HAPE AND HACE

Washington, Mount Rainier, Camp Muir

On June 23 at 1745, rangers at Camp Muir were alerted of a climber (male, 49) who was having difficulty breathing after returning from a summit attempt and resting in the public shelter.Rangers and a physician’s assistant assessed the patient, consulted medical control, and concluded the man was suffering from high altitude pulmonary edema (HAPE). A decision was made to airlift the patient from Camp Muir, using a contract helicopter that was already in the park doing project work.

While rangers were preparing to fly the HAPE patient off the mountain, another report came in from guides at Ingraham Flats who were attending to an independent climber (female, 41) showing severe signs of high altitude cerebral edema (HACE), including rapidly decreasing levels of responsiveness. Due to the seriousness of the second patient’s condition, a decision was made to fly her off the mountain also.

Analysis

High altitude pulmonary and cerebral edema can happen to anyone who is at altitude, and the only cure is to go to a lower elevation. Both patients were able to descend and get to definitive medical care in a timely manner. Patient care was expedited by experienced climbers and medical personnel who saw the signs of HAPE and HACE and reacted quickly.

One thing to note, though, is that the signs and symptoms of HAPE and HACE were not reported or reacted to early on by the people in the patients’ climbing party but rather by other climbers and guides who happened to be on the mountain. In a popular mountain environment such as Mount Rainier, people often seem to rely on the presence and expertise of other more experienced climbers rather than using their own knowledge and skills to make decisions.

Another large contributing factor to altitude emergencies on Mount Rainier has to do with people living at relatively low elevations, then coming to the mountain and ascending from approximately sea level to 14,410 feet within 48 hours. These rapid ascents, especially when the person climbing might not have much experience with altitude, leaves little time for the body to properly acclimate. (Source: Edited from a report by Cooper Self, Climbing Ranger)