FALL ON SNOW, PNEUMOTHORAX

Alaska, Mount McKinley, Karstens’ Ridge

Jonathan Giesen’s (25) accident happened July 5 at 2200. We summitted the previous day (July 4), arriving back at high camp at 1850. We slept in on the morning of the fifth, relaxed, and prepared to go on a “night schedule” for our descent. We started the descent from high camp (16,800 feet) at 1700 July 5. It had snowed earlier in the day so that our trail to Browne’s Tower was covered with a foot of fresh snow. Jonathan was on the trail-breaking team led by Jeff Carter.

After a rest break to retrieve our cache at Browne’s Tower, Rob Hess’ rope team took over leading and breaking trail down the Coxcomb and Karstens’ Ridge. Jeff's rope team followed in second position, with Jeff at the back of the team. Approximately 1.5 feet of new snow covered our tracks on this portion of the route, making footing somewhat tricky but doable, especially with the protection afforded by the fixed line which we installed on the way up. On the last section of the fixed line, Jonathan had the jumar on the fixed rope in his right hand and his ice ax in his left hand. Here he stumbled and somersaulted approximately six feet. The fixed line held him on the relatively gentle slope (< 35 degrees), and he regained his feet, apparently unhurt, and continued 15 feet to the end of the fixed line. He disconnected from the line and continued with the rope team down Karstens’. After 100 more feet, he stopped and bent over, prompting an inquiry from Jeff Carter. Jonathan replied that he couldn’t get his breath and thought that he might have “stuck” himself. Jeff instructed the rest of his four-person rope team to stick their ice axes in for anchors, then belayed himself down to Jonathan. He was obviously having a difficult time breathing and upon inspection had a wound in his left side that did not initially appear serious to Jeff. Nevertheless, Jeff dressed the wound with an occlusive dressing. Leaving Jonathan’s pack, Jeff got Jonathan to his feet to continue the descent to the camp at 12,200 feet (short-roped). However, as soon as Jonathan stood, his breathing worsened and he was unable to move.

Richard Lewis, a student on one of the following rope teams, is a practicing paramedic. Jeff requested that his rope team pull parallel so that Richard could consult with Jeff about Jonathan’s injury. The remaining rope team began to construct a tent platform at a more level spot immediately below the fixed line. After examining the wound, Richard agreed with Jeff that the wound was not immediately life threatening and that Jonathan should be able to move down the mountain. The two of them calmed Jonathan. Jeff traveled behind Jonathan down the ridge and at various points belayed him down steeper sections to camp at 12,200 feet. Jonathan’s pack was left behind for others to bring down. Jonathan’s breathing moderated during the descent and he was able to move slowly down to camp, where two other roped teams had a tent and hot drinks waiting for him.

Once in the tent, Jonathan was placed in a sleeping bag with hot water bottles and given hot drinks. A more thorough secondary survey was completed, and the wound was cleaned and dressed. Jonathan’s breathing became more labored and painful, and he was unable to take a deep breath without pain in his upper left quadrant.

The four instructors and Richard Lewis were concerned about the possibility of a tension pneumothorax, and observed Jonathan closely for signs of such. The weather was clear and calm, with inconsistent cloud cover at approximately 10,000 feet. Evacuation procedures were initiated at 0120 with a cellular phone to NOLS requesting helicopter support. (Source: Jeff Carter, NOLS Instructor)

At 0210, the Talkeetna Ranger Station was notified of the incident by Park Dispatch. The NOLS party had prepared an LZ at the 12,200 foot camp. The Parks contract LAMA helicopter with Pilot Doug Drury and Ranger Roger Robinson departed at 0546. Hudson Air's 206 with pilot Jay Hudson and SCA Doug Demarest departed at 0556 to fly cover for the helicopter. Weather was clear and calm allowing for a direct flight to Karstens’ Ridge via the East Buttress. The LAMA landed at 0637 and was back in the air with Giesen at 0644. Giesen was given oxygen in flight and flown straight to Talkeetna.

Upon reaching Talkeetna, Giesen's pulse was 72 and his respirations were shallow at 26. His skin color and condition were normal. An Alaska Air Guard Pavehawk helicopter landed at 0704 and transported Giesen to the Alaska Regional Hospital in Anchorage, where it was determined that Giesen had sustained a pneumothorax.

Analysis

A pneumothorax is a life threatening injury that requires immediate medical attention. The NOLS party made the right decision to evacuate Jonathan Giesen as quickly as possible. This party had excellent communication through the use of a cellular phone and an aircraft radio. Due to their remoteness on the north side of the range, these forms of communication became a real life-saver. (Source: Roger Robinson, Mountaineering Ranger.

(Editor's Note: First, a correction from last year’s ANAM in the section on Alaska. On page 17, it was reported that Dennis Gum was experiencing “chain stokes’ breathing.” That should, of course, read, “Cheyne-Stokes...”

A final note is about a climber from Poland who was issued two Violation Notices upon returning from his climb on Mount McKinley. One was for disposing of food at 11,000 feet, and the other for disposing of fuel, food, and garbage at 14,200 feet. He stated “I was too tired to pack it out, it was so heavy. ” He did say also that he was sorry for leaving it.

In any case, the business of citations for such things as this and “creating a hazard” has become a part of mountaineering rangers’ routine.)