911 button or Sissy?

[oldranger]

All,

Obviously the term "sissy" was just to attract attention and I started the thread to make everyone think about something we don't want to think about and "know" it won't happen to us.

I'd like to know if a person who has a cardiac arrest due to a heart attack at high elevation, who normally lives at low elevation, is 2 hours away from advanced medical care, has been revived thru CPR and survived? Or what is the longest advanced medical care was delayed and the patient survived.
My understanding is that survival in a high elevation wilderness setting is unlikely and a large group of people is of little comfort unless there is also means of rapid deployment of advanced medical care.

Russ,

Before our next trip you should know that should you go down I will step on your chest 30 times and mark will kiss you on the lips 2x while Tom does the counting! (since I can't count to 30 and mark can't count to 2 ) This is more than my skiing buds will do for me (they say they will slide me to the side of the trail so I won't be in anybody's way then call Kathy when having their after ski beer.)

In all seriousness everybody please pay attention to your health and your body! (Mark that does not mean for you to sit and contemplate your navel! Damn I did it again.)

Mike

[rlown]

If i go down, It'll be a drowning.. my cardio cath came back clean.

I watched my Dad give CPR to a guy who just came out of the south rim of the grand canyon.. He revived, but then died later..

I watched a guy drive his dodge ram into a fence down on our road. Massive coronary.. The fire dept is 2 blocks away.. he was blue.. died.. he smoked a lot..

We're all gonna die. we shouldn't get hung up on it.. Just hope we can go in a place we're happy to be.. For me.. Fishing or attempting to fish a certain lake.

[markskor]

Before our next trip you should know that should you go down I will step on your chest 30 times and Mark will kiss you on the lips 2x while Tom does the counting! (since I can't count to 30 and Mark can't count to 2 )

FYI, I can actually count to 11 if I drop my pants.

In all seriousness everybody please pay attention to your health and your body! (Mark that does not mean for you to sit and contemplate your navel! Damn I did it again.)

Nothing wrong with a little Naval intelligence.

Adding - I believe in the same values as shown on the show TOP Gear: If it breaks and you can fix it there - do so...
If not, just let Mike lie there and head down the trail. I will call Kathy though and let her know - shortly after the trip is over and, and of course, right after the beers.

[rlown]

for cardiac, there's the concept of the "golden hour".. Your SPOT takes 20 mins to send. you're pretty much dead if you're in weather, so there will be no immediate SAR response.. That's where those who you are with get creative and make you take any drugs they may be carrying and keep you in your sleeping bag.

If you're solo.. that was your choice.. so quit whimpering, buck up and face it.

That's why I love it out there.. It's me, or me and my friends, and you get what you get..

Choices are personal.

[BrianF]

Back to the original question about mild but worrying symptoms and pushing 911: not all "heart attacks" involve keeling over and needing CPR so the question is quite valid, especially as it seems that many of us here are over 50. As a carrier of a spot (mostly I do solo trips), I have pondered appropriate use. Given OR's scenario and recent experience I would say hit the button. For anyone with a medical history that would indicate a deeper problem it would be the smart response. For someone like me, who has been lucky in making it this far with no medical problems I would probably just keep going and monitor what happens - not smart but its how I react.

[oldranger]

Brian

The way you say you would react is exactly the way I would have reacted last summer. I must have had pretty significant blockage in that artery last summer, though.

And you are exactly right that not all heart attacks involve cardiac arrest. I actually brought this up because of the the discussion concerning CPR on mavericks First Aid Thread (old age made me think it was on this thread). As you can tell by coments from my "friends" if I were to sprain my finger they would probably ensure that it was fatal let alone something serious. And my philosophy (and understanding of probability) is that the more in the group the more likely some one person will get sick or injured and there goes the trip.

Mike

[rlown]

I actually brought this up because of the the discussion concerning CPR on mavericks First Aid Thread (old age made me think it was on this thread). As you can tell by coments from my "friends" if I were to sprain my finger they would probably ensure that it was fatal let alone something serious. And my philosophy (and understanding of probability) is that the more in the group the more likely some one person will get sick or injured and there goes the trip.

Mike

Don't sprain your finger.. or at least not your casting finger. We need it. Probability of death means nothing w/o a predetermination.. I'm vetted, you're vetted, Mark is, well, of Greek decendance and immune to most stuff. My thought is the more in your group (3) gives you degrees of freedom from most harm. Solo gives you zero.

I'd still be proud to stand on your SPOT device to see if it fires in an emergency.

[gdurkee]

There are options between pushing 911 and just continuing. First is to educate yourself on the early symptoms of the most common ailments and then listen to your body. Also educate yourself on symptoms of mental conditions. Anxiety can mimic heart problems, OR actually be caused by heart problems. Repressed fear creates some strange symptoms. To complicate things, even after you hit the 911, there will be some time before rescue reaches you. Honestly, if you are having an acute heart attack they are not going to get to you in time. If something is mildly suspect, you could also turn around and go back or head to a nearby trailhead (if that trailhead has communication services or people there). As you are retreating you can evaluate the situation and may still have to push the 911, but maybe not. Get out and get checked out be a doctor even if the symptoms go into remission. Retreat is a hard decision to make.

Gotta be really careful with any pain or discomfort involving chest or even upper abdomen. As I've often been told in EMS training, you can't rule out a cardiac event in a male over 30 (yes, that was last year's recommendation -- cocaine use has lowered the age for concern...) years old.It's absolutely true that a bunch of things, anxiety high among them, can imitate heart conditions, but you don't know... . You can't diagnose in the field, it takes blood tests and an EKG. (I'll add, that you can't diagnose most anything serious in the field without some advanced gizmos). In almost all cases, they're flown out.

When someone -- especially a male over 40 -- says to me they've got mild chest pain or abdominal pain, they're most likely outta there. I can call it in to a base hospital, but the decision is almost always to fly them out. I wouldn't recommend hiking out to "evaluate" when more stress on the heart could make it could go very, very badly. The few cases I've seen that might be called "acute" have also turned out well -- serious and almost unquestionably cardiac-related pain have all gotten out in time for definitive treatment and a good outcome. The reason for that is the people reported it quickly enough so we could get them out.

Which is all to say I disagree with the above. On the whole, when people complain about assorted symptoms, they're pretty genuine -- rarely someone trying to get a free ride out; they're authentically concerned about something. It's hard not to get into a 2nd guessing yourself loop -- whatever the symptoms -- but I'm a major fan of getting help. The SPOT and related gizmos have become a pain sometimes, but not in the case of medical issues.

George

[oldranger]

Thanks George!

Mike

[Wandering Daisy]

I do not think the issue is taking people's complaining seriously, but rather if you are out there alone how you determine if what you feel is serious or not. They say in First Aid that the objective observer is often better at knowing something is wrong than you yourself because denial and ego get in your way. There are a continum of symptoms from none to obvious. You are not trying to be macho or get a free ride. You are trying to evaluate your situation, all there by yourself. And often just being by yourself is scary. I know what a panic attack feels like.

It is at lower end of symptom severity that we have trouble making the decision. Everyone need to learn to listen to their body. I have certain quirky symptoms that I know are not serious that if someone were watching me they may be inclined to call 911. It is when I get any symptom, barely discernable or acute, that I have NEVER experienced before that I get worried.

I read the original question as "where is the line when you are out there self-evaluating?" OR also said that once the problem was located, he could look back at subtle symptoms he had had for some time. I think that applies to all of us. We need to pay more attention to subtle symptoms.

In theory "push the button" sounds like the correct answer, but realistically, I do not think it is an easy decision. I am not an "either/or" thinker and can get way emotional if I have had a hard day. Framed as "push buttoon or be sissy" backs me into an emotional corner and if I instead think of all the other options, I can calm down. Maybe guys do not freak out. But I have a fear factor built in me that I need to calmly evaluate if it is panic or a real symptom. Denial is one end - hypochondria the other. Just wanted to share the thought that, for me, knowing I have many options is reassuring. This is a far cry from saying ignore it.