Medical Problem Hoist

March 12, 2014
San Jacinto Mountains

Written by Helene Lohr

Surprisingly enough, it isn't a dark and stormy night. The sun shines warmly on my back, a light breeze whispers through the pines. Little chickadees sing of spring. All in all, its a beautiful early spring afternoon. In the middle of this Disney day, my phone vibrates against my leg. Its RMRU member, Lee calling. "Want a helicopter ride?" is his greeting. "There's a hiker, possibly in full arrest, in the High Country. Star-9 needs a team ready to go immediately." My prep has an extra edge to it. I pull on my uniform; quickly check my backpack for the essentials, head out the door, and jump into Lee's waiting truck. We're on our way in a handful of minutes towards Keenwild helipad. On the way, we get the news that Donny and Les will be backing us up as the ground team hiking into the high country, with the rest of the team on standby to head in if we need assistance.

The A-Star helicopter touches down as we arrive. Technical Flight Officer Eric Hannum leans out and waves us in. He briefs us as Pilot Mike Calhoun speeds us towards the High Country. Our subject's name is Donna. She is a 70 year old woman, blond hair, blue eyes, white jacket, and black pants. She was hiking with her husband near Laws Junction when she experienced "heart attack symptoms. Her husband hiked several miles back to Notch 5 in the State Park before he could call for help. Eric relates that the husband reported a "large opening" in the trees nearby that he thinks should be perfect for a helicopter landing. Well, we will soon see if it really is a big spot. Star-9 makes a series of wide circles above the trail near Laws for what seems like eternity, but is in reality only a few minutes. We peer down, trying to somehow pick up any slight movement, any change in color. Where is she? It doesn't help that our subject is wearing black and white against a background of patchy, half-melted snow, blackened remains of trees left over from the Mountain fire, and dark mountain soil.

Rescuers Searching

Lee and TFO Eric Searching
Photo by Helene Lohr.

As the minutes tick by, I start to doubt the location information we've been given. The husband had to have hiked out along the Hidden Divide trail to get back to Notch 5 from Laws. And it could be that they never made it all the way down to the actual junction, especially if they had to go through the burn area to get there. I key my microphone: "Hey guys, why don't we locate the upper end of the Hidden Divide trail and backtrack?" Mike swings the helicopter to the North and we start to scour the steep slope for the remains of the trail. Bingo! Within 2 minutes of changing our strategy, we've located the subject. Even better, she is obviously still responsive and no longer alone. Two other hikers have joined her to help in her time of need.

Unfortunately what seemed like a "large opening" in the tree cover to the husband is far too small and dangerous to land a helicopter. Pilot Mike thinks quickly and flies us back to the closest clearing large enough to land and insert us. Once on the ground, we grab a screamer suit to carry with us. We're pretty sure this will end up being a hoist situation, and we want to be prepared to get our subject safely in the air as soon as possible. The afternoon sun is fading into a warm alpenglow; the evening wind is starting to kick in and the already crisp temperature is starting to drop. We had best get moving before our window of opportunity closes. I don't know if our subject can survive a night out here, and we don't intend to find out. The helicopter flies out to convert to their hoisting setup as we hike at double time down through the brisk mountain air towards our subject's location. Within minutes we see her ahead of us, sitting on a rock flanked by her caretakers. It's a relief to see her responsive and in far better condition than we had expected from the original call-out.

Lee and I quickly introduce ourselves to our subject and her helpers. Our subject, Donna, greets us with a shy sweet smile, bright blue eyes and a friendly, soft spoken voice. Instead of meeting her situation with panic, she is calm, although obviously worried. I begin my medical examination as Lee heads down the trail to search the nearby forest for a safe hoisting location. I notice right away that Donna is trembling; I'm not sure yet if it is due to the cold or to something more serious. I ask her questions to get her talking and to help me assess her mental state. I check her pupillary response, then her vitals. Her pulse is rapid, but not strong. Breathing is somewhat labored and slightly fast. She has recently eaten and had water, already taken aspirin, and reports no history of cardio vascular disease or any other medical conditions or medications. Even as I lead the conversation to what happened, I'm closely watching my subject. I am always assessing her, watching for any clues to her condition, or information that will need to be passed on to the hospital. She is alert and aware of what has happened to her, has a good memory of the situation and can explain it well. She describes hiking down the trail to the clearing, then having lunch with her husband. She had a slight headache and took a nap. She woke to extreme shortness of breath and muscular weakness. She was unable to hike at all, and found it hard to even walk a few feet. They quickly decided that the husband would run for help.

One of the hikers has kindly shared her jacket with Donna. Despite this, she is still shivering. As soon as I've made sure there is no immediate threat to her life, I break open my pack, pulling out a down jacket, a thick wool beanie, and warm wool gloves. Once she is warmer, we will be better able to assess the source of her trembling. Since we are out this far in the wilderness, our best bet is to get her out as quickly as possible. Unless an immediate emergency comes up, our priority is to prep her for transport, take care of her immediate physical needs, and get a pattern of vitals established so we have some trends to hand off to the hospital. Any information we can gather at this stage may play a key role in saving her life if her condition suddenly worsens. Lee arrives back from his scouting trip. "There's a good hoist location just a two-minute walk to the west," he says, his arm pointing down the slightly inclined slope. It's a short and clear walk downhill. It should be manageable if we take it easy. Donna's heart and respiratory rates have slowed down a bit and her breathing seems much less labored.

I glance to the sky. The sun is hanging low. We need to get Donna out of here while we can still easily do so. I'd much rather hoist while we still have light to do so safely. Donna is a real trooper and makes the trek with no complaint. Now time to get her ready for the hoist. Lee holds up the screamer suit for her to put her arms through as I strap her in and join the rings with a locking carabiner, securing her into her "cradle. Lee verbally walks her through the steps of the process. Lee keys his radio: "Star-9, we are ready for hoist."

Subject Hoist

Subject on Hoist
Photo by Helene Lohr.

The helicopter approaches, the rapid beat of its rotor blades echoing up and through the wide ravine. The sudden gale throws up ash from the recent fire, pelting my face with bits of debris. I turn to shelter Donna from the onslaught as Lee reaches out for the rapidly descending hoist hook. The air crew manages to swing the hook right into Lee's hand! I clip Donna into the hook, double check that the system is securely closed, and wave my hand upward and out from my helmet to signal the TFO to lift. The wind from the chopper is brutally cold, and my hands have become painfully stiff from just a couple minutes of exposure. I'm going to need all the dexterity I can manage to clip myself into the hoist, so this could be a problem. I jam my hands deep into my jacket pockets to warm them up. Another minute and I'm gazing up expectantly, positioning myself, reaching for the hoist, clipping in. Suddenly I'm flying straight up. As I reach the helicopter, I walk my hands on the struts to avoid bumping my head. The TFO gives me a nod and a smile and helps me into the seat next to Donna. Our unwieldy packs come up next, spinning in the wild wind currents. It takes far longer for Lee to come up and as the minutes tick by, I start to get worried. Is something wrong? Finally I see Lee's head emerge over the edge of the deck. He looks sick. He has completed the most hoist rescues ever of anyone on the team, but I've never seen him like this. The TFO clears up the mystery: "He spun like a top on the way upI've never seen anything like it!"

There's not enough room in the small cabin for all of us and for the enormous packs, so Lee and the TFO sit perched on the outside of the copter, safely clipped in, but exposed to the bitingly cold wind as we fly towards the desert. As we beeline towards our destination, the scenery is majestic enough to take our breath away: craggy cliffs, the sharp relief of impenetrable ravines, and razor ridge lines flying by almost too quickly to absorb. Donna is fascinated; it's a real joy to see the worry leave her face, replaced by wonder... "What an adventure!" We arrive at the transfer point and pass our subject off to the waiting EMTs. I give them a briefing on her vitals and current condition. Then I shake the hand of her eagerly awaiting husband, give her a big hug, and wish her well.

RMRU Members Involved: Lee Arnson, Donny Goetz, Helene Lohr, and Les Walker.

RSO Aviation: Pilot Mike Calhoun and TFO Eric Hannum.