HAPE

Alaska, Mount McKinley, West Buttress

At 1245 on Mayl 1, George Payot (63), a member of the Denali French Expedition, approached the NPS 14,200-foot camp complaining of shortness of breath. Payot stated he first began experiencing respiratory problems the previous day when he arrived at the 14,200-foot camp. The Denali French Expedition spent one night each at the 8,000-foot and 9,700-foot camps, three nights at the 11,000-foot camp, and one night at the 14,200-foot camp while ascending the West Buttress. Upon medical examination by NPS volunteer nurse practitioner George Rodway, Payot was diagnosed with mild to moderate High Altitude Pulmonary Edema (HAPE) with audible crackles in his lungs. His O2, saturation was 64%. He was treated by NPS staff with O2 at six liters/min via a non-rebreather mask and remained at the NPS camp for further evaluation. By 2050, Payot stabilized with no audible rales at an O2 saturation rate of 84- 86% on two liters of O2/min. Payot remained on O2 at the NPS camp for the night of the 11th. By morning, his condition remained stable with clear lung sounds bilaterally. At this time, NPS staff recommended to Payot that he descend. His team agreed to walk him to 11,000-foot camp. However, by 1200 on May 12, he refused any further NPS medical advice or treatment and chose to remain at the 14,200-foot camp while the other members of his team attempted to summit. On May 12, Payot signed a release and left NPS care. He was able to descend without assistance.

Analysis

If the Denali French Expedition had descended to a lower elevation at the initial onset of Payot’s respiratory problems, perhaps he would not have needed medical assistance. As with the previous case, note that susceptibility to altitude related illnesses is greatly increased when individuals gain altitude before allowing their bodies to acclimatize properly.