RESCUE TECHNIQUES

FOR
EMERGENCY RESPONSE

Cave Rescue
Cave Rescue

edited by Trevor Calafato

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

Editor: Trevor Calafato

Authors: 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 liability
This 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
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

Cave Rescue Contents | 3

Cave Rescue Contributors | 4

Contributors
The 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.
Preface
The 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

Cave Rescue Preface | 5

Cave Rescue Introduction | 6

Introduction
The 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.
Essentials

Ethical Interactions
It 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 & Landscape

Speleogenesis, 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

Cave Rescue Essentials | 7

Cave Rescue Essentials | 8

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

Carbon Acidic rain water

dioxide Disappearing
dissolves stream
into water

Cracks formed Cave

by dissolution system

Soluble
Spring rock

Impermeable rock

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 Surface water

Limestone plateau
outcrop
Limestone walls Underground
Crack water
Doline

Gallery
Fault
Impermeable
rock
Cave
Stalagmite Stalactite Impermeable rock
Resurgence of underground water

Karst Shaft
limestone
outcrops

Chimney
Limestone

Gallery
Well

Source

Underground
river

Cave Rescue Essentials | 9

Cave Rescue Essentials | 10

Cave Zones & Ecosystems

The 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:

Organic Material
(guano & other)
Transferred into the cave via:
• vertebrates
• cave flooding
• air currents
• generated by cave fauna

Microorganisms
Predators
& Decomposers
example: example:
• salamanders • bacteria
• cave fish • fungi
• spiders
• centipedes
• crayfish

Omnivores
& Herbivores
example:
• millipedes
• amphipods
• planarians
• crustaceans

Cave Rescue Essentials | 11

Cave Rescue Essentials | 12

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 Cartography
To 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 Cross Section View
Main and
subordinate
measuring points

Underlying galleries

Possible
continuation

Step

Pit

Pit opening to the

surface

Altitude above sea

level

Siphon

Cave Rescue Essentials | 13

Cave Rescue Essentials | 14

The figure below shows an example of a cave map – the Hotbox

Cave in Kentucky.
Equipment

Rescuer PPE
This 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
Chest ascender
(not shown)

Harness
Over
suit
Under
suit

Cow’s
tail
Descender
+ friction
Gloves carabiner
Knee
pads

Foot
Boots + Socks ascender
(not shown)

Cave Rescue Equipment | 15

Cave Rescue Equipment | 16

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 / • Adapted accordingly to the cold/

Under-suit 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 • Three-point Purcell prusik

positioning • At least one point should be
lanyard adjustable in length

Single pulley • Carried with prusik & carabiner

Cave Rescue Equipment | 17

Cave Rescue Equipment | 18

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 Equipment
This 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.

Cave Rescue Equipment | 19

Cave Rescue Equipment | 20

Team Survival
The 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.

Rescue Operations
Rescue 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

operations planning logistics

rescue maps EQUIPMENT

caving teams food and

water supply
extrication

progression techniques

stretcher manoeuvres

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Cave Rescue Rescue Operations | 22

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.

Cave Rescue Rescue Operations | 23

Cave Rescue Rescue Operations | 24

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 Techniques
Progression 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:

Primary Belay or Y-Hang

Deviation

Traverse Line

Rebelay

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Cave Rescue Rescue Operations | 26

Ascending
Uses 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

Footloop
attachment
Cowstail
attachment

3-point Purcell prusik

Chest ascender

Foot loop
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)

Descending
Uses 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.

Cave Rescue Rescue Operations | 27

Cave Rescue Rescue Operations | 28

Rescuer using Petzl® STOP for descent

 Rescuer using Petzl® SIMPLE for descent

Cave Rescue Rescue Operations | 29

Cave Rescue Rescue Operations | 30

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 Device

A 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.

Cave Rescue Rescue Operations | 31

Cave Rescue Rescue Operations | 32

Progression past a rebelay

Descending 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 Bolt

Maillon

Knot loop

Fig. 8, Fig. 9
or Alpine knot

Rebelay loop
Lower rope
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.

Cave Rescue Rescue Operations | 33

Cave Rescue Rescue Operations | 34

Progression past a deviation

Descending 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.

Rope Bolt

Maillon

Carabiner
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.

Cave Rescue Rescue Operations | 35

Cave Rescue Rescue Operations | 36

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.

Cave Rescue Rescue Operations | 37

Cave Rescue Rescue Operations | 38

Other techniques and considerations

In 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

Water stream
Dry area
Siphon
Stretchers & Manoeuvres
Stretchers 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

Cave Rescue Rescue Operations | 39

Cave Rescue Rescue Operations | 40

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 method
Whether 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.

A1 A2

B1
B2

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.

Cave Rescue Rescue Operations | 41

Cave Rescue Rescue Operations | 42

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 stretcher
This 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 1 Step 2

Step 3 Step 4

Cave Rescue Rescue Operations | 43

Cave Rescue Rescue Operations | 44

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 guideline
This 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.

Cave Rescue Rescue Operations | 45

Cave Rescue Rescue Operations | 46

Vertical lift to Horizontal transition

This 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

Cave Rescue Rescue Operations | 47

Cave Rescue Rescue Operations | 48

Tensioned line progression

In 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.
Conclusion
Cave 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.

References
This field guide has been prepared with reference to:
• Calafato, T. (Ed.), Rescue Techniques for Emergency Response,
Volume 1, (Malta: EVOLSAR, 2017).
• Calafato, T. (Ed.), Rescue Techniques for Emergency Response,
Volume 2, (Malta: EVOLSAR, 2020).

Cave Rescue Conclusion & References | 49

Cave Rescue Image Credits | 50

Image Credits
Bonnici, Joseph – EFRU
Pages: 10, 25, 38.

Campos, Diana – SARTEAM (EPS)

Page: 21.

Kalnitz, Howard (www.cavecartography.com)

Page: 14.

Mizzi, Josef – EFRU

Cover 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 – EFRU

Page: 11

vRigger™, compiled using (vRigger.com)

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

Project Partners

ISBN: 978-9918-0-0205-4

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