Some thoughts about when things are bad enough to hit the 911/mommy button &/or determine if you need to get out right away:
Some of the criteria I use in evaluating:
1) Altered Mental Status (e.g. delirious, unconscious, stumbling/uncoordinated). No question whatsoever, that person needs to get out by the quickest way possible. For sure hit the button &/or start out if that's the quickest way. This could be from any number of things (HACE, HAPE, drugs, electrolyte imbalance etc.). Doesn't matter. Your job isn't to figure it out, only to recognize that the brain is affected and things are going really badly.
2) Is the person significantly slower than the rest of the party? Walking 100 or so feet, then stopping and having to rest/breathe?? Listless. Having to sit up to breathe at night rather than lying down. Not acclimating better by day 3. Have to consider HAPE and getting out. The more severe the symptoms, the better it is to hit the button. The stuff you read: cough, frothy sputum, rales/gurgly lung sounds are all very late stage. If you have any of those symptoms, you absolutely need to get out. That's an authentic emergency too. Often happens by night 3 at altitude.
3) Unable to control vomiting. You can really mess up your electrolyte balance by just a few hours of vomiting without fluid & electrolyte replacement. This can lead to altered mental state; heart arrhythmia and bad stuff. Stopping, resting and getting someone to just take tiny sips of diluted gatorade -- a sip every five minutes or whatever they're comfortable with. Soup. Whatever works and they can hold down. If they can't even then hold anything down, you've got to get out of there. Again, the more severe the symptoms, the more justified hitting the button.
4) Chest pain that doesn't go away or is made worse by exercise. Especially in someone over 40. There's no way you can rule out heart problems in the field. Our base hospital will just automatically recommend a medivac.
There's other stuff -- broken bones, impaired circulation from sprains or breaks, dislocations etc. but the above are the biggies. I'm sure others have good general rules.
Edit: Moved this post to its own thread from its original post within the "Article: SPOT Satellite Tracker" thread.