The RAT-SAR team spent the weekend with teams from North Carolina for their third annual cave rescue exercise. The event has grown since its inception three years ago with more rescuers and teams participating. This year’s even featured a multi-drop vertical that required the rescuers to navigate some horizontal passage, as well as raising the patient through three vertical drops. The rescue required improvising anchor systems, building friction reducing high directionals, and using techniques we teach in our Limited Resources Rescue class. The exercise lasted 10 hours not counting the previous day that was spent in the campground going over improvised climbing techniques and building mechanical advantage systems, as well as performing tests on those systems with load cells. Once again, we can’t say enough good things about the North Carolina SAR and MSAR teams for their expertise, knowledge and thinking out of the box.