A – Assess scene, Alert EMS (EMERGENCY MEDICAL SERVICE) and Airway Open. You assess the scene for safety, call the Emergency Medical Service and open the patient’s airway.
Q: Is there air moving in and out? Think: Look, listen, and feel. If the climber has sustained a fall that could have damaged his spine, stabilize his neck and protect his spine.
A: YES – Move on to B.
A: NO – Look for cause of obstruction. If you see something, remove it. Attempt to open the airway with jaw thrust or head tilt-chin lift and begin CPR. Call for help immediately.

B – Breathing
Q: Is the patient breathing, and if so, how? Fast rate, uneven chest rise, or laboring to catch their breath?
A: YES – Breathing without difficulty, move on to C.
A: NO – No breathing = begin CPR and call for help.
A: NO – Labored breathing = Position for comfort, reassure, give oxygen (if available), and call for help.

C – Circulation
Q: Does the patient have a pulse? Check multiple locations (radial/wrist, carotid/neck, femoral/groin).
A: YES – Move on to next question for circulation.
A: NO – Begin CPR, call for help.
Q: Is the patient bleeding profusely? If so, where?
A: YES – Find source (Look on the ground, the chest, abdomen, pelvis, and thighs. Remember bleeding can be internal) and stop bleeding with direct pressure, elevation, or tourniquet.
A: NO – Move on to D.

D – Disability
Q: Is the patient fully alert?
A: YES – Move on to E.
A: NO – Assess by AVPU scale. How do they respond? Call for help.
A – Awake
V – Verbal
P – Pain
U – Unresponsive

E – Exposure
Q: Does your current environment offer danger to patient’s condition?
A: YES – Protect your patient and limit exposure. Get them dry, warm, insulated from cold ground, and out of the wind. If at altitude, move lower if possible.
A: NO – Think about evacuation or continuing to climb if no injuries.

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