HAPE, ASCENDING TOO FAST

Alaska, Mount McKinley, West Buttress

An eight-member expedition climbed from 7,200 feet to 14,200 feet in three days via the West Buttress. On May 14, eight days after the start of their climb, the expedition arrived at the 17,200-foot camp. Soon after their arrival, one of the members (45) expressed to his expedition members that he “felt tired.” On May 17, two members of the expedition were encountered at the NPS rescue cache attempting to obtain oxygen from the NPS medical cache. Mountaineering Ranger Tucker Chenoweth asked if they needed medical assistance. They indicated they need assistance because one of their team members was “sick.”

NPS Rangers responded with medical supplies and oxygen to the tent of the reported sick climber, who was found supine in his sleeping bag complaining of feeling disoriented and lethargic. A detailed patient exam was conducted finding: a heart rate of 129; respirations of 16; fine crackles in both of his lower lung lobes; a blood-oxygen saturation (Sa02) of 50%; and ataxia when trying to walk. Patient was treated for high altitude pulmonary edema (HAPE) using oxygen therapy, albuterol, and nifedipine. Poor weather conditions prevented immediate evacuation. It was decided to continue treatment and monitor him throughout the night. Preparations were made on the evening of May 17 in anticipation for a technical lowering the following day.

At 0700 on May 18, the climber’s condition remained stable. When taken off oxygen, his SP02 quickly returned to 40%. Due to the limited supply of oxygen, it was decided that immediate evacuation was necessary. Weather conditions remained poor preventing any possibility of a helicopter evacuation. As a result, a 2,500-foot technical lowering operation was initiated at 1330. By 1500, the technical lower was complete and care was transferred to an NPS ground team who evacuated him the remaining distance by means of ski toboggan to the 14,200-foot medical tent.

The patient’s condition resolved at the 14,200-foot camp where he was released to his remaining expedition members and descended under his own power.

Analysis

The eight member expedition climbed from 7,200 feet to 14,200 feet in three days. According to the affected climber, he had very little experience with high altitude climbing. The other seven members of his team had all climbed at elevations above 16,000 feet. They had the experience necessary to recognize the early symptoms associated with altitude illness. A three-day ascent to 14,200 feet is dangerously fast. It may have been appropriate for some of the members of this expedition to ascend this quickly, but not for all of them. Although it is nearly impossible to predict if someone will develop altitude illness, a quick ascent dramatically increases the odds. As a result of their quick ascent and disregard for early symptoms of altitude illness, the climber was unable to descend under his own power or with the help of his team. This required a difficult and potentially dangerous NPS rescue.