David Cifaldi and his two hiking companions were crossing Montana’s ominous Froze-to-Death Plateau and approaching the top of the state’s highest peak when their adventure took a bizarre and dangerous turn: Cifaldi slipped and impaled himself on his trekking pole as he fell.

The 44-inch (112-centimetre) steel-tipped pole passed through the flesh beneath Cifaldi’s left arm, missing any vital organs, and protruded from his back. After conferring with his friends – and considering the high cost of a helicopter rescue – Cifaldi knew who would save him: himself.

“I was like, ‘We’ve got to get off this mountain.’ And they’re both like, ‘I don’t know about that,’” Cifaldi said of his friends’ initial reaction. “I’m pretty confident this is outside my chest wall. ’Tis but a flesh wound.”

The 32-year-old nurse, who works in wound care at a Billings, Montana, hospital, did a self-assessment. He was alert. There was little pain or blood. And the pole wasn’t moving. The group used a satellite-based communication device, a Garmin inReach, to contact local authorities and inform them of their plan to self-rescue.

Then they started hiking out. They carefully descended from the plateau along an unmarked route, navigating through boulders and snowfields before bushwhacking their way to an established trail.

After more than six hours in which they travelled about 10 miles (16 kilometres) and descended roughly 5,000 feet (1,500 metres), the group reached a trailhead where one of them, Cifaldi’s friend Jesse Ross, had parked a vehicle.