Mt Whitney Zone
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.
Those are great guidelines for sure George.Thanks.
Most of those would be easily recognizable signs and symptoms for for Yuppie 911/mommy call.It is easier for someone to determine someone elses need for rescue especially under those guidelines George.The hard part is for someone traveling alone who becomes impaired in their own judgement and abilities by accident,exposure or AMS to know when to push their own button.Most of criteria you list would render a person incapable of making his own decision.
THIS write-up by George Durkee is well worth being considered as a rough guideline/checklist. If I had known this info (I had never even heard of HAPE, HACE, & Hypoxia) on my group hike with the sick hiker, I would have been more equipped to make a rational decision{s}.

Up until recently, I thought that most of my responsibility to myself and others on the mountain was to be fit. If I was fit and strong, than most potential problems/liability could be avoided. Wrong. I found that by being fit-- but ignorant -- I RAISED my potential for trouble, due to the fact that I could go farther and be hampered by bad judgment in out of the way places.

SO much to learn.

George's post above is so helpful, and his related post goes along with it:  Who is to say when someone is in trouble?

I especially like this part:
Originally Posted By: George Durkee
I found a guy on the switchbacks. When I first talked to him, he seemed fine -- for about 2 minutes when he started talking about his wife's garage sale on the summit. That's called a clue.

(For those who may not know, Mr. Durkee is a backcountry ranger with Seki -- Sequoia/Kings Canyon National Park.)
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