HAPE/HACE, Failure to Descend

Alaska, Mount McKinley, Browne Tower
Climb Year: 2011. Publication Year: 2012.

On the morning of June 29, Russian and American climbers Alexander Kharkovskiy (52) and Sergie Loz (58) began ascending from Browne Tower to an intended high camp on the upper Harper Glacier. An NPS patrol led by ranger Chris Erickson observed them to be moving extremely slowly, taking nearly six hours to move less than one half of a mile. The next day, the NPS patrol contacted the team while climbing past them on a carry. One of the climbers reported that his partner “wasn’t feeling too well” and so was advised by the patrol to descend to a camp where his partner could better acclimatize. The team then slowly descended to Browne Tower, and at 2000, the partner returned to the NPS camp to request help for his sick teammate. The initial patient assessment, led by NPS Volunteer-In-Park Tom Gall (EMT-P), revealed that the patient had an SP02 of 46, resting HR of 120, and respirations 28/min, shallow and labored. Kharkovskiy and Loz were advised at this time to attempt to descend under their own power in the morning, as the patient could still walk and stand on his own.

The following morning, his oxygen saturation had worsened to 32 percent with all other vital signs remaining the same. NPS Physician- advisor Dr. Jennifer Dow was consulted via satellite phone and Albuterol, Diamox, and Dexamethasone were administered on the suspicion of High Altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE). Through the course of the next 12 hours, 16 inches of snow fell on the Browne Tower camp and numerous signs of natural avalanches/slope instability were observed. Also during this time period, the patient’s condition and vital signs did not improve, and at 1200 Mr. Gall reported that the patient was no longer able to stand on his own or walk under his own power. The patient’s condition, the lack of available technical rigging supplies, the inability to mitigate the increasingly severe avalanche conditions, and an unfavorable weather forecast led the NPS patrol, in consultation with Dr. Dow and the Talkeetna ICS system led by John Loomis, to begin preparations for a helicopter evacuation.

The weather remained non-flyable for the rest of the day. On July 2, the clouds and snow lifted enough to allow the NPS helicopter to fly to Browne Tower, which lies at the top of Karsten’s Ridge, an area that is consistently between 20 and 40 degrees in angle. A landing zone requiring approximately 24 labor-hours of digging and flattening was built and the helicopter was able to land there. At 1000, pilot Andy Hermansky, attended by Ranger John Loomis (EMT-P), departed with both climbers, one being uninjured yet considered to be unable to safely descend the crevasse-prone route on his own.


Due to the length of approach and tougher glacial conditions, most parties move slowly on the Muldrow Glacier and are thus less likely to contract Acute Mountain Sickness, HAPE, or HACE. This expedition’s pace was not considered overly fast. Regardless, the sick climber’s health was clearly negatively affected by the altitude at Browne Tower. The team’s one true error was that, despite the sick climber not feeling very well, they attempted to move up. Had they recognized the signs and symptoms of HAPE/HACE in the sick climber and decided to descend that day, they most likely would not have required NPS assistance. Given the remoteness of the Muldrow Glacier route and the fact that it is not patrolled as consistently as the West Buttress, the two climbers should are fortunate that help was so close and available at that time. (Source: Chris Erickson, Mountaineering Ranger)

(Editor’s Note: In another case of illness, pneumonia, a climber whose life was not immediately threatened wanted a helicopter evacuation. The best means of treatment by medical personnel was to take antibiotics and descend on his own power— with his guides. The park clearly states its position with each expedition during the orientation. Here is an excerpt:

Denali National Park and Preserve recognizes that a certain number of park visitors each year will become ill, injured, or incapacitated in some way. It is the policy of Denali National Park and Preserve to assist those in need, when, in the opinion of the park personnel apprised of the situation, it is necessary, appropriate, within the reasonable skill and technical capability of park personnel, and provides searchers and rescuers with a reasonable margin of safety...

Denali National Park and Preserve encourages self-reliance, preventive education, and user preparation. We believe the prudent use of these elements to be the best possible means to safely enjoy the park.

The rangers on site during this episode said, “The NPS mountaineering rangers are on the mountain to protect the resource and to assist climbers in their time of need. This fact should not encourage climbers to rely on this safety net but instead to call for assistance when their team’s rescue resources have been overwhelmed or depleted. This group had ample resources at their disposal to have dealt with this issue in a much more efficient and professional manner”)