{"id":34348,"date":"2015-06-02T11:06:38","date_gmt":"2015-06-02T10:06:38","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=34348"},"modified":"2015-06-02T11:11:19","modified_gmt":"2015-06-02T10:11:19","slug":"toby-shipway-down-the-wire","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/06\/02\/toby-shipway-down-the-wire\/","title":{"rendered":"Toby Shipway: Down the wire"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/toby_dtw1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-34349\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/toby_dtw1.jpg\" alt=\"toby_dtw1\" width=\"260\" height=\"160\" \/><\/a>&#8220;Down the wire&#8221; is the process of winching down and up from a helicopter to locations otherwise inaccessible. It\u2019s a phrase that I associate with films involving Navy Seals, the SAS, and the effervescent Steven Seagal; not, and lets make this clear, me. So, you can imagine my surprise to find myself in a classroom, with an enthusiastic instructor, being informed I was part of the first group of doctors in the Northern Territory to undergo training on all things winching, the aim of which was to make us winch-ready for clinical retrievals. With raised eyebrows, I glanced across at my colleague and met a steely look of determination and an affirming nod. I altered my look to a mirroring middle-distance gaze, which seemed a fitting response.<!--more--><\/p>\n<p>First up was a series of videos demonstrating the use of winching in difficult terrain, highlighting how clinicians can be expertly slotted into the trickiest of locations. We were shown winches from 300ft down into crevasses, onto mountainsides and cliff edges, into forest clearings, and onto ships at sea. Then, both doctor and patient were winched up either in a neighbourly embrace, with a thumbs up, or with the patient on a stretcher and a protective doctor or nurse overlooking the ascent. This was quite cheering, and the idea of winching down onto <a href=\"http:\/\/en.wikipedia.org\/wiki\/Jim_Jim_Falls\">Jim Jim Falls<\/a>, or another spectacular NT feature, sounded pleasant enough.<\/p>\n<p>After some theory, the basics were explained\u2014these being the main things to take away:<\/p>\n<p>1. Don\u2019t break the expensive winch hook (or look inside it! The hook is attached to the wire using a small ball bearing.)<br \/>\n2. Don\u2019t let any slack into the winch wire. This can lead to shock loading and cause it to snap, which, if you\u2019re hanging from it, can cause a few issues.<br \/>\n3. Finally, do not, and this was emphasised, fall out of the helicopter. Remember to keep yourself attached to some aspect of the helicopter at all times.<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/toby_dtw2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-34350\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/toby_dtw2.jpg\" alt=\"toby_dtw2\" width=\"260\" height=\"160\" \/><\/a>The basic pointers of winching down (called insertion) and then back up (recovery) were then explored and related to specific moments to trigger our memory. On insertion we were told to remember:<\/p>\n<p>Exit safely\/ Watch the Step (firm footing)\/ 10 foot signal (on approaching the ground)\/ Disconnect (when you\u2019ve landed, preferably)\/ Cable awareness (don\u2019t get knocked in the head by the cable as it returns upwards)<\/p>\n<p>On recovery:<\/p>\n<p>Earth the cable (to prevent static)\/Connect yourself to the hook\/Cable awareness (don\u2019t get tangled), Lift (keep your core strong whilst letting everything else go floppy)\/ Fend (don\u2019t get knocked out by the helicopter as you head up)\/Entry (enter safely and strap in)<\/p>\n<p>We concluded the afternoon by watching several more videos on &#8220;when winching goes wrong.&#8221; These are<a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/toby_dtw3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-34351\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/toby_dtw3.jpg\" alt=\"toby_dtw3\" width=\"260\" height=\"160\" \/><\/a> not to be watched on a full stomach, as it generally doesn\u2019t end well for either the wincher or the winchee. Winching really is a risky business, as you battle a whole host of problems. These include strong winds, large waves at sea, uneven weight distribution of those hanging below the helicopter causing them to spin viciously, or the enormous downward vertex winds caused by the rotary blades, which blow onto the very spot you are hoping to either drop onto, or be picked up from.<\/p>\n<p>As the whole picture slowly came into focus, the reality of some of the isolated and treacherous situations that might be encountered hit home. But that doesn\u2019t fit with a steely gaze or confidant stance, so we strode assertively out to our real-life winching scenarios.<\/p>\n<p><em><strong>Toby Shipway<\/strong> is working as a retrieval registrar for Careflight based out of Darwin. He has taken a brief interlude from his anaesthetic training in the NHS to experience diverse pathology, a markedly different medical system, and some fantastic scenery along Australia&#8217;s Top End.<\/em><\/p>\n<p><em><strong>Competing interests:<\/strong> None declared.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;Down the wire&#8221; is the process of winching down and up from a helicopter to locations otherwise inaccessible. It\u2019s a phrase that I associate with films involving Navy Seals, the [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/06\/02\/toby-shipway-down-the-wire\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-34348","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Toby Shipway: Down the wire - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/06\/02\/toby-shipway-down-the-wire\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Toby Shipway: Down the wire - The BMJ\" \/>\n<meta property=\"og:description\" content=\"&#8220;Down the wire&#8221; is the process of winching down and up from a helicopter to locations otherwise inaccessible. 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