By Tom Vines
Photos Courtesy Grand Teton National Park

On July 21, Grand Teton National Park rangers completed an extraordinary, complex and challenging rescue for numerous climbers hit by lightning strikes on the 13,773' Grand Teton Mountain. The operation was breathtaking in scope—a mass-casualty incident response in one of the lower 48’s most rugged areas. Even for the Teton rangers, who have a history of pulling off complex and daunting rescues, this was a daunting operation under some of the most dangerous and difficult conditions imaginable.

The marathon response lasted 9 hours and involved two high-altitude helicopters, a dozen climbing rangers, two mountaineering physicians and numerous other responders. It was a monumental test of rescuer skills and stamina, combined with incident command management ability. Note: Check out the detailed illustration of the climbers' locations at the bottom of this post.

The Trouble Begins
The Grand Teton in western Wyoming is a classic alpine peak for which an entire national park was named. Climbers from all over the world are drawn to it. But it can be a treacherous mountain that undergoes sudden changes in weather.

The first notice of trouble came in the form of a cell-phone call at 1224 HRS to the Teton Interagency Dispatch Center, the joint dispatch center for the Teton National Park and the Bridger Teton National Forest. The caller, from the Tyler climbing party high on the mountain, was requesting help for five people who became injured after a lightning strike; two of them were unconscious.

Soon after the 911 call, personnel were paged to report to the Lupine Meadows Rescue Cache. Rescuers also needed to recall the park’s contract helicopter, a Eurocopter B-3, which was at that time providing support on a wildland fire near Pinedale, Wyo., approximately 45 minutes away. While waiting, incident commanders (ICs) started the process by briefing responders on the known situation and developing initial plans.

The short-term plan: Get eyes on scene to better understand the situation. The problem at this initial stage was that the responders did not know for sure how many people were involved. They knew that there were other climbing parties on the mountain. Were they unscathed or too disabled to call for help? How many people in total would they need to rescue and where on the expanse of the mountain?

At 1330 HRS, as the IC began to assign duties, the center received a cell-phone call from a second climbing party, the Kline group. They reported a party of four injured by a lightning strike on the Exum Ridge, one of the highest points on the mountain.

Then, as the rescuers were trying to absorb this information and provide for an expanded response, there came a third cell-phone call from a climbing party of seven. The Sparks party reported persons injured by lightning, along with a mystery: One person had disappeared during the lightning strike and was nowhere to be found.

With each call, the rescue mission increased in size and complexity. Now there was a total of 17 climbers from three parties in trouble—13 in two parties on the Owen-Spalding Route and four on the Exum Ridge.

Getting Started
The Lower Saddle, a comparatively level area at 11,600 feet, was the staging area for the operation. At that location, rangers maintain a hut complete with ropes, climbing gear and some EMS gear. In addition, the helicopter could fly in sling-loads of equipment, including rescue gear, sleeping bags and “screamer suits,” large bag-shaped harnesses constructed of load-supporting webbing and nylon fabric to contain a person flown below a helicopter in a short-haul. The helo could also fly in groups of rescuers from the valley.

The plan: Small groups of rescuers would move along climbing routes to the upper mountain to find and assess the injured people. The rescuers would use ropes and specialized gear to ascend exposed vertical faces. With rescue equipment, medical gear and their own personal gear, they would be climbing at high altitudes carrying packs weighing some 45 lbs.

Rescuers created a triage center on the Lower Saddle using the Exum Mountain Guide’s weather hut, a structure with a wood-frame deck and canvas cover. There, one physician would evaluate each patient, attach a triage tag and prepare them for transport off the mountain.

Patient Transport & Care
Planning ahead, the IC was aware of one additional logistical challenge: getting rescuers to the site of the injured climbers and evacuating them. The Eurocopter has high-altitude capabilities (one version of the ship has landed on the summit of Mount Everest), but has limited capacity for rescuers and patients.

The Eurocopter could be used for patient transport to the Lower Saddle by short-haul, hanging them below the helo on a rope in the screamer suits. But additional transport would be needed to shuttle patients from the Lower Saddle to the Valley Rescue Cache to be checked by the second physician and then ground-transported to the hospital.

The Teton IC thus requested the Lama helicopter from Yellowstone National Park, just to the north of Teton. The Lama also has high-altitude capabilities, but its use would be limited, since its pilot wasn’t familiar with the Teton terrain and hadn’t been certified for short-haul operations with the Teton crew.

Handling patient care at high altitudes also requires tactical precision. There were a limited number of rescuers to cover a wide area with a large number of patients. The solution: a “moving triage.” As park medics made their assessments at higher altitudes, they would classify the patients as either “walking wounded” who could descend on their own to the Lower Saddle, or those who had to remain in their position to be short-hauled. The first wave of medics then would move on up to additional patients. A next group of rangers would follow to either help guide the people down or assist them with donning the screamer suits for short-hauling.

One critical question: Would the patients be able to tolerate being short-hauled in a screamer suit? All the injured climbers were mountaineers, so they could deal with the heights encountered in the short-haul. But they might react negatively and would need to first be cleared of possible spine injury if they were to be short-hauled using screamer suits.

Therefore, the IC decided the patients would need a thorough examination on the Lower Saddle. Lightning injuries are difficult to analyze. An obvious injury—such as a painful burn to an extremity—may mask more serious and potentially life-threatening damage to body parts, including muscles and the brain, or long-term neurological damage. So a physician was helicoptered to the Lower Saddle where he could do a more thorough exam, attach a triage tag and alert a second physician at the rescue cache landing zone as to what was headed his way. The doctors were also mountaineers with the knowledge and gear to operate comfortably in the environment.

Reaching the Victims
It took rangers 2 hours to reach the first patients. All 17 climbers sustained some type of lightning-related injury, ranging from burns to varying levels of neurological injury. However, as is common with lightning injuries, some patients improved before EMS personnel reached them. A patient who had been reported not breathing had been given rescue breathing by other members of the party and began breathing on his own after six rescue breaths. Another patient who had been reported paralyzed now was improving. He could not walk but could stand when supported by other people.

As a rescue crew of three climbed from the Lower Saddle to the Upper Saddle, they encountered seven members of the Sparks party, the group in which one member had disappeared. They were retreating on their own from the mountain, but two climbers from the group were going the wrong way, rappelling down a gulley known as the Idaho Express, which would have led them into an even more dangerous and potentially deadly situation. The combination of the lightning strikes and the loss of one of their group most likely contributed to their confusion.

The rangers steered the group in the right directions, but two of the group had already moved into the Idaho Express and had to climb back up to take the correct route.

To help get patients down, the rangers called on the Exum Mountain Guides, who were all intimately familiar with the mountain.

Air Crews Move In
When the Yellowstone Lama arrived in the Tetons area, the pilot of the Eurocopter led the Lama into the Lower Saddle. The Lama pilot initially experienced some problems with setting down because of ground resonance, an extremely dangerous condition that can occur in fully articulated multi-bladed helicopters during touchdown. See the sidebar "What Is Ground Resonance?" below the photos at left.

Eventually, the pilot was able to set the Lama down safely and took aboard four patients triaged by the doctor; he then took off for the valley.

Soon thereafter, weather closed in, so the helicopters had to leave the area and rescuers had to shut down operations for just over an hour. Finally, the weather cleared and operations resumed, with the first helo resuming short-haul operations on the mountain. For the next several hours, rescue teams climbed from one group of injured and traumatized climbers to others, assessing patients and providing initial medical care.

At 1956 HRS, the Eurocopter arrived at the Lupine Meadows cache with the last climber. All the patients had been triaged either “yellow” or “green.” Yellow was for those patients who require observation. Their condition was stable; they weren’t in immediate danger of death, but they needed hospital care. Green was for the “walking wounded” who had minor injuries but still required evaluation in a hospital. Ambulances from Jackson and Teton counties transported the more serious patients, while the walking wounded were transported by van with a medical provider aboard to monitor patient conditions. One helicopter searched the bottom of the West Face but could find no sign of the missing 21-year-old climber.

Three rangers remained overnight at the Lower Saddle rescue hut to help wind up operations and make certain no one else was on the mountain.

At about 1000 HRS the next day, a helicopter crew searching the area found the missing climber’s body at the bottom of a feature known as the Black Ice Couloir. The 21-year-old had apparently fallen approximately 3,000 feet when hit by the lightning strike. After their investigation, rangers found that although it is difficult to determine exactly what happened, it appears that the deceased climber had not securely attached his seat harness to the rope.

After all the climbers had been examined at St. John’s Medical Center, five were admitted for treatment. All five were discharged over the next couple days. One patient had been taken via helicopter to the Eastern Idaho Regional Medical Center in Idaho Falls for further treatment, but was subsequently discharged.

For 2 days after the rescue, high winds prevented helo flights from retrieving the rescue gear. Finally, on July 24, winds let up and rangers were able to gather up all their equipment.

Sources: Grand Teton National Park climbing rangers Scott Guenther and Jim Springer provided information for this report. Some additional details were taken from an account of the incident by The Jackson Hole Guide.

LESSONS LEARNED/LESSONS REINFORCED:
Although this incident involved conditions and technical rescue challenges many firefighters may not face, the mass-casualty challenges of the incident provide some lessons for all first responders:

• Limited resources challenge an IC on where and how to allocate the resources. It’s critical that the IC be constantly aware of conditions, particularly if personnel and material resources are limited. They must know the priorities for providing the limited resources. It’s similar to a military situation where intelligence provides critical information from the field to the commander and can determine the course of a battle and, often, the final outcome. Ranger Jim Springer, who was the IC on this operation, says that what is so important to the IC is a good field ops person who can paint an accurate picture of the situation for the IC. This makes it easier for the IC, but it also helps the IC support those on the front lines of the operation.

• Springer also notes that positioning one physician on the Lower Saddle and the other at the point of transportation worked very effectively. The two could operate autonomously, which took a great deal of pressure off him and his staff.

• Medical evaluation of lightning injuries can be tricky, in part because what seems most obvious, such as an extremity burn—which the patient may loudly complain about—may mask much more serious conditions such as damage to vital organs, which may be life-threatening. And as is often the case with lightning strikes, patients may spontaneously improve over time. So continuous monitoring is critical.

• As lightning storms kept reappearing over the mountain, it was critical to get the patients down as quickly as possible within the limits of safety. Rescuers had to make several decisions about time vs. safety and the urgency of the situation. In urban EMS, responders often have time to fully immobilize any patient remotely suspected of potential spine injury. In this situation, with continuing lightning strikes, rescuers didn’t have that luxury. They had to use “wilderness protocols” on clearing the spine to get patients out of potential danger. Urban responders face similar situations when responding to active-shooter incidents or other situations where patients are threatened by imminent fire or explosion. The medics on the mountain did learn during their evaluation that none of the patients had taken falls or gotten hit on the head by rock, which meant that spinal damage was less likely.

• After every incident, the Teton rangers conduct a rigorous after-action review that looks closely at every aspect of the operation. This helps improve safety and efficiency for future operations. The rangers dealt with a similar but smaller lightning-caused incident in 2003 that involved one fatality and four injuries, and required shorthauling a total of seven people. The lessons learned in their after-action review of the 2003 incident helped the team deal effectively with the challenges of this summer’s larger and more complex incident.

Rescue Editor Tom Vines is the co-author of “High Angle Rescue Techniques” and “Confined Space and Structural Rope Rescue.” He operates a rope-rescue consulting group in Red Lodge, Mont.

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