Accident Reports

Appalachia, June 2005

Hypothermia in July
On July 5, 2004, Nelson C., 59, was hiking with his son, Darren, up the Great Gulf headwall when, at around 3:30 p.m., he began to shiver on a rainy day. Darren called his mother, telling her that they planned to return to their campsite near Spaulding Lake. He called her again around 4:45 p.m. to tell her that his father continued to shiver and had fallen on his way back to the campsite. She then contacted the Mount Washington Observatory, which in turn contacted Fish and Game. At 6:30 p.m., Mike Pelchat and Diane Holmes, from the Mount Washington State Park, started down to Spaulding Lake, arriving there at 8:10 p.m. They evaluated Nelson's condition, and found that he was lying in a warm sleeping bag, with dry clothes, and that they had adequate food and water. It was mutually agreed that the hikers would spend the night in their tent and hike out, unaided, the next morning. They left their campsite around 3:30 p.m. the following day and hiked out, reporting that they were in good health.

Comment: This incident illustrates a fundamental rule of safe hiking on Mount Washington: hypothermia can occur there at any time of the year, so be prepared. I am assuming hypothermia not only because of the shivering but because of the incident of falling. Hypothermia leads to loss of coordination, stumbling, and slurred speech. Since there was no rescue, the hikers were not interviewed by Fish and Game. Rather than speculate at what may have caused the hypothermia, I will briefly discuss some of the factors that can lead to its development.

Weather: The weather that day was normal by Mount Washington standards: a high of 53 degrees, winds of around 27 mph, and 0.15 inches of precipitation. Conditions were certainly milder in the Great Gulf. Nevertheless, the combination of moderately low temperatures, wind, and, above all, precipitation, can lead to hypothermia, especially if a hiker is not equipped with enough warm clothing. The authors of Mountaineering: The Freedom of the Hills (The Mountaineers, 1997) write: "A drizzly day with the temperature around 50 degrees Fahrenheit and a strong breeze is a more typical setting for hypothermia than an obvious risk situation, such as exposure to a minus-30-degree cold snap at the ice cliffs."

Fitness: Fitness alone does not, in the presence of sufficiently foul weather, prevent hypothermia. Its absence, however, greatly diminishes the body's ability to respond to such weather, thereby making a hiker more vulnerable to hypothermia. Body temperature is the result of the balance between heat production and heat loss, and fitness ultimately determines how much heat a body can produce (how much exertion a person can make) and for how long.

Clothing: Scandinavians say there is no such thing as bad weather, only inappropriate clothing. And they do mean "inappropriate" rather than "insufficient." Cotton jeans, sweatshirts, and sweatpants are particularly bad; cotton will happily absorb any moisture (from precipitation or from sweat) and hold it. The resulting wet clothing close to the skin is a major factor in the onset of hypothermia, which leads to the hikers' warning: "cotton kills." Wool, silk, and the large number of synthetic fibers currently available are all far safer. A waterproof covering will help keep precipitation off, but it must be breathable; otherwise, sweat will have exactly the same effect.

Food and drink: Dehydration and lack of food both contribute to the development of hypothermia, since the body needs fuel to produce energy, and water to facilitate the utilization of the food. In addition, alcohol, by dilating the skin blood vessels, produces the illusion of warmth but, alas, not the reality. The dilated skin vessels accelerate the loss of heat. In spite of all the pictures of St. Bernard dogs with their brandy flasks rescuing lost travelers, alcohol can kill in cold weather.

Miscellaneous Slips and Falls
There were twenty-one incidents of injured hikers needing help. Surprisingly, not a single accident occurred at the traditional scenic spots (Arethusa Falls, Sabbaday Falls, Artist's Bluff, etc.). The two partial self-rescues are particularly noteworthy.

On June 26, 2004, Celine F., 45, left Greenleaf Hut, where she and four companions had spent the night, to do a traverse of the Franconia Ridge. Around 10 a.m. she injured her ankle near the summit of Mount Lincoln. Her companions carried her piggy-back style back to Lafayette and down to Greenleaf Hut, where the staff called for assistance by radio. She was carried out and taken to Littleton Regional Hospital, where she was treated.

Comment: Self-rescue, when feasible, is far preferable to waiting for a rescue party. Thanks to her companions, Celine was back in the comfort of the hut long before a rescue team could have been assembled and dispatched. The trail from the summit of Lincoln to the hut is about two miles long, and rocky the whole way, so the carry was a challenge. Her companions should be credited with doing the right thing and being self-reliant under difficult circumstances.

On September 1, 2004, Lauren P., 21, was hiking with five other members of the Dartmouth Outing Club (DOC) when, at about 4:15 p.m., she twisted her right ankle and heard a loud crack or pop. The group contacted the DOC in Dartmouth, telling them of the accident and saying that they planned to attempt to reach the hut on their own but might need help getting to the trailhead. Lauren was able to put minimal weight on the foot but unable to walk. Somehow her companions managed to get her down to the hut by 8:30 p.m., having covered roughly a mile of very steep and rocky terrain in a bit over four hours. A rescue had been initiated shortly after the original phone call, and by 9:30 p.m., rescue personnel started arriving at the hut. By 9:50 they started the carryout, and reached an ATV that had gone partway up the trail at a little before 1 a.m.

Comment: The Twinway from the hut to the summit of South Twin is one of the steepest and roughest trail segments in the White Mountains. When I go down it I curse my stiff joints; I can imagine how difficult the descent of an injured hiker must have been, both for her and her companions. The rescuers must have been extremely grateful that they did not need to carry the victim down that trail in a litter.

What is the value of a partial self-rescue? After all, rescuers still have to respond; what difference does a mile more or a mile less make? In fact, it makes a big difference. Carrying a litter on the rough trails of the Whites is very hard work, with progress often measured one step at a time. The self-rescue on Franconia Ridge halved the distance rescuers had to carry the litter, clearly a significant reduction of effort. It is not just distance but the nature of the terrain that must be taken into account.

I also believe that a partial self-rescue is psychologically valuable, because it is clear to the victim and to the companions that progress is being made toward the goal of reaching safety, which many people find preferable to waiting for rescuers to arrive.

--Mohamed Ellozy, Accidents Editor