HAPE, HACE, AMS

Alaska, Mount McKinley, West Buttress

On May 4, the “Joyful Expedition,” led by Chun Byung-Tai, was flown to basecamp on the Southeast Fork of the Kahiltna Glacier by Hudson Air Service. The eight man Korean expedition began their ascent of the West Buttress route on Mount McKinley on the same day and made their first camp at the 7,800-foot level. Continuing up the route the team arrived at the 14,200- foot camp on May 8. On May 9 two members, Kgyoung-Su Han and Chi- Hyeon Pack, began suffering from acute mountain sickness (AMS) with symptoms including nausea, headaches, and lassitude. Accompanied by one healthy teammate, Jinyong Kim, the sick climbers descended to camp one at the 7,800-foot level where they had an extra tent. Later in the day members of the expedition came to the National Park Service camp requesting that we look at Young-Tak Chin (23) who was feeling ill in their tent.

Air National Guard Pararescueman John Loomis and Park Service Volunteer Chris Eng responded immediately and discovered the patient unconscious and not responsive to pain stimulus at 1445. Mr. Chin was sledded to the medical tent where he was put on oxygen and given a shot of dexamethasone. Within ten minutes of being given supplemental oxygen Chin regained consciousness. Nurse practitioner George Rodway evaluated Chin and diagnosed him with both cerebral and pulmonary edema. For the next three nights Mr. Chin remained in the Park Service medical tent breathing supplemental oxygen. Chin’s cerebral edema resolved rapidly, but the pulmonary edema remained critical for several days. Each morning and afternoon, when his teammates brought him meals, volunteer Rodway would have him walk around camp without oxygen and then monitor his blood oxygen saturation level. Improvement was slow but steady. The flow rate that Chin was breathing was down to 1 liter/ minute on May 11. On the morning of May 12 he was able to maintain his oxygen saturation in the low 80s without supplemental oxygen and the weather had improved.

With the consent of sponsoring physician Dr. Ken Zafren, Chin descended under his own power with supplemental oxygen to the 11,200-foot camp. NPS personnel Joe Reichert, Chris Eng, and Paul Barendregt followed Chin to the lower camp and then released him from NPS care. He descended to basecamp with a teammate, Jeon Woo-song, and they were flown to Talkeetna the same day.

Analysis

The illnesses experienced by two members of this expedition were preventable. Had the Joyful Expedition taken a few more days ascending to the 14,200- foot camp, most likely two members would not have become ill. (The third sick member was later diagnosed with an ulcer and evacuated by helicopter.) Most parties take six to eight days to climb from basecamp to the 14,200-foot level. This group arrived at fourteen on the fifth day climbing. Gaining alti-

tude this quickly does not allow the body enough time to acclimatize and therefore makes one more susceptible to altitude related illness.