Blue Mountains climber safe after dramatic 24-hour rescue at Medlow Bath

It was the most difficult rescue critical care helicopter paramedic Luke Frost from Glenbrook had ever completed.

Experienced Blue Mountains climber Cameron "Macca" McPherson, 57, had fallen while climbing a new route on the 200m tall Carne Wall, near Point Pilcher Lookout at Medlow Bath on Sunday, May 17.

It was late afternoon, and acutely aware of the fading light, Mr Frost and his colleague Libby Hanrahan were in a helicopter flying to the site 15 minutes after receiving the 4pm call. From the air they soon spotted the injured climber and a climbing companion, about 70m down the cliff face.

"We looked at the size of the wall and realised that this was going to be a big rescue," Mr Frost said.

The paramedics were dropped off at the top of the cliff and began setting up to abseil down to the climber, tying their ropes to a boulder.

"Bushfires had torn through the area recently so we were short on trees to tie the ropes to. By this time it was dark and I was getting ready to go over the edge," Mr Frost said.

Fortunately they had lined the ropes up perfectly, with Mr Frost abseiling down right next to the climber. If they had miscalculated he would have had to climb back up the cliff carrying a bag with 45kg of gear.

"It was a massive relief once I came down and was bang on target," Mr Frost said.

The climbers were on a ledge about 80cm wide, and Mr Frost set about securing the injured climber, giving him pain relief and preparing splints for the fractures in his lower legs and wrist.

"He was cold and in a great deal of pain and relieved we had been able to get to him," the paramedic said.

He was joined by two police rescue operators and Ms Hanrahan who lowered a stretcher down and they carefully set about moving Mr McPherson onto the stretcher, keeping him warm in a sleeping bag on a foam mat and covered with a chemical warming blanket.

The plan had been to lift him to the top of the cliff, but Police Rescue determined that the cliff edge was unsuitable and there weren't enough trees to tie the ropes and hauling device to, so plan B was activated.

With the NSW Ambulance Toll Rescue helicopter and PolAir making multiple flights to light up the cliff, the rescuers painstakingly lowered the patient 20m down the cliff face to where a crack in the rock had carved out a ledge with enough room for the stretcher out of the elements. It was 4.30am at this point. They waited until first light and over several hours, moved Mr McPherson about 20m further down the cliff and inched 10m across to part of the cliff where it would be safe to get the helicopter close to the wall to winch the climber out on the stretcher.

"The aircraft has to come directly above you and has to stay off the wall ... it [the air velocity from the rotating blades] can dislodge trees and rocks, as well as blowing you off your feet. You have to be in a position that's safe and you're not going to get hit by the falling debris," Mr Frost said.

Battling rain and fog, at times the rescuers faced the prospect of another night on the cliff if the helicopter couldn't get in, and the risk to the patient of infection, dehydration and being out in the elements for an extended period of time.

"The biggest difficulty would have been that we had moved from the crack that provided good shelter and we couldn't go back up," Mr Frost said.

But fortunately there was a break in the weather around 3pm and the climber was successfully winched out to the helicopter and flown to Westmead Hospital.

"It's the most difficult rescue I have been involved in and one of the bigger rescues that has occurred in recent times," Mr Frost, 37, said.

It was a massive relief for the rescuers to see Mr McPherson on his way to hospital, and their spirits were boosted. Over the next few days they caught up on sleep and reflected on the gravity of the rescue.

"It was a massive team effort that couldn't have been achieved without everyone doing their part, and over the coming weeks we will debrief on it and how the mission went," Mr Frost said.

"Everyone is quite proud of what we did achieve and to have such a good outcome for the patient."

Mr McPherson has a long road to recovery, but was doing well, the paramedic said.