Cerebral Edema, Washington, Mount Rainier

Publication Year: 1996.

CEREBRAL EDEMA

Washington, Mount Rainier

At 1030 on June 16, the climbing team of volunteers Dave Turner, Jim Funsten, and I met Todd Auker (37) and his rope mates Dave Walters and Scott Weir on the summit of Mount Rainier, in mildly lousy weather. Auker made the comment, “I think my brain stem is pushing through my foramen magnum,” which I understood to be an amusing way of saying that he felt altitude sick, and had early symptoms of cerebral edema.

My party waited for a half hour to descend in order to be the last climbers down the Disappointment Cleaver Route and to search for overdue Liberty Ridge climbers. At 1120 we found Auker at 13,800 feet, descending very slowly. We stayed behind to be able to assist if needed. At 1130 Auker stopped to vomit. He said he had vomited on the summit earlier, and complained of a painful headache and intermittent ataxia and disorientation. Both Auker, a doctor, and I suspected altitude sickness and possible cerebral edema, for which descent is required.

I suggested that Auker would be able to descend more efficiently if he traded his ax for a pair of ski poles to improve his balance. He said his rope team was technically weak, so that he wanted to keep his ax for self-arrest unless I tied into his rope. Our rope teams joined. I attempted to report to the park communications center, but my radio battery failed. We descended slowly to the top of The Cleaver, arriving at 1340.

Auker was cold so I put my down parka on him. I gave him water and orange drink. I switched radio batteries and notified communications center of our progress. Our climbing party rearranged itself on our ropes so that I was immediately behind Auker. (I showed him how I had tied him in. Later, when he felt better, he said he couldn’t recognize the knots I had used, even though they are familiar to him.) For the descent of The Cleaver, I held the rope a few feet from Auker's harness and had him slide on his back while I plunge-stepped to control his speed. Turner and Funsten were alert to help me arrest a slip. Auker walked leftward traverses to stay on the cleaver, and rested by glissading the fall-line portions.

He felt much improved at Ingraham Flats. We arrived at Camp Muir about 1615. Auker rested while Walters and Weir packed their camp. Turner, Funsten and I packed our gear, leaving Auker under Walters’ eye. Walters is a doctor with EMT/ski patrol experience, familiar with high-altitude medical problems. RMI guides filled three water bottles for me to give the Auker party to save them the time of melting snow.

When we were packed I returned to check on Auker and accompany him on his descent. He felt weak enough that we decided to take him out in a toboggan. I gave him supplemental oxygen at four liters per minute through a nasal canula. Funsten’s friend agreed to assist in our descent to Paradise. Ranger Jennifer Erxleben helped prepare the toboggan and package Auker in it. RMI guides offered to monitor the park radio in case we encountered problems in the evacuation. My second radio battery failed as I updated the communications center of our plans. We left Muir at 1830 and arrived at Pebble Creek at 1930. Auker felt sufficiently improved that he preferred to walk the rest of the way We arrived at Paradise at 2050. I encouraged Auker to see a doctor and left him in the care of Walters and Weir. (Source: John Gillett, NPS Ranger, Mount Rainier National Park)

(Editors Note: There was another case of cerebral edema in WA, this one on Mount Adams at the 9,000foot level. The victim became very combative. His partner was able to get a 911 call through on a cellular phone. A helicopter evacuation in the early morning hours probably saved the victim’s life. He was back at work within a week, but does not plan to go above 8,000feet in the future.)