Mountain Rescue Incident Rescue of Climber with High Altitude Cerebral Edema on Mt Rainier August 13, 1998

A mountain Rescue Incident is a rescue in which a member of Tacoma Mountain Rescue participates, but the unit itself has not been officially involved. Editor

On Aug 13, Maria Level, Mike Mixon and Roger Ternes arrived at the White River Camp ground to provide load bearing assistance for a scientific study led by Francois Le Guern who is a noted French volcanologist. Bill Lokey coordinated TMRU's assistance through Jeff Sharp. The purpose of the study was to gather scientific baseline data on the summit of Mt. Rainier for changes is gas temperatures, summit lake temperature, determination of the existence of life in summit's lake, cave mapping and other scientific information. The team consisted of ten members. The mission was to bring food and about 200 lbs of scientific equipment to Camp Schurman for transport to the summit. In order to acclimatize, the team arrived at Camp Schurman on Aug 13 and camped at 12,500 on Aug 15. A photographer from the Tacoma News Tribune who was part of the team appeared to show signs of high altitude sickness at 12,500'. The photographer indicated that he was very tired but felt that he would be able to continue to the summit. The team arrived on the summit Aug 16 at about noon. The photographer was checked on the summit and continued to show the same signs of high altitude sickness. He indicated that he should feel better with rest. The photographer's pulse was high at 104, which he indicated was normally 80. He had no headache, showed no signs of confusion or lack of coordination. The photographer stayed at the summit camp to rest while other members went to the west crater to find the entrance of the summit lake. The entrance was difficult to locate since the opening was only about 18" high between the ice cap and the crater's rock rim. Once inside the entrance of cave, Francois took an air sampling and determined it was safe to descend about 300' down into the cave to reach the lake. The decent was an ugly loose rock muddy scramble. The lake was about 50' X 30' and was crescent shaped with an ice wall on one side and the scramble slope on the decent side. The cavern where the lake is located is about 75' wide and 50' high. The ceiling of the cavern is sculptured ice, which is also the bottom of the summit's ice cap. The lake and ice cave are a spectacular sight. The temperature of the lake was .05C (+32F). Gas temperatures where checked and an inflatable boat was carried to the summit to check lake temperature. The boat was also used to drag the lake with a scientific sieve for marine life.

At 8:30PM, the team returned to the camp. The photographer's condition was checked and found to be about the same. His pulse was still high at 104. He indicated that he had a slight headache. His eyes dilated normally. He was asked questions to check his mental coherence and got all the questions correct and showed no signs of confusion. He indicated that he felt tired, but wasn't cold and otherwise OK. His breathing was clear and no gurgling noises in his chest were heard. About 20 minutes later, his condition was again checked and found to have significantly deteriorated. His eyes were glassy and he was groggy. He was again asked questions to check his coherence and he fumbled with the answers. At that point, our concern turned from acute altitude sickness to High Altitude Cerebral Edema (HACE). At that time, two NPS climbing rangers arrived to camp on the summit. Mike Gauthier was one of the rangers. Gauthier checked the photographer and agreed that the photographer's situation was very serious. His pulse had risen to 120 and his respiration was 60. Gauthier called NPS to try to get an airlift since there was still sufficient daylight remaining. However, after several discussions it was determined that the airlift could not be performed until daylight. In the mean time, NPS had arranged for an oxygen bottle to be brought up the Muir route. Unfortunately, the route conditions on the Ingraham glacier prevented passage, which prevented arrival of the oxygen. The possibility of performing a technical lowering was also discussed since that was the only viable option available to team members who were on the scene. However, after surveying the group, it was determined that a lowering was not a viable option since the photographer was not ambulatory and there were only 4 or 5 members who were physically capable of participating. The Emmons route had some significant crevasses to cross on the decent and a lowering was determined to be too dangerous for both patient and rescuers. The patient's condition seemed to improve somewhat when he received "assisted breathing". This was not CPR, but rather someone breathing into the patient's mouth in sync with the patient's own breathing. A doc familiar with HACE was contacted who indicated that the patient should not be allowed to go to sleep and that we try to get the patient to hyperventilate. The doc also suggested that we give the patient a diuretic. The purpose the diuretic is to reduce HACE fluid pressure on the patient's brain. However, none of these measures worked since the patient soon fell into a coma. Fortunately a summit cloud cap lifted and the patient was airlifted by a Chinook at about 0900 and taken to Madigan. Fortunately, the patient seems to have recovered without any adverse permanent effects. On Aug 16, the team explored the eastern summit caves to include a viewing of the aircraft wreckage that has worked it's way to the bottom of the ice caves from an accident in the early 1990's.

The team returned to the White River campground on Aug 16 and concluded the support mission. Maria and Roger hosted a farewell gathering and potluck for everyone associated with the mission, to include NPS personnel on Aug 17.

In summary, it's uncommon for someone to get HACE so quickly. The problem is that the typical symptoms of acute attitude sickness are often the same as the early stages of HACE. The patient had spent two days at 10,000' and one day at 12,500' before going to the summit. Usually it takes several days to develop HACE taking 24 to 48 hours of mild altitude sickness followed by another 24 to 48 hours of increasingly severe symptoms before the emergence of specific signs and symptoms. Signs and symptoms include disorientation, confusion, hallucinations and problems with coordination. When the patient falls into a coma, death is imminent, usually within 24 to 48 hours.

Maria Level & Roger Ternes

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