When a 911 call is made for an individual experiencing weakness, shortness of breath, nausea and chest pain while hiking on Mount Monadnock, there is no time to waste.
“It’s like running an uphill race on steep and uncertain terrain, yet feeling sick every second because you know if you’re a little slower than you should be the patient may die,” said Dave Targan, chief mountain patrol ranger and advanced EMT for the New Hampshire Division of Parks.
Targan said, in most scenarios, if a patient arrests while on the trail, there is little chance for survival. Even a 20 to 50 minute delay can be too long for CPR to be effective. Mount Monadnock has seen fatalities, which fall in with the norm for heart attacks in the backcountry.
In cardiac arrest cases, crews are going all out, fueled by the adrenaline of knowing someone is on the mountain whose life is on the line.
“You’re out of breath the entire way, heart pounding, just running up as fast as you can,” Targan said. “At the same time you feel pretty nervous to the point of feeling sick – because even though you’re at 99 percent of your cardiorespiratory capacity, you know that someone’s life is at stake.”
Crews have successfully revived three hikers who experienced cardiac arrest on the mountain – once this year and twice in previous years. That may be the most successful amount of AED deployment in the backcountry of anywhere else in the country, Targan said.
The small portable device known as an AED transmits a shock to the heart to restore a regular rhythm during a cardiac arrest incident.
“The difference is that we at Monadnock have so many visitors – many first-time hikers, some of whom are unaware of preexisting cardiac issues – that it makes sense to elevate the standard of care above that for other wilderness areas because, simply stated, we can,” Targan said.
Huge swaths of wilderness in the Sierras of the Tetons can’t support enough trained rescuers to respond within minutes to a patient in critical need, he said. Those backcountry rangers often don’t even carry life support equipment because it could take hours to get to a patient. At that point it would be too late.
“Our park and its mountain is contained enough, however, that we usually arrive on scene in under an hour, and sometimes within minutes,” Targan said.
James Suozzi, emergency care associate medical director at Cheshire Medical Center/ Dartmouth-Hitchcock Keene, said while Mount Monadnock is still the backcountry, the mountain isn’t secluded like some areas of the White Mountains and has a lot of access points, which makes rescues more viable. The area does have notoriously bad cell reception though, he said, which can ping GPS coordinates incorrectly and hinder response times.
Brian Bissell, who lives in Massachusetts, is one of the three hikers who was revived in the backcountry late last summer after he went into cardiac arrest while hiking with his daughter, Sam.
About 30 or 40 minutes into the walk, Brian said, he noticed his first symptoms.
“It wasn’t like a heart attack on TV,” Bissell said. “There were no chest pains. I thought I was dehydrated.”
But Sam said she knew something else was up.
“He kept falling down and speaking gibberish,” Sam said, adding that not long after she flagged down two hikers who happened to be registered nurses.
Brian said at that time he remembers feeling drunk, and being unable to walk. He remembers asking for chips and Gatorade, he remembers medical personnel running up the mountain with a backpack of medical supplies and he remembers meeting the crew that was carrying a stretcher.
Then it goes dark.
Later, he learned that a defibrillator was used to restart his heart.
“I was conscious for the descent. It was difficult to focus my eyes, but I was aware of the green forest canopy, and a continuous series of faces who kept looking into mine, encouraging me to stay awake and keep talking,” Brian said.
At the bottom a medical helicopter and crew were waiting, which transported him to Baystate Medical Center, where a stent was put in his heart.
Brian said he has been passing recovery milestones, and said his cardiologist recently told him that he was “crushing rehab” and that he will likely make a 100 percent recovery.
Sam said rescue crews were able to give her dad a second chance at life.
“It just didn’t look like something anyone could survive,” Sam said. “I thought ‘This is it, I’m going to lose him’.”
She said the rescue was a result of quick response time and a knowledgeable medical personnel.
“I’m still amazed [by the rescue team],” Sam said. “My dad isn’t the only person who they’ve helped. These people have made careers out of helping other people, and I just can’t thank them enough.”
Brian says the experience has changed his life.
“The experience underscores for me how completely we depend on each other,” Bissell said. “It really inspires me to look for ways to be useful.”