The trapped mountaineer has survived after enduring 16 hours of freezing cold in a crevasse in Denali (Mount McKinley) in Alaska. His long and difficult rescue in frigid conditions and his care following critical disasters are examined in the current issue of the Official Journal of the Wilderness Medical Association, Wilderness and environmental medicine, published by Elsevier. This compelling case study highlights the distinct factors that led to the successful outcome.
The mountaineer was wedged about 20 meters into the crevasse, waiting for the rescue team to arrive for 4.5 hours, followed by an 11.5-hour ejection process. His condition deteriorated and he eventually lost consciousness. Although the rescue team collectively felt there was little or no chance of survival, they continued their rescue efforts until the victim was pulled out of the crevasse. He was placed almost immediately in a hypothermic wrap with active warming, loaded onto a rescue helicopter, and flown to a hospital in Fairbanks, Alaska. He was released after 14 days and made a full recovery.
“This case documents the heroic, sustained, and expert rescue efforts of a group of people dedicated to saving lives. After consulting with the Chief Rescuer and Chief Medical Officer, we compiled our collective insights into the challenges of extracting climbers from extremely confined spaces and providing medical care to those exposed to prolonged cold,” he explained. Principal investigator Gordon Gesprecht, PhD, Exercise and Environmental Medicine Laboratory, School of Kinesiology and Leisure Management, Departments of Emergency Medicine and Anesthesiology, University of Manitoba, Winnipeg, MB, Canada.
Their recommendations are based on lessons learned from a previously published case study of a helicopter pilot who died after being trapped in an ice crevasse for just four hours. In that paper, Dr. Giesbrecht identified the need to develop processes for search and rescue personnel to prevent collapse surrounding rescue, a complex physiological response to extreme cold that is exacerbated by improper patient handling. He warned that rescuers should be trained on the principle that the colder the victim, the more care required to carry out the horizontal rescue as gently as possible. Adding a few minutes of gentle handling and repositioning will not only greatly increase exposure to cold, but it will greatly reduce the chance of a rescue collapse.
“Responders should be aware of the causes, symptoms and prevention of rescue collapse. Training should include techniques for gently moving the victim from a vertical position to a horizontal recumbent position or, for narrow passages, to a lateral recumbent position. Even if the victim has to be pulled in Vertical laying, which is a simple technique using a sling or rope under the knees that allows for a simple, gentle, horizontal dislocation from the crevasse to the surface,” noted Dr. Giesbrecht.
This case emphasized the need to continue rescue efforts and treatment for a cold patient even when survival with hypothermia seemed impossible. She also stressed the need for rescue teams to pre-plan equipment and procedures for rift rescue for potentially cold patients.
This case highlights an important mix of preventive and resuscitation lessons and recommendations regarding rift rescue in a secluded location:
- Urge climbers to travel across glaciers with ropes in areas with known and potential crevasses.
- Ensuring that any rescuers going down the cracks are constantly observed by someone still on the surface who has radio contact to call for immediate assistance.
- Recognizing that breathing is often more easily detected than pulses.
- Try unconventional methods of clearance when necessary.
- Rescue teams deployed for crevasse rescues must carry kits equipped with an air hammer (important for elimination), a tripod and winch, a hypothermic wrap made of a sleeping bag and chemical heating blankets, an onboard oxygen supply with a transducer that attaches to the patient’s nasal prongs or mask, and a mechanical chest compression device, an automated external defibrillator, and a saline solution with fluid heating device. Denali National Park and mountaineering rangers now include these groups in their rescue aircraft.
Investigators plan to submit a standard rescue operation based on these recommendations for publication after field testing is completed in the summer of 2023.
When asked what he considers the most important factor for survival, Dr. Gisprecht emphasized that rescuers should never give up even when a patient’s survival with hypothermia seems impossible.