Traffic is a B—-!

In the last couple of days over 200 people summitted the highest mountain in the world. Elaine Yu wrote about it in Wilderness Medicine Magazine, where many of the details from this post were first reported yesterday. That volume of climbers heading up and down the same fixed route means a bit of a traffic jam, only it’s not L.A., and it’s not just gas and patience that are running low. It’s oxygen and thermoregulation (heat loss) that are at risk at such extreme altitude.

Source: Outside Online September 12, 2012

Baby, it’s cold outside

As a result, in addition to summits, this week has also brought injury, illness and four fatalities. 2016 Everest ER Doctors Tatiana Havryliuk (New York) and Yogesh Subedi (Nepal) have seen a bump in business over the last 10 days, and are expecting more as climbers continue to summit and descend. Two of the fatalities on the mountain occurred on descent, after summiting. Everest ER, founded in 2003 by Dr. Luanne Freer, provides quality high-altitude-savy medical care to the climbing community, thereby subsidizing/providing free healthcare for the Sherpa community in the Khumbu region. True its mission, the majority of patients coming through the Everest ER are Nepali climbers and support staff.

This season the Everest ER has treated over 300 patients which is customary for spring climbing season. In the last few days there have been helicopter rescues directly from Camp 2 (6,400 m or 21,000 ft) for severe altitude illness. “There have been a few very cold and crowded summit days where people were definitely exposed to the elements for hours while waiting in lines,” says Dr. Havryliuk. Dr. Subedi reports “By radio traffic we know some of them are suffering from altitude illness and exhaustion. Of course the longer climbers wait around (including Sherpas) the more likely they are to get cold, run out of O2 and thus be at increased risk of frostbite and altitude illness. The first summit window was rather smooth sailing, but because of crowds the second window we are seeing more sick patients.”

Still to come is the much anticipated summit without oxygen from the Tibet side by Adrian Ballinger of Alpenglow and National Geographic photographer Cory Richards. They are live tweeting and snapchatting the adventure.

Frostbite cases, not surprisingly, were on the rise in the last week. Over 15 cases seen at Everest ER, some severe. Everest ER shared the clinical images below with Wilderness Medicine Magazine.  The key part is understanding that superficial frostbite (1st and 2nd degree) means minimal anticipated tissue loss whereas deep (3rd and 4th degree) corresponds ultimately to more anticipated tissue loss. The WMS Practice Guidelines for Prevention and Treatment of Frostbite is an easy to use source for classifying, prognosticating and managing frostbite in austere settings.

2nd and 3rd degree frostbite

frostbite treatment in Everest ER

Dressing frostbitten fingers at Basecamp

Third-degree frostbite (deep)

Mix 2nd and 3rd degree frostbite

The patient in photo number one descended for further care.

Huge congratulations to the summitteers on their achievements; bravo to the Sherpa community for persevering after two devastating seasons, and namaste to all the climbers still on the mountain, the support crews along the way and the literal lifesavers at the Everest ER at the base of this magical place that magnetically attracts climbers and trekkers from across the globe.

Mt. Everest (8.848 meters or 29,029 feet). The world’s highest mountain as seen from Kalapatthar. Namaste