An interesting case report was recently published in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. It documents a case where a 28-year old female climber survived a vertical fall 300 feet (100 metres) straight into the deck except for when she bounced off the rock face once at 200 feet. The velocity at impact was estimated to be 75-80mp. Splat.
The case is remarkable in many ways. In a recent study it was demonstrated how falls from 8 stories (90-100 feet) carry a mortality of 100%. The authors of the case report suggest this is the first documented case of anyone surviving a free vertical fall of 300 feet onto a hard surface.
Then you have the extent of her injuries. They are listed in the table to your right.
The author suggest her landing feet first saved her life. This way the force of the impact was broken by the feet, then the pelvis and finally her back. So that’s how you survive a 300 feet fall. No problem. I can do that.
The craziness aside ,the paper is an interesting document of good trauma care from the EMTs work on the scene all the way through the ED, radiology, the ICU, surgery and to the wards.
Some points I noticed, for what they are worth
- The boyfriend provided first aid.
- She was intubated and sedated on scene
- She was transfused at the local medical centre where she was aggressively resuscitated with fluids and blood.
- She was rapidly transferred to a level 1 trauma centre
- Where she underwent further resus with a point-of-care Tromboelastography guided transfusion protocol.
- She was extubated on day 4 with a GCS of 15.
Importantly she did not suffer some of the later stage killers like infections, ARDS or other organ dysfunction. This was very lucky, but perhaps also a testament to modern trauma management including standardized resuscitation strategies like transfusion protocols and limiting the interventional burden with damage control strategies the first days after the trauma. Her fractures where externally fixated with no definitive surgery until day five or later.
Survival following a vertical free fall from 300 feet: the crucial role of body position to impact surface. Weckbach S, Flierl MA, Blei M, Burlew CC, Moore EE, Stahel PF. Scand J Trauma Resusc Emerg Med. 2011 Oct 25;19:63.