HAPE/HACE

Wyoming, Grand Teton National Park, Grand Teton

On August 8 about 0400, Ranger McPherson contacted Rangers Holm, Larson, and Montopoli at the Lower Saddle hut. On August 7, Dan and Selanta McPherson (25 and 22) had successfully ascended the Grand Teton by the Complete Exum Route and had returned late that day. During the return, Dan became ill, exhibiting symptoms of High Altitude Pulmonary Edema (HAPE) and possibly High Altitude Cerebral Edema (HACE). He had been unable to sleep and was experiencing violent coughing episodes that resulted in spitting out sputum containing pink phlegm especially after he had lain in a horizontal position. His past medical history included three previous bouts of HACE at altitudes above 14,000 feet, but none was as intense as he was currently experiencing.

Ranger Holm medically evaluated Dan McPherson and made a decision to await daylight hours to escort him down the dangerous terrain to the valley floor. He was instructed to rest in a sitting position and to inform the rangers immediately if his medical condition deteriorated. At 0600 Ranger Montopoli contacted McPherson and they began to prepare for the descent. His condition had not changed during the night. After Holm reevaluated him medically about 0700, the McPhersons began their descent to the valley floor. Ranger Montopoli escorted them and assisted them by carrying about 20-25 pounds of their equipment.

During the descent, Dan McPherson’s condition did not improve. He required several breaks, especially after ascending—which is sometimes required on the descent—any distance. Coughing bouts were especially pronounced when he started to hike after the rest stops. When the group reached the Lupine Meadows Parking Area, D. McPherson stated that he would seek farther medical assistance at his home in Cedar City, for which he departed immediately. (Source: Ranger George Montopoli)

(Editor's Note: This is an unusual case of high altitude illness because of its severity at moderate elevation.)