ACUTE ABDOMEN

Alaska, Mount McKinley, West Buttress

On June 2, at 2100, Tom Bohanon of the “Three Guys on Denali” expedition came to the ranger camp at 14,200 feet complaining of hematemesis (vomiting blood). Bohanon was examined and diagnosed as having an acute upper gastrointestinal bleed. VIP’s Dr. Colin Grissom and Dr. Lada Kokan assessed Bohanon's medical condition and felt it was life threatening. Bohanon was evacuated at 2315 with the NPS helicopter to Talkeetna, and was transferred to a “Flight for Life” fixed wing aircraft and flown to an Anchorage Hospital. (Source: Daryl Miller, Mountaineering Ranger, Denali National Park)

Analyses

These three illnesses reported above, all of which required costly evacuation, demonstrate the spectrum that runs from preventable to unpredictable. The dehydration and heat exhaustion case is not uncommon—even at altitudes and in the snow environment. Those who are relatively new to glacier travel on sunny, windless days “forget” to take in adequate liquids. The atrial fibrillation case was a pre-existing condition for which the victim—a doctor at that—had medication. However, altitude may play a part in amounts and frequency of medication, and often these factors are not taken into consideration. Age can also be a factor. As for the gastrointestinal bleed—with no previous history, the reality is that sometimes acute illness strikes, no matter where we are. (Bohanon was able to be put on IV fluids, oxygen, and medication at the 14,200 foot camp—a luxury that is not always available.) Knowing one's medical history and understanding the environments to be encountered—which includes the evacuation possibilities—can reduce the potential for life threatening illness. (Source: Jed Williamson)