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WMA WFR Action on the Inca Trail, Peru

By Kate Malone, WFR

(Kate graduated from a Wilderness Medical Associates WFR course in Jackson Hole, WY taught by Ty Garland and Sue Purvis.)

We were in the dinner tent about two days and 15 miles out from Machu Picchu (about 12,000 feet) when one of our guides came into the tent asking if anyone was a doctor.  We had one podiatrist from New Zealand, a RN (my mom), and me, the lone WFR.

Our guide explained that a porter from another group had fallen head first down an extremely steep section of the rocky trail with 20+ kilos (44+ pounds) on his back consisting of a pack and a 3 foot x 2 foot 4-burner metal stove, amongst other things.  We were told he was still bleeding badly from above one of his eyes.

Six of us headed down to the building he was in to find him lying in a bed with his head bandaged.  My mom unbandaged his head to find a surprisingly well-steristripped huge gash above the left eye.  It wasn't bleeding and we decided to leave it the way it was rather than risk reopening it. 
While she was doing that, I was taking vitals and trying to get some information from him and the guys who were with him at the time of the accident (all in Spanish).  It turns out he had lost consciouness in the fall, but no one knew for how long.  They also told us he couldn't walk.  His eyes were glazed over and he was A, but not a great A, on the AVPU scale.

He had been lying in bed with only a bandage and two alpaca blankets for nearly six hours.  He was being watched over by other porters with no medical experience.  My mom and the podiatrist were focused on this cut and possible orbital fracture.  Twenty-plus more people were frantically moving about the room trying to keep the one light bulb that they had in the room from fizzling out and shining four

headlamps in his face.

I recalled our fabulous WFR training by Ty and Sue and offered to do a body check.  I lifted the blankets off him, and he gestured to his left leg.  There was a huge lump just below his knee cap (looked like a very unhappy tib/fib) and when I slowly tried to mobilize it, he groaned loudly.  He

also was in incredible pain when I moved most of his other parts, maybe some broken ribs and a lot of very sore muscles.

This man clearly needed to be evacuated, but they couldn't move him until dawn when the trail would be safe.  The trail is incredibly steep and uneven - up a quick several thousand feet then down and up another several thousand with rain and some snow in the higher elevations.  We explained how to

properly load and strap him to the backboard.  We gave him some tylenol and a bag of cold stream water and elevated his most likely broken leg.

He was gone by 5:45 am when my mom went to check on him.  It was cool to be able to help and to know how to go about assessing the situation in an organized way (go three triangles!) out there in the absolute middle of nowhere on the Inca trail.

The language barrier was also challenging, and it's pretty amazing how much Spanish you all of a sudden remember when someone's life is possibly in danger.  It was amazing to see people work together nonverbally.  Cheers to you all.  WMA

(At the time Kate wrote this, she was living in New York with plans to return to Peru this fall to

teach English and hopefully work for Backroads in the spring in Cusco.)

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