I took part in a rescue effort last week on Mt Washington, trying to revive a man who collapsed on the Tuckerman Ravine Trail, we believe from a heart attack. There were about a dozen of us altogether, performing CPR and assisted breathing for nearly 2 hours until Gorham EMS arrived on the scene with an AED (defibrillator) and tried to revive him. Sadly, they arrived too late and he was pronounced dead at the scene.
When I arrived on the scene, my friend Martin and I were climbing up Mt Washington to begin a 2 day trip in the Northern Presidentials. We were about a mile, just one mile, from the Pinkham Visitor’s Center, when we saw a commotion ahead on the trail with a half dozen people kneeling beside a man who was lying on his back on the rocky trail.
The first person on the scene had been an ICU nurse who arrived a minute or two after the man collapsed. He had organized a small group of people, all trained in CPR, who’d stopped their hikes and pitched in to try to resuscitate the man. It was a remarkable scene. When I saw what they were doing, I dropped my pack and told Martin that I had to stay and help.
More people arrived, also CPR trained and we lined up, taking turns performing CPR and mouth-to-mouth in order to keep the man’s body and brain alive until an AED arrived to shock and restart his heart. We needed all hands: CPR is very hard work and doing it for 2 hours straight is inconceivable without multiple helpers.
We worked as a well oiled machine during the incident, using our training to improvise a breathing mask, keep the count going, and rotating in when people got tired. Everyone was completely focused on prolonging this man’s life until EMS could arrive and resuscitate him, but we still shared a few smiles when we flubbed the compression count, unable to articulate “24,25,26,27..30” fast enough to keep up with the person doing the compressions.
I was really impressed by the people who chipped in to help this man. Three of them were eagle scouts, all young men, trained in CPR. I talked to them after the incident and I was really impressed by their poise. Another nurse joined the group, a magazine editor, a policeman, and several others who left the scene after EMS released us and before I could learn more about them. Complete strangers who spontaneously answered the call and then dispersed.
I have written about learning CPR here on Section Hiker and encourage you to take a Red Cross course in how to perform it. If you are with someone whose heart stops suddenly and goes into cardiac arrest, performing CPR is the best chance they have to retain brain and bodily function without future impairment.
In urban areas, the first 7-10 minutes before EMS can arrive are really the most important. If you can keep a person’s oxygenated blood moving through their circulatory system by pumping their heart for them, you can keep them alive and vastly improve their chances of having a complete life when they are revived.
Wilderness Medical Services
It took Emergency Medical Services 2 hours to reach our patient despite the fact that we were only 1 mile up a trail from the Appalachian Mountain Club’s Pinkham Notch Visitor Center at the base of Mt Washington. That’s a sobering fact of life with emergency assistance in a backcountry location; help is seldom available in an urban time frame and it may take hours or even days before it can arrive.
Some other factors to consider:
Consider the potential communication hurdles: We had extremely poor cell phone reception during this incident, despite the fact that there is a cell tower on Mt Washington. I tried phoning 911 several times, but my calls kept getting dropped because the signal was so poor. We ended up sending people down the trail to the visitor’s center and up to Hermit Lake ranger station to get help, though one caller did get through by hiking up the trail to a better cell location.
Consider the effort level required to perform CPR for 2 hours non-stop: If your heart stops in a Wilderness area or if you have serious physical issues, you’d best hike with enough people who can sustain your life until help arrives, know about your medical issues, and are trained in CPR and Wilderness First Aid. If CPR is required, a small group cannot sustain CPR compressions for very long without further assitance. It is simply too exhausting
Consider the access issues: We were 1 mile up a rocky trail and the only way for EMS to reach us was on foot. When EMS arrived, it was clear that they had run up to the incident scene. Don’t assume that you’ll be picked up by a helicopter in the backcountry.
While the outcome of this incident was tragic, I was genuinely moved by the selfless efforts of the people who tried to keep this man alive until emergency services arrived. I think that says something about hikers and the kinship we feel with each other. I’ve met many many people who have helped me or others in the backcountry, just because it’s the right thing to do. Thank you.