most exciting and challenging sports,  there are also many dangers involved in mountain climbing which one should  consider. To decrease the odds of falling victim to a damaging or fatal injury  on the mountain, make sure that you are aware of all of the hazards and take  appropriate safety precautions.

The Risks facing a mountain climber

First Aid for Mountain ClimbersThere are many risks associated with Mountain climbing and any of the risks could increase exponentially with increased elevation of the mountain. First Aid is to be taken very seriously and help is not always at hand to treat the injured casualty straight away. A lot of mountain climbing is about your mental attitude because you will need to make sound, fast judgments about conditions, directions, and safety.

For many mountaineers, the mental challenge is a large part of the allure because you are taken completely out of your usual routine of air-conditioned offices and easy lifestyles into a world where decision-making has major consequences and you’re thoroughly tested.

Some of the common injuries faced by a mountain climber include:

  • Injury (or death) from a fall, including those caused by slips or by wind
  • Injury or suffocation from rocks, ice, or snow falling on you
  • Injury from exertion (heart, muscles)
  • Injuries from temperature extremes (mainly hypothermia and frostbite)
  • Injuries related to breathing thinner air (heart, lungs, muscles, brain)
  • Effects of untreated illnesses, or lack of medical care
  • Vision loss from glare (snow blindness)
  • Lack of food (and on some mountains, water)
  • Equipment-related injuries
  • Drowning
  • Accidental, negligent, or intentional injury by other climbers

Many people have done a first aid course in the past. But afterwards it’s easy to let the knowledge slip. But just what are the basics of first aid that every climber should know?

First Aid for Mountaineers Simple as ‘ABC’

First Aid for Mountaineers – Most first aid courses follow this mnemonic so you can remember what to do under stress – like when you’ve watched your partner crater. ‘A’ stands for Airway, but it can also stand for Assess. Assessing the situation for danger is your first priority – there’s no point in getting killed before you can offer help. Then turn to the casualty. If they’re screaming their head off you can breathe a sigh of relief, they’re conscious and breathing – all you need to worry about is them bleeding to death.

Coming up for air

The silent casualty is a situation to dread, as you need to start diagnosing some pretty vital stuff without any help. First open their airway. This is really easy and involves carefully tilting the head back, opening the mouth and pulling the chin forward. Look inside the mouth to make sure there are no broken bits in the way and then listen for breathing. An unconscious casualty may not have the muscle tone to keep their tongue from blocking their airway and this simple manoeuvre has saved lives countless times. If you can’t detect any breathing then it’s possible that either you’ve missed it or they’ve had a heart attack. The only thing that can revive a heart attack victim is a defibrillator and some pretty advanced drugs. CPR may help keep the person alive for a limited amount of time but must be started as soon as possible.

Stopping the flow

Conscious or not, the next priority is bleeding. Massive external bleeding is not only easy to see but can be relatively easy to stop. Apply direct pressure with a pad (a NATO First Field Dressing is the best thing) but check the wound first to make sure you don’t drive anything deeper into the wound. Arterial bleeding is difficult to stop – you have to press really hard in exactly the right spot. Internal bleeding from the chest, belly, pelvis or thigh is just as serious but more difficult to diagnose and impossible to stop without surgery. If the casualty is going into shock (rapid weak pulse, rapid breathing, cold and clammy) then suspect internal bleeding. Treat for shock (raise the legs and keep warm) and seek evacuation as soon as possible.

Head injuries

A common climbing injury that often looks worse than it is. A wound to the scalp bleeds profusely but may not be too serious. As with other bleeding, check the wound site and apply direct pressure. A fractured skull is far more serious and may also involve a compression injury to the brain, any head injury must be treated with as a priority. Either way there’s not much you can do apart from to monitor their vital signs (pulse rate, breathing rate and size of pupils) as a record of this will really help when they get to hospital. Protect the casualty from the environment and get a rescue team in as soon as possible.

Leaving the casualty

With the possibility of fractures to the spine and pelvis in any climbing fall, the casualty should only be moved if absolutely necessary. But if you’re leaving an unconscious casualty to fetch help you must leave them in a safe airway position. Some call this the recovery position but it doesn’t really matter what the position is, so long as any vomit or mucus produced by the casualty drains out of their mouth rather than going back down their throat. Get them in this position as carefully as you can without twisting or bending their spine (a cushion or rolled up fleece under the head helps) and make sure they won’t roll when you leave them.


Do a first aid course if you’ve not done one in the past, they can even be quite fun! And if it happens for real, remember that you can only do your best. And the best thing you may be able to do is to keep that airway open.

Why do people do it?

Why do they scale the highest peaks with so many threats always trying to get the better of them? It seems that nothing can compare to the view that a person can get once they climb to the highest point that they are able to. The feeling of being on top of the world and conquering something that seemed impossible to do are huge motivating factors and cannot be compared to anything in the world. People will continue to climb mountains despite the challenges and dangers that might affect them. The sport of mountain climbing looks all set to become even more popular than it is today and new and exciting climbing destinations will continue to be unearthed all over the world.

It seems very much a case of attitude over altitude

Useful links for First Aid for Mountaineers:

BMC – An introduction to risk in climbing and mountaineering.  Plus how the BMC is involved in improving safety and promoting best practice.

How to make A Mountain First Aid Kit – Kath Wills is a member of the Llanberis Mountain Rescue Team and a Recue Emergency Care (REC) first aid instructor. She runs Active First Aid in Snowdonia. Here, she advises what to put in a comprehensive general mountain first aid kit for a group of people.

First Aid Courses at GK First Aid Training in London and the UK

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