[pct-l] [John Muir Trail] High-altitude cerebral edema (HACE)

[ned at mountaineducation.org]

As a Wilderness EMT, Pro Ski Patroller at Heavenly (altitudes to 10,000 feet), active SAR member around Lake Tahoe, and former urban Paramedic, the signs and symptoms of AMS are always on my mind whenever I meet anyone in the backcountry. It is, also, not unusual for our students to manifest these s/s when they arrive up from the lowlands to the trailheads where our courses start. 

This is just another safety item all hikers and wilderness travelers need to keep in mind when out recreating. Just like hypothermia or dehydration, it doesn't take some sort of "extreme" condition to bring AMS on. Every body is different. Don't ever say that something "will never happen to me" or "I'm always ok out there." Things change from trip to trip. Just stay tuned and aware to what's going on inside and around you. Don't be paranoid or afraid, just aware of what can happen.

How do you get this awareness? Experience, Education, Listening to those who have been there, or take a course in Wilderness First Aid, Wilderness First Responder, or Wilderness EMT. Know what to watch out for and be prepared. Remember to pay attention to those alarms going off in your head, even if they are slight and quiet and in the "back of your head." Unless you try to find out what you're up against before you go into those remote mountains, you'll not have the knowledge or experience to ring those bells. 

Be able to communicate with members of your group no matter how spread apart you all are on the trail. People get lost, turned around, confused, and fatigue, dehydration, exhaustion, altitude, and hot/cold conditions don't make things any better. Been there, done that (right, Squatch?)! Someone, even in a group of two, has to be aware of the whole. Then, comes the ability to communicate out of the wilderness. A SPOT works, but the SAR folks need to know the nature of the problem before they launch from the Incident Command so they take what is needed. Nothing beats the ability to speak and verbally describe to the Dispatcher or Officer on the other end where you are, what happened, and what you see, whether it is about you or someone seeking your help. Consider the SAT phone.

Communication goes beyond the group to the Hiking Community itself on the trail where you are. You may be savvy enough to get through anything, but what do you do for another who needs your help? Are you prepared to be there for anyone on your next trip? I think we all care and are willing, but is emergency response, much less concern, one of the things foremost on our summer-hiking minds when preparing for a trip far from roads and way in the backcountry? 

Wilderness Rangers are not always close by to get help from or even to summon additional resources. Who knows where they are for the most part unless they leave a message on their "station" (tent or building) and then you have to know where that is, run to it, bang on the door or yell around, then look for the note. I served as a WR in Sierra NF and know how this works. Yes, they can call in the helicopter. They have the radio. So can you, if you had the foresight to anticipate it and have the phone numbers to call the Sheriff or Ranger in the area where you're going.

So, don't go into the remote backcountry without being aware of what you're up against, what can happen, and having a plan on how you're going to deal with or respond to it. There is a responsibility you have in the wilderness, not just for you and yours, but for others, as well. Yes, enjoy your hike; it is your vacation. Just don't be so foolish to think that "It won't happen to me" or "them." Maturity accepts Responsibility and Responds because it Cares. 

Let's do this, as a Community! Thank God that there was an EMT on-trail and in the vicinity when this case of AMS occurred. Let this story (and the other regarding the broken ankle from Seldon Pass) open our eyes and quicken our desires toward each other for community safety.

Was this "fear-mongering?" 


"Just remember, Be Careful out there!"

Ned Tibbits, Director
Mountain Education
South Lake Tahoe, Ca. 96150
    P: 888-996-8333
    F: 530-541-1456
    C: 530-721-1551
    http://www.mountaineducation.org