May 15, 1999
The following dispatch is from the Everest Extreme Expedition (E-3), a team of about a dozen doctors from the Yale Medical School, who have set up a medical tent at Everest Base Camp to monitor the health of climbers, provide advanced medical support, and conduct research on high altitude physiology. Members of the E-3 expedition are monitoring the climbers vital signs with biopaks and have established the first-ever Telemedicine clinic, using telecommunications to connect the harsh environment of Everest with Yale Medical School, a leading medical and research institution.
The afternoon of May 14th turned out to be extremely busy. Just as the E-3 team began its daily medical rounds with Yale University, our team of doctors were asked to respond to an emergency in a nearby climbing camp. A climber had just returned from two nights at Camp IV, an elevation of 26,000 feet (7,930 meters) above sea level, and was reported to have severe difficulty breathing.
Dr. Jennifer Grin, Dr. Javier Davila, and Dr. Ken Kamler responded, evaluated the patient, and determined the patient was in acute respiratory distress. The patient was immediately transported to the E-3 Base Camp medical clinic in order to receive appropriate emergency care. While the telemedicine team at Yale University observed, and provided expert guidance, the E-3 team went to work stabilizing the patient. Intravenous solutions were warmed in bowls of warm water prior to administration. Dr. Kamler assessed the patients lungs and determined that the patient did not have pulmonary edema, but instead suffered from bilateral pneumonia. Dr. Chris Macedonia confirmed this diagnosis using 3-D Doppler ultrasound.
Dr. Jennifer Grin administered oxygen while Dr. Davila started an I.V. and administered intravenous antibiotics. The E-3 team was able to rapidly determine the presence of gram positive bacteria utilizing the OLYMPUS Digital Microscope stationed at Everest Base Camp. At the same time Jennifer Kreshak performed a blood chemistry analysis using the portable i-STAT machine. Within 30 minutes the patient was stabilized, and an hour later was breathing easily and asking for chocolate. Dr. Chris Macedonia stayed with the patient throughout the night. Early this morning he was discharged from the E-3 clinic, happily walking around Base Camp and profusely thanking the E-3 team and the consulting doctors at the Yale School of Medicine.
This morning the E-3 team awoke to a clear sky for the first time in many days. By mid morning a large number of climbers could be seen returning down the Khumbu Icefall from camps higher on the mountain. High winds and new snow at Camp II had destroyed some tents, and it was extremely windy and cold for several days. Higher on the mountain, conditions are reported to have been very windy, making for a limited number of successful summit attempts. One returning climber appeared at the E-3 clinic today seeking treatment for snowblindness from Dr. Jennifer Grin. Telecommunications expert Jim Bruton conducted a live two-way audiovisual test with OLYMPUS headquarters in Long Island, New York, USA, in preparation for the live telemedicine and education programs being coordinated by Claudia Biondi. Portions of the program will be streamed live to a number of leading educational institutions and will also be made available on the Internet.
Medical testing continues as members of the E-3 team continue their scientific investigation into the circulatory response of the human body to hypoxia. The weather at Everest is mysteriousclouds swirl around our camp and snow falls periodically interspersed with bright sunshine. With all the activity high on the mountain, the E-3 team anticipates a number of patients among the climbers returning to Base Camp.
Scott Hamilton, E-3 Expedition Leader
Follow the Yale Medical Schools Everest Extreme Expedition at: www.everestextreme99.org