rescue techniques cave rescue - v.i.a.t.i.c.u.m

RESCUE TECHNIQUESFOR

EMERGENCY RESPONSE

Cave Rescue

Cave Rescue

edited by Trevor Calafato

Cont

ents

© EVOLSAR, 2022The European Association of Civil Protection Volunteer TeamsFirst published in 2022.

Editor: Trevor CalafatoAuthors: SARTEAM (EPS,Portugal)

The Emergency Fire & Rescue Unit (EFRU, Malta) Edelweiss (Italy)

Design and typesetting: IdeaSoft – www.ideasoftmalta.com

All rights reserved.No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission in writing by the publisher.

ISBN: 978-9918-0-0205-4

Waiver of liabilityThis field guide is not intended to substitute appropriate training provided by professional instructors, but simply as an aid. The authors do not have any control on how the contents are used by the reader and consequently cannot be held responsible for any outcome, directly or indirectly, from the use of information contained within this field guide.Furthermore, whilst the content has been prepared to the best of the authors’ knowledge and expertise, and based on existing good practice, it is not presented as all-inclusive and should not replace organization policies or standard operating procedures in case of divergence from the content of this field guide.

Co-funded by the Erasmus+ Programme of the European Union

EU disclaimer:‘The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein.’2019-1-IT02-KA204-062192

Cave Rescue Contents | 3

Contents

Contributors 4

Preface 5

Introduction 6

Essentials 7

Ethical Interactions 7

Cave Morphology & Landscape 7

Cave Zones & Ecosystems 10

Cave Cartography 12

Equipment 15

Rescuer PPE 15

Team Equipment 19

Team Survival 20

Rescue Operations 21

Operational Planning 21

Progression Techniques 25

Stretchers & Manoeuvres 39

Conclusion 49

References 49

Image Credits 50

Cont

ents

Cave Rescue Contributors | 4

PrefaceThe purpose of these field guides is to act as a quick reference tool while being operational. Written and compiled by rescuers with vast expertise in different kinds of rescue techniques and who authored both Vol. 1 and Vol. 2 of Rescue Techniques for Emergency Response: An Introductory Manual for European Volunteer Rescuers; these field guides contain a pool of techniques that are in use and have been tested in various circumstances.

The aim is to provide a platform that briefs the various rescue methods that could be utilized in diverse scenarios. As editor I could only commend and laud such initiative, where the intention is that even in times of pressure the deployed rescuers can assess the effectiveness and functionality of these different approaches while facing dire circumstances.

Thus, I hope that the ambition expressed by these authors to provide advice and guidance, that adhere to best practices within the field in a succinct and comprehensive, yet easy manner, is well received and fulfils its principal utilities – the saving of lives while keeping the rescuer relatively safe.

Trevor Calafato Editor

Pref

ace

ContributorsThe Cave Rescue field guide has been prepared by volunteer members of three teams, who have worked in close collaboration together:

SARTEAM (EPS, Portugal)

The Emergency Fire & Rescue Unit (EFRU, Malta)

Edelweiss (Italy)

More information on these teams may be found on the VIATICUM project website:

https://www.viaticumrescue.eu/who-are-we/

The Emergency Fire & Rescue Unit (EFRU, Malta) has also supported the creation of this field guide, while overall coordination was performed by Edelweiss (Italy).

Editing of this field guide has been entrusted to Trevor Calafato, who has also edited Rescue Techniques for Emergency Response: An Introductory Manual for European Volunteer Rescuers Vol. 1 and Vol. 2.

Cont

ribut

ors

Cave Rescue Preface | 5

PrefaceThe purpose of these field guides is to act as a quick reference tool while being operational. Written and compiled by rescuers with vast expertise in different kinds of rescue techniques and who authored both Vol. 1 and Vol. 2 of Rescue Techniques for Emergency Response: An Introductory Manual for European Volunteer Rescuers; these field guides contain a pool of techniques that are in use and have been tested in various circumstances.

The aim is to provide a platform that briefs the various rescue methods that could be utilized in diverse scenarios. As editor I could only commend and laud such initiative, where the intention is that even in times of pressure the deployed rescuers can assess the effectiveness and functionality of these different approaches while facing dire circumstances.

Thus, I hope that the ambition expressed by these authors to provide advice and guidance, that adhere to best practices within the field in a succinct and comprehensive, yet easy manner, is well received and fulfils its principal utilities – the saving of lives while keeping the rescuer relatively safe.

Trevor Calafato Editor

Pref

ace

ContributorsThe Cave Rescue field guide has been prepared by volunteer members of three teams, who have worked in close collaboration together:

SARTEAM (EPS, Portugal)

The Emergency Fire & Rescue Unit (EFRU, Malta)

Edelweiss (Italy)

More information on these teams may be found on the VIATICUM project website:

https://www.viaticumrescue.eu/who-are-we/

The Emergency Fire & Rescue Unit (EFRU, Malta) has also supported the creation of this field guide, while overall coordination was performed by Edelweiss (Italy).

Editing of this field guide has been entrusted to Trevor Calafato, who has also edited Rescue Techniques for Emergency Response: An Introductory Manual for European Volunteer Rescuers Vol. 1 and Vol. 2.

Cont

ribut

ors

Cave Rescue Introduction | 6

Essentials

Ethical InteractionsIt is to be appreciated that cave systems offer unique habitats for significantly evolved species. Minimising impact on the living organisms and their habitats should be an important factor in the decision-making process when cave operations are to be undertaken.

In principle, nothing is to be removed from or moved into a cave.

Cave Morphology & LandscapeSpeleogenesis, that is the formation and development of caves, can occur over millions of years, and may result in diverse cave types and formations based on different geological processes, some of which are illustrated overleaf. There are different kinds of caves and these can be summed up in the list below.

Cave types

• Karst caves (solutional caves, most commonly found)• Primary caves (e.g. lava caves or reef caves)• Sea caves• Glacier caves• Erosional caves

Esse

ntia

ls

IntroductionThe Cave Rescue pocket manual in the series of Rescue Techniques for Emergency Response Field Guides supports the rest of the books in giving the reader a basic insight to the chapter of Cave Rescue in the second volume of the book Rescue Techniques for Emergency Response. In no way, is this field guide comprehensively covering all that one needs to know and should be trained in, before one may conduct or is deployed in cave rescue activities. This work offers quick references for knowledge relating to ‘Essentials’, ‘Equipment’, ‘Techniques’ and ‘Rescue Operations’.

Caves and cave systems have intrigued humans for a very long time. This led to the development of various interactions (shelter, scientific research and recreation) of humans with such ecosystems and terrain. Interaction with caves may be inherently dangerous leading to the need for specialist rescue resources. This field guide gives an overview of such resources and considerations and allows for an effective ‘common language’ among rescue teams that shall adopt / use this guide as reference.

Caves can be extremely intricate and complex. In cave operations, the importance of situational awareness is key. There is no room for doubt when it comes to safety procedures to ensure due risk management.

Intr

oduc

tion

Cave Rescue Essentials | 7

Essentials

Ethical InteractionsIt is to be appreciated that cave systems offer unique habitats for significantly evolved species. Minimising impact on the living organisms and their habitats should be an important factor in the decision-making process when cave operations are to be undertaken.

In principle, nothing is to be removed from or moved into a cave.

Cave Morphology & LandscapeSpeleogenesis, that is the formation and development of caves, can occur over millions of years, and may result in diverse cave types and formations based on different geological processes, some of which are illustrated overleaf. There are different kinds of caves and these can be summed up in the list below.

Cave types

• Karst caves (solutional caves, most commonly found)• Primary caves (e.g. lava caves or reef caves)• Sea caves• Glacier caves• Erosional caves

Esse

ntia

ls

IntroductionThe Cave Rescue pocket manual in the series of Rescue Techniques for Emergency Response Field Guides supports the rest of the books in giving the reader a basic insight to the chapter of Cave Rescue in the second volume of the book Rescue Techniques for Emergency Response. In no way, is this field guide comprehensively covering all that one needs to know and should be trained in, before one may conduct or is deployed in cave rescue activities. This work offers quick references for knowledge relating to ‘Essentials’, ‘Equipment’, ‘Techniques’ and ‘Rescue Operations’.

Caves and cave systems have intrigued humans for a very long time. This led to the development of various interactions (shelter, scientific research and recreation) of humans with such ecosystems and terrain. Interaction with caves may be inherently dangerous leading to the need for specialist rescue resources. This field guide gives an overview of such resources and considerations and allows for an effective ‘common language’ among rescue teams that shall adopt / use this guide as reference.

Caves can be extremely intricate and complex. In cave operations, the importance of situational awareness is key. There is no room for doubt when it comes to safety procedures to ensure due risk management.

Intr

oduc

tion


In karst caves, the formation of the karst surface and cave features happens through the dissolution of soluble rock as depicted below.

Acidic rain water

Soluble rock

Cave system

Disappearing stream

Impermeable rock

Spring

Carbon dioxide dissolves into water

Cracks formed by dissolution

Secondary mineral deposits, speleothems, develop the cave structure further through the dissolution of calcite, seepage of dissolved calcite in water and the redeposition of calcite. The following are different structures that may form as calcite deposits:

• Dropstone (stalactites, stalagmites & columns)• Flowstone• Speleogens


Through water action, karst features occur at the surface and within rock leading to intricate cave systems, as shown in both illustrations below.

Karst limestone outcrop

Limestone wallsCrack

Limestone plateau

Stalactite

Surface water

Doline

Fault

Underground water

Resurgence of underground water

Gallery

Impermeable rock

Impermeable rockStalagmiteCave

Shaft

Limestone

Well

Source

Underground river

Karst limestone outcrops

Chimney

Gallery


Cave Zones & EcosystemsThe zones in a cave are defined by the extent of sunlight access which determines the development of specific habitats and ecosystems.


Trogloxenes or subtroglophiles, or in simple words ‘cave guests’, are animals that spend only part of their lifecycle in the cave, specifically in the twilight zone. On the contrary, troglobites spend their entire life in the dark zone of the cave.

All living organisms that spend at least a part of their life in the cave contribute to the food chain in the cave’s ecosystem:

Microorganisms & DecomposersPredators

Omnivores & Herbivores

Organic Material (guano & other)

Transferred into the cave via:• vertebrates• cave flooding• air currents• generated by cave fauna

example:• bacteria• fungi

example:• millipedes• amphipods• planarians• crustaceans

example:• salamanders• cave fish• spiders• centipedes• crayfish


The highly specialised flora and fauna, together with the intricate food chain in the cave’s ecosystem, calls for utmost respect towards the habitat. Thus, it is IMPERATIVE not to remove anything from inside caves or leave anything behind other than footsteps.

Cave CartographyTo read a cave map, one needs to understand the principles of cave mapping standards including the different symbols, the orientation and any additional surveyor notes. A proficient cave rescuer is expected to be able to fully interpret a typical cave map.

A cave map is generally composed of:• a plan view,• a cross-sectional view showing the vertical shape of passages

and• a side-view or projection, showing the different levels of the

cave and how these connect.

The map should include:• a cave name and number,• an area name,• a scale legend,• the orientation,• a legend for colours and/or symbols,• a survey date,• the cave walls, generally drawn in a thick line,• the topographic details (floor and roof steps, and slopes),• contents, such as water, sediments and fauna,• surface features, such as dolines, streams and boundaries,• navigation and rigging information and• other special characteristics unique to the cave.


Some of the more important conventional symbols that appear in cave maps are shown below.

Plan View

Main and subordinate measuring points

Underlying galleries

Possible continuation

Cross Section View

Step

Pit

Pit opening to the surface

Altitude above sea level

Siphon


Equipment

Rescuer PPEThis shows the geared-up rescuer with essential equipment. The complete list of personal gear is summarised in the table on the next pages.

Helmet + headlamp (not shown)

Over suit

Under suit

GlovesKnee pads

Boots + Socks (not shown)

Chest ascender

Harness

Descender + friction carabiner

Cow’s tail

Foot ascender

Equi

pmen

t

The figure below shows an example of a cave map – the Hotbox Cave in Kentucky.

Cave Rescue Equipment | 15

Equipment

Rescuer PPEThis shows the geared-up rescuer with essential equipment. The complete list of personal gear is summarised in the table on the next pages.

Helmet + headlamp (not shown)

Over suit

Under suit

GlovesKnee pads

Boots + Socks (not shown)

Chest ascender

Harness

Descender + friction carabiner

Cow’s tail

Foot ascender

Equi

pmen

t


Personal Caving Equipment – the ultimate basics

Helmet • Rugged, low profile and lightweight• Good chinstrap (mandatory)• Attachment points for headlamp

Headlamp • Mounted on the helmet• Easy to operate with gloves on

Other light sources • Refer to Light sources section, further below

Boots • Calf-high rubber boots with grippy rubber sole

Under-garments / Under-suit

• Adapted accordingly to the cold/wet conditions of the cave

• Polypropylene underwear as a base layer

• Synthetic jogging pants and shirt or sweatshirt as intermediate layer

Over-suit • One-piece, abrasion-resistant but flexible, caving Cordura® with neoprene & Velcro® seals.

Socks • Preferably neoprene socks• Toenails should be trimmed to

avoid injuries and discomfort


Gloves • Made of rubber• Flexible and waterproof

Harness • Caving harness should be lightweight, durable, with high strength webbing and minimal or no loops

Chest ascender • Fitted to the chest harness• Used in combination with hand or

foot ascender

Hand ascender • With foot-loop & connected with cow’s tail.

• Used in combination with chest ascender

• May be replaced by foot ascender

Descender • Specifically designed for caving, with friction carabiner

• E.g. Petzl® STOP or Petzl® SIMPLE

Progress capture • With carabiner• E.g. Petzl® I’D or Petzl® Shunt

Cow’s tail positioning lanyard

• Three-point Purcell prusik• At least one point should be

adjustable in length

Single pulley • Carried with prusik & carabiner


Backpack • Flexible, small, nylon, heavy duty and waterproof

• No outside pockets• To carry spare batteries, chemical

light sticks, waterproof and shockproof watch, food, drink, personal first aid kit, folding multi-tool with knife

Light Sources

Each rescuer should carry at least three (3) light sources in separate locations on the body, including spare batteries:

• the main headlamp on the helmet• a secondary headlamp in the pack and• the third one can be a flashlight in a secure inside pocket.


Team EquipmentThis depends on the variables set forth by the cave including:

• horizontal and vertical profile of the cave,• distance to be covered and• topography.

The basic team equipment required for a functional rescue team of three to four personnel includes:

• 400m of static rope (split into 50m lengths),• 8x 3m lashing rope,• 50x steel carabiners,• 10x single pulleys with carabiners,• 6x pear shaped alloy carabiners,• 2x descender devices,• 2x kits: caving hammer, self-drilling anchors, and complete

caving bolt hangers,• Cordless drill with Durium drill bit,• UHF/VHF radio for communications,• Stretcher and• A first aid kit.

Equipment exposed to the cave environment must be rigorously cleaned and checked after use, to have it readily prepared for prospective operations.


Rescue OperationsRescue planning is key to the success of an operation.

It should consider:

• Emergency plan & response• Interorganizational coordination• Required skills• Required infrastructure

Emergency plans must be optimised for maximum efficiency, given the constraints of space and time. Information gathering prior to entry and team briefing are critical.

Operational Planning

event

planning

maps

caving teams

logistics

EQUIPMENT

food and water supply

operations

rescue

extrication

progression techniques

stretcher manoeuvres

Resc

ue O

pera

tions

Team SurvivalThe physical and psychological preparedness of all rescue team members is critical to cave rescue operations. Moreover, essential survival kit materials need to be carried by the team to ensure that the team can thrive healthily during their cave operations. The extent of the kit depends on the expected conditions inside the cave and the operation duration. Expectations are based on rigorous planning activities that are commanded by proficient and experienced team leaders and rescuers.

Each rescuer should carry the following as part of the team survival kit:

• Sleeping bag• Sleeping pad/mat• Lightweight small tent• Camping stove• Sand bags• Food: light, nutritious and with the necessary sources of

energy e.g. cereal bars, dried fruit, chocolate, pasta.• Water: in abundance and should be carried in durable plastic

(e.g. Nalgene®, Platypus®) or metal bottles.

Tents at base camp, at night.

Cave Rescue Rescue Operations | 21

Rescue OperationsRescue planning is key to the success of an operation.

It should consider:

• Emergency plan & response• Interorganizational coordination• Required skills• Required infrastructure

Emergency plans must be optimised for maximum efficiency, given the constraints of space and time. Information gathering prior to entry and team briefing are critical.

Operational Planning

event

planning

maps

caving teams

logistics

EQUIPMENT

food and water supply

operations

rescue

extrication

progression techniques

stretcher manoeuvres

Resc

ue O

pera

tions


Rescue operation planning considerations

Logistics

• Is the cave entrance accessible? How can it be reached?• What is the local weather?• What is the cave type?• What is the cave topography?• Is the location of the victim known and what is the travel

distance and depth within the cave?• Worst case scenario: What is the maximum travel distance

into the cave and what is the greatest depth that can be reached?

• What is the quantity and depth of vertical shafts?• Are there any known difficult passageways and what are the

associated challenges?• Is it expected that rescuers find material that needs to be

cleared?• Are any drainage problems expected and what tools are

available to clear, divert and drain the area?• Are there any siphons?• What are the quantities, availability, expertise and equipment

of the rescue personnel?

Victim(s)

• What details of the accident are known?• What is the number of victims?• Is there any background information on the victim(s)

including age, sex, build, medical conditions and purpose for being inside the cave?

• How long has the victim been inside the cave?• What is the state of consciousness of the victim?


• What are the probable or suspected injuries?• Is the pain scale (1–10) known?• Is the victim’s condition known to be stable?• Are there any known special requirements?• What is the risk of hypothermia?• What is the risk of dehydration?• What is the risk of shock?• What is the risk of sepsis?• Is onsite medical stabilization (advanced relief) available?

Operational Organisation

• Coordinate with the local rescue regulation body;• Organise transport to the cave;• Plan and coordinate access to first aiders as quickly and safely

as possible;• Establish a communication channel with first aiders;• Draft the extrication plan (split into sections based on the

cave’s topography, particularly by vertical shafts);• Organise logistics, including food and technical supplies;• Organise the operational teams, assign responsibilities, and

assign respective sections;• Organise base camp (including communication, equipment

and food);• Organise rescue personnel work/rest schedules and

replacement system;• Coordinate the onsite medical stabilisation team for the

victim transfer to hospital;• Organise decontamination for all cave rescuers and kits.

The rescue commander coordinates the strategic management of the rescue operation in liaison with all key stakeholders.


The rescue team is usually a team of three including the team leader who is responsible for the extrication of the casualty. Other teams may support the extraction team along the way.

Trauma management may need to be adapted based on the conditions of the cave. In person assistance by a doctor or nurse facilitates trauma management during the progression out of the cave.

The following illustration shows an extraction team next to the casualty while the neighbouring teams are supporting the provision of equipment and are undertaking preparatory work for the prospective progression of the casualty out of the cave.


Progression TechniquesProgression Techniques are required for effective access to the casualty and the extraction of the same casualty. Such complex progression techniques should not be initiated unless all teams are in place as this ensures unnecessary waiting time once the casualty has been moved.

The following are a series of Progression Techniques that each rescuer should consider as part of his/her ‘skill toolbox’.

Secure rope rigging is adapted according to the topography of the cave as illustrated hereunder:

Rebelay

Traverse Line

Primary Belay or Y-Hang

Deviation


AscendingUses a chest ascender and hand ascender with foot loop or foot ascender, to climb up a rope. Shifting of weight from one ascender to the other enables progression.

Hand ascender

3-point Purcell prusik

Footloop attachment

Cowstail attachment

Foot loop

Chest ascender


A 3-point Purcell prusik assists with rope manoeuvres, to pass belay points and deviations, while its longer adjustable tail is used as a tether to the hand ascender. It functions in a similar manner to a cow’s tail but the latter may not be adjustable or as adjustable as the 3-point Purcell prusik. Any reference to the cow’s tail or the Purcell prusik in this text refers to either of the two pieces of equipment.

3-point Purcell prusik (cow’s tail)

DescendingUses a Petzl® STOP or Petzl® SIMPLE device that creates friction for a controlled descent or abseil, as shown on pages 28 and 29. When stopping, locking of the descender is a must to secure oneself. The process of locking on either device is shown on page 30 for both descender devices.


Rescuer using Petzl® STOP for descent


Rescuer using Petzl® SIMPLE for descent


Petzl® STOP

Petzl® SIMPLE

Changing from ascent to descent

1. Attach the descender to the rope and lock off;

2. Step on the foot loop to unload the chest ascender and remove it from the rope;

3. Shift the weight onto the descender;

4. Remove the hand ascender from rope;

5. Remove the rope from the foot ascender, if being used;

6. Unlock the descender and start descending.


Changing from descent to ascent

1. Lock the descender;

2. Attach the hand ascender with foot loop to the rope;

3. Step on the foot loop to unload the descender;

4. Attach the chest ascender to the rope, taking up any slack in the rope;

5. Remove the descender from the rope;

6. Attach the rope to the foot ascender, if being used;

7. Start ascending.

Selection of the Descender DeviceA Petzl I’D may be used as a descender device but the Petzl® STOP and the Petzl® SIMPLE are more advisable for cave operations because they are less prone to getting clogged with mud.


Progression past a rebelayDescending or ascending past a rebelay section on a cave lifeline necessitates due consideration and specific techniques may be used, as described further below.

Upper rope

Maillon

Knot loop

Bolt

Fig. 8, Fig. 9 or Alpine knot

Lower ropeRebelay loop

A rebelay section


Descending past a rebelay

1. Abseil until level with the rebelay knot;

2. Clip the short cow’s tail or the short end of the 3-point Purcell prusik into the rebelay knot;

3. Abseil until weight is transferred to the cow’s tail;

4. Remove the descender from the upper rope, attach it to the lower rope, and lock;

5. Shift the weight off the cow’s tail by either standing on the rebelay loop, or else use the hand ascender and foot loop;

6. Unclip the cow’s tail, and shift the weight onto the descender;

7. Remove the ascender (if used), unlock the descender and continue abseiling.

Ascending past a rebelay

1. Climb to just below the rebelay knot;

2. Clip the long cow’s tail into the rebelay knot;

3. Stand on the foot loop, remove the chest ascender, and attach to the upper rope;

4. Shift weight onto the chest ascender, remove the hand ascender, and attach to the upper rope;

5. Unclip the cow’s tail and continue climbing.


Progression past a deviationDescending or ascending past a deviation on a cave lifeline necessitates due consideration and specific techniques to ensure the safety of the operator, as described further below.

Descending past a deviation

1. Abseil until level with the deviation carabiner and lock the descender;

2. Reach for the lower rope and pull to get closer (horizontally) to the deviation point;

3. Clip the short cow’s tail into the deviation tape or rope loop, below the deviation carabiner;

4. Unclip the deviation carabiner from the rope;

5. Clip the deviation carabiner back on the rope, this time above the descender;

6. Unclip the cow’s tail, unlock and continue abseiling.

Maillon

Carabiner

BoltRope

Tape/rope loop

A deviation section


Ascending past a deviation

1. Climb to just below the deviation carabiner;

2. Clip the long cow’s tail into the deviation tape or rope loop;

3. Unclip the deviation carabiner from the rope from above the hand ascender, and control the slight swing outward as the long cow’s tail comes under tension;

4. Take some slack of rope from below the chest ascender and clip it in the deviation carabiner;

5. Pull all the slack of the lower rope from underneath the deviation carabiner, hold the tension and unclip the long cow’s tail from the deviation tape or rope loop;

6. Control the swing away from the deviation by a controlled release of the lower rope, as the weight shifts in line with the upper rope;

7. Release the lower rope and continue ascending.

In a deviation, the cow’s tail should be attached to the deviation to stop the rescuer from swinging away from it. The weight must always remain on the rope NOT on the cow’s tail.


Progression along horizontal lifelines

A horizontal lifeline example

Horizontal lifelines or traverse lines allow for horizontal progression over gaps and voids. Same principles of progression apply.


Counterweight technique

The counterweight technique is used to haul the victim up using two 1:1 (or re-directional pulleys) systems, each operated by a rescuer who uses own body weight to raise the casualty at the other end in a coordinated manner. The rescuer or first aider accompanying the casualty would ascend on a separate rope, while remaining above the stretcher.


Other techniques and considerationsIn certain caving environments other techniques might be required such as:

• diving to overcome a siphon – if practical, the siphon can be drained, taking into consideration where the water is being drained to and the possible need to detour the flow using sandbags;

• swimming or using a small boat to access the casualty, in the case of large underground lakes or rivers;

• cave areas at risk of collapse will need to be shored and secured;

• in some caves there may be the need to clean debris, to create a safe passage for the rescuers and the casualty.

Cave ceiling

Dry areaSiphon

Water stream


Stretchers & ManoeuvresStretchers must secure the casualty in the smallest space possible (e.g. low profile) whilst providing a sufficient level of protection against the rugged surfaces inside the cave.

Space restrictions may necessitate the transfer of the casualty from a full stretcher to a short board e.g. Kendrick Extrication Device (KED). The casualty may be transferred back to a full stretcher when space allows.

The typical stretchers used are the SKED® stretcher and the Petzl® NEST stretcher:

SKED® stretcher Petzl® NEST stretcher


Stretcher handling techniques used in cave rescue need appropriate considerations because of restricted space the team may be subjected to. Typical examples of horizontal progression of the stretcher are given below:

Hand-over-hand methodWhether to progress with the casualty head-first or feet-first is a prerogative of the team leader’s assessment based on the terrain, spatial restrictions and manoeuvres required in the circumstances.

A2A1

B2B1

The illustration is exemplifying a feet-first approach where rescuers A1 and B1 are handing over the casualty while rescuers A2 and B2 are receiving the feet-side of the stretcher.


Stretcher along the knees

Side-view Top-view

Passing the stretcher over the knees of oppositely-positioned rescuers is practical when the ground is too uneven to walk on with a stretcher.

Horizontal progression in a low ceiling area may also necessitate that rescuers lie down with their back on the ground and passing the stretcher from above them.


Alternatively, rope, together with pulleys and anchor points may also be used to assist in the horizontal movement of a stretcher, as shown above. This would minimise the need for having several rescuers handling the stretcher with the casualty, directly.


Stretcher movement on ropes

Changing the orientation of the stretcherThis manoeuvre (steps 1 through 4) is generally required when there is a need to raise the stretcher through width-restricted zones. At any point in time, there are three points of connection to the stretcher.

Step 4Step 3

Step 2Step 1


The following rope technique enables stretcher movement both horizontally (in this case to the left) as well as vertically when required. Each rope is controlled by a rescuer. Controlled release of the ropes on the right, on descender devices, and tightening of ropes on the left side will shift the stretcher to the left in a controlled manner.


Progression along a guidelineThis technique (demonstrated below) necessitates the use of a slanting rope (green), acting as a guideline, to carry the weight of the stretcher and allow it to slide in the direction where the blue and red ropes are pulling, along the same green line.


Vertical lift to Horizontal transitionThis technique allows the stretcher to be lifted vertically followed by an adaptation to the system to shift into horizontal progression. The last two illustrations show two alternatives for horizontal movement, with a 2:1 mechanical advantage featured in Step 3a.

Step 1

Step 2


Step 3a

Step 3b


Tensioned line progressionIn this case, the guideline that is also bearing the weight of the stretcher (blue line), is fully tensioned. The red line controls the horizontal movement to either side along the guideline and acts as a back-up to the blue line. The knots securing the red line to the head-side and feet-side of the stretcher, effectively transfer any pulling force to either side of the red line, directly to the stretcher.

ConclusionCave rescue operations are relatively rare when compared to other types of rescues but this kind of rescue tends to be among the most complex. Despite borrowing techniques used in common types of rescue operations, most notably rope rescue, the environment and conditions where these techniques are employed make errors unforgiving. Thus, a high degree of knowledge and experience for all deployed rescue team members is fundamental and key to a successful outcome.

The need for situational awareness throughout operations cannot be understated and there should be no room for doubt when it comes to the safety of the employed teams as well as the patient during the whole operation. Rudimentary actions, such as marking of the path on the way in and at all intersections, and the basic necessity that all members of the team always remain together, are all crucial to facilitate the way out and ensure the team’s safety. Furthermore, a resting schedule should be established, and adhered to, thus avoiding exhaustion.

Finally, caving equipment is crucial to the safety of the operator and the casualty in case of a rescue. Careful maintenance of the equipment remains critical to ensure it is functioning as required when most needed.

ReferencesThis field guide has been prepared with reference to:

• Calafato, T. (Ed.), Rescue Techniques for Emergency Response, Volume 1, (Malta: EVOLSAR, 2017).


Conc

lusi

on &

Ref

eren

ces

Cave Rescue Conclusion & References | 49

ConclusionCave rescue operations are relatively rare when compared to other types of rescues but this kind of rescue tends to be among the most complex. Despite borrowing techniques used in common types of rescue operations, most notably rope rescue, the environment and conditions where these techniques are employed make errors unforgiving. Thus, a high degree of knowledge and experience for all deployed rescue team members is fundamental and key to a successful outcome.

The need for situational awareness throughout operations cannot be understated and there should be no room for doubt when it comes to the safety of the employed teams as well as the patient during the whole operation. Rudimentary actions, such as marking of the path on the way in and at all intersections, and the basic necessity that all members of the team always remain together, are all crucial to facilitate the way out and ensure the team’s safety. Furthermore, a resting schedule should be established, and adhered to, thus avoiding exhaustion.

Finally, caving equipment is crucial to the safety of the operator and the casualty in case of a rescue. Careful maintenance of the equipment remains critical to ensure it is functioning as required when most needed.

ReferencesThis field guide has been prepared with reference to:



Conc

lusi

on &

Ref

eren

ces

Cave Rescue Image Credits | 50

Image Credits

Bonnici, Joseph – EFRUPages: 10, 25, 38.

Campos, Diana – SARTEAM (EPS)Page: 21.

Kalnitz, Howard (www.cavecartography.com)Page: 14.

Mizzi, Josef – EFRUCover page, Cave Rescue pictogram.Pages: 20, 26, 27, 32, 34, 36, 37, 39 (left), 43-48.

Nikolaou, Elina – CCPVC Pages: 8, 9, 13, 40-42.

Pipicelli, Pasquale – Edelweiss VIATICUM project logo

Petzl® (www.petzl.com)Page: 39 (right).

Rocha, Francisco – SARTEAM (EPS)Pages: 15, 18, 24, 28-30, 37, 43-48.

Vassallo Micallef, Maria – EFRUPage: 11

vRigger™, compiled using (vRigger.com)

Pages: 32, 34, 36-37, 43-48.

Imag

e Cr

edits

Project Leader

Project Partners

ISBN: 978-9918-0-0205-4

y(7IJ9B8*KKMKPO(

rescue techniques cave rescue - v.i.a.t.i.c.u.m

Documents