PULMONARY EDEMA, ASCENDING TOO FAST Alaska, Mount McKinley

On May 18, 1993, at 1400, SSgt. Michael J. Dunn (31) reported to the ranger camp at the 14,200 foot level of Mount McKinley's West Buttress complaining of severe headache, nausea, and the production of bloody sputum during coughing. Dunn was one of 15 U. S. Marines that had split into several groups once on the mountain. They had flown to Kahiltna basecamp the afternoon of May 14, and Dunn's symptoms developed shortly after his arrival at the 14,200 foot camp on May 17.

NPS Ranger Jim Phillips examined Dunn and found him cyanotic, with rales in both lungs and an 02 saturation of 39. In consultation with Dr. Peter Hackett by radio telephone, Phillips administered Promethazine (50 mg. IM) and oxygen (10 L/min.) to the patient and kept him under observation through the night.

The following morning at 0830 a decision was made to evacuate Dunn based on his continued shortness of breath, headache, and overall lack of significant improvement. A ground evacuation was considered unreasonable in light of Dunn's severe exhaustion and the need for a rapid descent. The park's high altitude Lama helicopter was dispatched from Talkeetna at 1039 and landed in clear, calm weather at 1117. Dunn was flown directly to Talkeetna, where his condition drastically improved. He became virtually asymptomatic. He was transferred to the Air National Guard Pavehawk helicopter and flown to the military hospital at Elmendorf AFB in Anchorage, but was not admitted.

Analysis

By the time SSgt. Dunn reached the 14,200 foot camp, barely three days had passed since his Marine team had registered at the Talkeetna Ranger Station (elevation 300 feet). The onset of Acute Mountain Sickness and Pulmonary Edema is neither surprising nor difficult to recognize after an ascent of nearly 14,000 feet in three days. Prevention, in the form of a more gradual ascent, would have been the best remedy. Failing that, it is unfortunate that Dunn and his teammates couldn’t have recognized the seriousness of his situation sooner. Self-evacuation to a lower altitude while Dunn was still ambulatory would have been preferable to a costly helicopter rescue. (Source: Mike Loso, NPS Ranger, Denali National Park)

(Editors Note: Another military expedition, out of the U. S. Army’s Northern Warfare Training Center in Alaska, had a member experience what was probably a pulmonary embolism. Shyam Blan (32) from India, experienced symptoms while descending from the summit. It was discovered that he had not been eating or drinking for three days. He was evacuated from the 14,200foot camp.)