Posted by Steve06877, 07-17-06
Last Friday we were all surprised with an Air Evacuation rescue from the West side of Whitney that resulted in a 24 hour hospital stay. The hiker was a 20 year old athlete and Eagle Scout with 5 years of backpacking experience up to 12,500 feet. He had acclimatized for 6 days by backpacking the High Sierras trail. At 12,500 feet he was hit very suddenly by severe nausea, coldness, and disorientation.

Two crews were planning to hike meet at the top of Whitney on July 14th. The first group of 13 started in Kings canyon and Hiked from Marvin Pass to Colby Pass, then joined the High Sierras trail at Jct Meadows. This group had no incidents (though Colby was very difficult as it is an unmaintained trail). I was a member of this group.

The hiker who became ill was in a second second group of five 20 year old men who started in Crescent Meadows on Sunday July 9th and followed the traditional HST. The hiker who developed High Altitude Sickness (AMS) had also climbed to Pear Lake as an overnight the prior Thursday (9500'). His elevations for the prior 10 nights were: 7000; 9500; 4000; 7000; 8500; 8500; 7000; 10,200; 11,500.

The groups met at Guitar Lake on July 14th, and the hiker appeared in perfect condition. He began up Whitney from Guitar Lake (11,500) at 5:00 am on July 14th, and became severely ill at the 12,500 foot mark at about 6:00am. The second group met them at 6:30. By this time he was vomiting, severely cold with blue finger nails, and disoriented.

We took him down to Guitar Lake hoping the 1000 foot decline would ease the situation. He was kept warm and we got him to drink 1.5 L of water and Gatorade. Fortunately an EMT hiked by and gave us great support including a brief exam, concluding as we did that this was altitude illness, and he was responding to the (slightly) lower elevation.

By 10:00, still at Guitar Lake, the situation deteriorated as he developed new symptoms including difficulty in standing, and blurry to lost vision. At this time we were able to contact SEKI and request ranger support and/or a transport. Ranger Rob from Crab tree Meadows ran to the site with O2, and a helicopter was redirected by Seq-Kings dispatch. They arrived before noon.

On exam the hiker had very low blood pressure (100/60), significant sounds in the lungs and breathing, and was unable to walk any distance. Everyone was startled at the sudden and severe symptoms. He was flown to Bishop where he spent 24 hrs in ICU. His Blood O2 had dropped below 90%.

The conclusion of the Bishop ER team (who were great, and very experienced due to Whitney and Mammoth) was that he had had minor HAPE for 2-3 days, and had "worked through" the symptoms until he had a severe reaction. Xrays showed fluid in 30% of his lungs.

Here is what we learned and the three errors: 1, He started the hike with a minor cold. 2, He felt tired and short of breath through out the trip (don't we all), and ignored this as just a hard hike. The doctors think this was the early development of altitude sickness, and some amount of fluid was building in his lungs. 3, He slept at higher elevations than he hiked at the two night prior to the Whitney climb. The inability to walk and the vision appear to have been caused by the significantly low blood pressure. Though the hiker is a healthy 20 year old athlete with significant backpacking experience at elevations up to 12,500', these errors appear to have created a situation where he was unable to properly acclimatize.

All symptoms were gone within 18 hours at 4000 feet. All other participants in the two crews (including my 14 year old son) were able to make the climb, so the acclimatization of the High Sierras Trail worked well...

Final note: SEKI is unable to fly out anyone with an ill hiker due to the thin air and the severe weight limits on the helicopters (the pilots did a great job getting in and out quickly). As a result I was able to rejoin him several hours later after hiking over trail crest and down to the portal. Ranger Matt from Whitey Portal met me at Trail Camp and showed me the fast path down, then drove me to Bishop. The hiker was also my son, and we are deeply appreciative of the help from other hikers, the SEKI and Whitney rangers and pilots...

The information on this message board was invaluable in helping all of us prepare, in helping the other 16 to summit, and in helping me know what to do when this occurred. Thank you, and I hope this post helps others...

Posted by DLO, 07-17-06
Thank you for the update on your son. We were hiking on 7/14 and saw the helicopter and heard bits & piece of the situation. I was particularly concerned for the poor father who had to hike out..worried about his son & most likely shook up (being a mother, I could not imagine the feeling.) At the time I saw the helicopter I took a moment to send good thoughts to all those involved & I'm so glad all is well!

Posted by MtnLion, 07-17-06
We were also on "The Mountain" and got bits and pieces. I am glad to hear everything worked out alright. Thanks so much for the education.

Posted by len, 07-18-06
Can anyone comment on how low blood pressure relates to altitude sickness? Mine is normally 90/55. Is this an issue? I'm planning a JMT thru-hike in three weeks. I've spent time at 6000 ft in the Mt. Laguna area down here in SD with no problem, but obviously that's no Mt. Whitney.

Posted by Ken, 07-18-06
Low blood pressure does not directly relate to altitude illness, at least not usually. Low blood pressure (also known as shock) in mountaineering activities is usually caused by dehydration, and that often happens in altitude illness, as people become nauseous, and reduce their intake. The treatment is generally to dump fluids in, usually intravenously. a person with Pulmonary Edema, this will almost certainly make the lung problem dramatically worse. This was the reason for the admission to the ICU. This was a highly dangerous situation, that required careful monitoring on a minute-to-minute basis.

The virus was undoubtedly a major contributing factor, but I really have to wonder if the hiker has a predisposing genetic factor for developing this. I guess time will tell, but I think that hiking in the future must be done carefully.
Good judgment comes from experience,
and experience, of course, comes from poor judgment.

Posted by len, 07-18-06
Thanks Ken. Hopefully I will have nothing more to contend with than my usually cold 'extremities'.

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