Hordes and Helicopters on Mt. Monadnock

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MonadnockVol

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On Sunday (10/13/08), Mount Monadnock was a zoo. The combination of the holiday weekend, fall foliage near peak, and beautiful weather brought people out in droves. One of the rangers told me that he thought the number of visitors was the highest that the mountain had seen in the last ten years. The two mile drive from route 124 to the park tollbooth took me more than 40 minutes because of the long line of vehicles waiting for admission. Eventually all the parking spaces at all six trailheads were full.

Most of the teeming hordes were polite, friendly, knowledgeable hikers out to enjoy a day in nature (along with thousands of fellow human beings). That being said, the job of the rangers and volunteers (such as me) was made a lot harder by a small but vocal minority who complained and complained. They complained about the lines to get in. They complained about the $4 entrance fee (the park receives no funding from the state, so if you want there to be a park instead of a condo development, don’t evade the fee: rejoice in the preservation of nature). They complained about not being able to bring in their dogs; they complained about not being allowed to go off trail, and they complained about a few other things that I’ll get to in a moment. I’ll repeat what I said earlier: these hikers are the minority, but their sense of entitlement is as big as all outdoors.

So on Sunday I started up the White Dot trail. Just above Falcon Spring (where the Dot starts to get steep), I heard “Hey Ranger Guy” and had my first call of the day. A young man from Boston had gone out too hard and was feeling dizzy and nauseous. He was sitting when I got there but shortly afterwards he felt too dizzy to sit and we lay him down on the rock. Soon, I was joined by another ranger and we were doing a medical history and the other stuff that we do when the young man sat up, said he felt better and expressed his intention to continue up the mountain. We urged him to reconsider – he had told us a few minutes earlier that he had a history of fainting – and pointed out that if he fainted on a steep slope the consequences could be severe, even fatal, and that our resources for dealing with an emergency were stretched thin. In the end he continued up and we never heard from him again, so I guess he was all right.

Later I was sitting on the summit when headquarters radioed up that they had received a cell phone call from someone injured on the Pumpelly trail. (If you’re planning on getting injured on the mountain make sure your service is Verizon. I have Sprint and can never get a signal.) I was first on the scene and found a woman a hundred yards or so below the summit. She was extremely fit – she had just finished a week-long cycling vacation – but perhaps she hadn’t been stretching enough because she had been hopping from rock-to-rock when one of the muscles in her calf “popped.” Once I radioed her precise location people converged and soon we had three rangers and me there. That’s when another one of those hikers I was talking about earlier popped up. Without asking anyone, he announced that he was a pharmacist and an EMT and immediately starting manipulating the patient’s leg and asking her where it hurt. That’s when one of the rangers – who is an EMT – asked him if he was licensed in New Hampshire. “I’m on the national registry of EMT’s” he replied. “If you’re not licensed in New Hampshire, step away from the patient” said the ranger. “But thank you, for your efforts” said the other.

Maybe you are thinking that the first ranger’s response was a little brusque, but consider this: two of the rangers on the scene were wilderness EMT’s and even teach this stuff. One was the chief medical officer on an Everest expedition. They deal with over 100 leg injuries a year and have more than 20 years combined experience on the mountain. In short they know their stuff. They were standing next to the patient conferring about the best course of action when this guy with no bona fides other than his say so doesn’t consult with anyone but immediately starts handling a patient. I have seen this before: it is usually a guy, and often one who doesn’t know what he doesn’t know, yet he feels a need to take charge. I suspect it is a form of testosterone poisoning because in eight years of volunteering on the mountain I have never seen a woman do this.

While this was happening several more things were occurring. The Old Toll Road trailhead radioed that they had received reports of a woman with a sprained ankle who was descending on the OTR under her own power and with the help of her party. The park manager dispatched a ranger with material to stabilize her leg and a pair of crutches to her location. At the same time HQ received a cell phone call that another young woman had sprained her ankle on the Red Spot Trail and was unable to move under her own power. A volunteer was dispatched to her location. And still at the same time two parents approached our party with the news that they hadn’t seen their child since the beginning of their hike several hours ago. And – at roughly the same time – two lost children (different from the one I just mentioned) wandered into Park HQ. And you wonder why the ranger was feeling a little testy?

In the end it was decided by Dave, the head mountain patrol ranger, to evacuate the woman by helicopter. A potential landing zone was found and the GPS coordinates radioed to Park HQ. Dartmouth-Hitchcock dispatched one of their choppers and Jaffrey dispatched one of their ambulances to the base of the mountain. And this is where some more of “those hikers” re-enter the story.

Landing a helicopter on a mountainside is an extremely dangerous thing to do. But people have watched too many MASH episodes and don’t take the danger seriously. They tend to get extremely put out if they are inconvenienced in any way. Maybe if they knew that it was for their own protection, they wouldn’t be so obnoxious. Last year, eight helicopters tipped over when trying to land. If that would to occur on the mountain, the blades of the rotor would disintegrate when they hit the rock, sending high velocity metal shrapnel and shards of rock in all directions. This particular landing zone was just below the summit which was occupied by over one hundred people. So it is standard procedure to block off the trails around the landing zone to keep the area clear. Well… you wouldn’t believe the outrage. My job was to stop the people who were coming up the trail. I stopped one couple only to catch them a few minutes later trying to sneak by me. Another volunteer had the job to stopping people descending from the summit. He wasn’t wearing a shirt and I’ll admit that he didn’t look that official (we joked later that we should have “New Hampshire Parks” tattooed on his chest) but he met with immediate resistance. One woman complained, “You can’t stop us. I’m cold and my kids are cold. We paid our money [$4 each] and if you’re going to stop us, I want my money back.”

When the helicopter tried to land I was with the patient. We were crouched behind a rock. The LZ was a little uneven. One skid was down and when the pilot eased back on the throttle, I saw the copter start to tip sideways. “Oh sh*t” I thought, “Here we go.” But the pilot powered back up and stabilized the bird. In the end, he dropped off a paramedic and took off. The plan was for the paramedic to wait with the patient and the helicopter would return, and balance on one skid – under power – while the patient was loaded. We started to move the patient to the landing zone with a ranger on one side of her and me on the other when we had to stop for crowd control. The people – including the angry woman – had pushed past the volunteer and were starting to march through the landing zone. But one of the rangers – remember the “testy” ranger from earlier in this account? – bellowed at them, and they retreated with sullen looks.

On the second try the helicopter successfully removed the paramedic and the patient. The trails were reopened (and several hikers, clearly embarrassed by the woman’s behavior, made a point of thanking us for our efforts), the lost kid was found waiting by his parent’s car, the woman on the Old Toll Road with the sprained ankle made it out under her own power, and the woman with the sprained ankle on the Red Spot trail was carried to the regular landing zone where the Dartmouth-Hitchcock helicopter evacuated her after they dropped off the first patient at the ambulance. But even then we weren’t done with “those hikers.” Those of us who were involved on this first helicopter evacuation were sitting high on the summit cone watching the second. We noticed that there were two hikers on the Smith Connecting Trail who, when they saw the helicopter landing, started bushwhacking: running directly at the helicopter. We radioed down to the rangers waiting with the second patient but there was no way to stop them. They were within 20 feet of the rear rotors when they finally stopped spinning.

I volunteer because I see how hard the rangers work and how much good they accomplish with so little funding and so few people. My plea to my fellow hikers is for us not to make their job harder. Monadnock – with over 100,000 summit hikers every year is a special case. If you haven’t been there on a busy weekend you probably can’t understand: Mt. Washington or Marcy Dam on a Sunday don’t come close. So things that are allowable elsewhere – like dogs & bushwhacking – would just kill this mountain. It’s great having a mountain with some much beauty and challenge so close to Boston, Hartford, etc. Let’s keep it that way for future generations.

- Monadnock Volunteer (aka Steve)
 
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Whitten

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I for one, thank you and all the other rangers for your efforts. I can only imagine the struggles and crap you have to put up with! I appreciate the time, effort and skill you all have - and am not shocked (but embarrassed) by the way others respond to situations such as the ones you were describing. Keep up the phenomenal work - some of us greatly appreciate it and the beauty of nature...(Without 'those hikers') ;)
 

poison ivy

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I very much appreciated reading your report... and hearing about some of the stuff that rangers have to deal with during a busy day.

Great effort on what sounds like an absolutely crazy day!

- Ivy
 

Christa

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Thank you very much for this account. It's always good to see things from another perspective. We were up on Pack Monadnock on Sunday, which was equally as crazy and wondered exactly how bad things were over on the big mountain.

It's a shame how just a few people can scar the experience for others.

Thank you very much for all of your efforts over there. They are much appreciated, even if it doesn't seem like it sometimes.
 

MonadnockVol

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Clarification

Well thanks for your thanks. I hasten to make clear one thing, however: I'm a volunteer not a paid ranger. I don't want anyone to think I'm posting as anything other than a private citizen.... certainly my views are only my own and not those of the Park, the State of NH, etc., etc.

- Steve
 

Quietman

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Thanks for the report! Monadnock is a wonderful mountain but can be a zoo on nice weekends. I can't even imagine the patience required to deal "those hikers" when they invade the mountain in large numbers. You can really tell the difference between the tourists and the hikers, and both groups should be thankful for what you and the other volunteers do. Thanks to all volunteers!!

I was on Mt. Race in Mass on Saturday and was amazed at how few people we saw on a beautiful day.
 

SAR-EMT40

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MonadnockVol said:
Without asking anyone, he announced that he was a pharmacist and an EMT and immediately starting manipulating the patient’s leg and asking her where it hurt. That’s when one of the rangers – who is an EMT – asked him if he was licensed in New Hampshire. “I’m on the national registry of EMT’s” he replied. “If you’re not licensed in New Hampshire, step away from the patient” said the ranger. “But thank you, for your efforts” said the other.

- Monadnock Volunteer (aka Steve)


Personally my belief is that both could have handled it better FWIW. I suspect that many wouldn’t like an EMT to appear wishy-washy or tentative about care or what they should do when coming in contact with a patient or ask non-medical personnel about a course of treatment. They usually want someone who appears to know what they are doing and takes charge when the situation calls for it. On the other hand, when someone walks in to a situation and there are 10 or 20 people milling around it is common sense to quickly assess the patient to identify any life threats. If there are no immediate life threats, before yanking limbs around, ask him/her if anyone is in charge. If someone claims to be in charge then tell them your credentials and tell them you are at their service after finding out their credentials. If he was an out of state EMT and/or a National Registry EMT it would be foolish to not make him a third or fourth, just in case if he wouldn’t’ mind filling that role. You can be clear that you and your partner will handle patient care. They can scribe or possibly help with patient packaging and transport. That keeps the lines of communications open and allows you to not have him touch your patient so no rules are broken. If he sees something that is remarkably stupid, or might have a better idea on how to do something he has a stake in the process and will likely tell you. Kicking him in the gonads and lighting him on fire in front of everybody is probably counterproductive. It might look cool and sound impressive but it is probably not in the patient’s best interest. And bottom line that is what you are there to serve.

I have practiced my EMT skills in NH several times but in NH they are first aid skills. More than once I have been first on the scene on the street and in the woods. Fortunately the EMT’s that have arrived on the scenes that I have been at have treated me the way I would have treated them. They listened to my report which gave them a sense that I knew what I was doing (I hope) as well as the signs and symptoms of the patient and the patient’s current status and how they were trending. At that point they had usually asked me what I wanted to do and that is the point I usually pass over control when I find out their credentials. It is after all, their state, and they are the ones certified. I still help and we continue to discuss patient care in transit and this has been my experience several times. My assistance has been appreciated more than once not only by the patient but by the EMT crews I have seen.

As far as clueless people at emergency scenes, nope never saw one, that never happens. :D Everyone at all emergency scenes are helpful and cooperative, always. :p

As a sidebar. Almost every state (last count was 48 IIRC) in the union uses the National registry tests as at least the initial qualification test for entry level EMT-Basics. I don’t know what it is for higher certifications. The NR certifies First responders’, EMT- Basics, EMT-Intermediates’, and EMT-Paramedics. No, that does not mean they are certified to practice in that state necessarily but it means they are certainly a resource that might be available for use since they have the same training as you and possibly more training and/or more experience is possible. It should also be noted that there is no such thing as a "Wilderness EMT" or "Wilderness First responder" in NH. It is taught as a class. It is offered as an upgrade in knowledge only. There is a state protocol being circulated but the certification does not exist as a state certification having a agreed upon protocol.

Cool report. Thanks for it and the things you do on the mountain Steve. It is appreciated.

Just my $.02,
Keith
 
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TCD

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I've only been up Monadnock once, MANY years ago, but I remember it has a nice, surprisingly pointy little rock summit. Having watched the helicopter evac in the Adirondacks yesterday, I'm a little surprised that the helicopters available to Monadnock don't have a cable and winch that could pick a litter, as opposed to landing, with all the attendant risks.

Wild report. You had your hands full with a crowd that size.

Tom
 

bikehikeskifish

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$4 per person, a car ride, and a summit-at-all-costs mentality for Monadnock? I thought that stuff only happened on $65,000 two-month Everest Expeditions.

;)

GOOD JOB, Steve!

Tim
 

DougPaul

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bikehikeskifish said:
summit-at-all-costs mentality for Monadnock? I thought that stuff only happened on $65,000 two-month Everest Expeditions.
Nope. Happens anywhere there is a goal-obsessed human. Monadnock, the Whites, your local molehill, anyplace...

Doug
 

Solitary

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Wow

Amazing TR, thanks for sharing it with us. I know there have been many times that I've seen Monadnock so crowded that sitting on Bald Rock I could tell exactly where the White Dot and White Cross trails were because there was a continuous line of people from base to summit.

Keep up the good work.
 

RoySwkr

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SAR-EMT40 said:
when someone walks in to a situation and there are 10 or 20 people milling around it is common sense to quickly assess the patient to identify any life threats. If there are no immediate life threats, before yanking limbs around, ask him/her if anyone is in charge. If someone claims to be in charge then tell them your credentials and tell them you are at their service after finding out their credentials.
We were told in EMT class that if appearing on a situation without prior call, you should state your credentials and ask _the patient_ before beginning treatment - you act without authorization only if the patient is clearly in immediate danger. Of course if there are rangers on the scene it is wise to ask them also. I don't consider this being wishy-washy, perchance the patient is an orthopedic surgeon and is just waiting for their partner who is also one to show up and begin treatment.
 

SAR-EMT40

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We were told in EMT class that if appearing on a situation without prior call, you should state your credentials and ask _the patient_ before beginning treatment - you act without authorization only if the patient is clearly in immediate danger. Of course if there are rangers on the scene it is wise to ask them also. I don't consider this being wishy-washy, perchance the patient is an orthopedic surgeon and is just waiting for their partner who is also one to show up and begin treatment.

I hope that I was clear that assessing life threats begins with looking at the patient as you approach. You are only assessing the ABC’s at that point, just life threats. Airway, breathing and circulation/heavy bleeding. Rarely is there ever a need to put your hands on a patient to assess life threats with a conscious patient. Also every competent, of age patient has the right to refuse your help. So you must first get their permission to treat if they are conscious. Wishy washy would be looking at a spurting wound and the patient looks at you for help and you stand back asking for a meeting with others on scene and wait for a majority decision to decide what to do. Like I said if there were no life threats I would ask the patient if someone was in charge and what the patients name was and what happened to them. That isn’t an accident that I ask the patient. That helps me establish his/her level of consciousness. It would tell me that they know what happened before and after the accident. Again, I still haven’t had to touch the patient. At that point I would feel it reasonable to not touch the patient and search out those that should be in the know. Almost any time you find someone with a broken or injured limb you will find that the person, if capable, will self splint and guard the injury themselves. It is not ideal but in a wilderness setting it will do until something better is devised. You can easily assess the color of fingertips, usually without touching the patient. The feet should have been exposed or exposed and covered if it is a lower limb to assess circulation/sensation/motion. The only touching here would be light touching at the farthest part of the limb. It should be clear that if someone has had contact with the patient that knows what they are doing the injury site should have been exposed already and the feet, if the injury was to the lower limbs, exposed to assess CMS in the toes. All of this should be pretty obvious and would indicate that someone that knew what they were doing was already probably involved with patient care. If I saw someone complaining of knee pain and the knee wasn’t/hadn’t been exposed and his/her shoe didn’t appear to be removed or at least removed once I would have serious doubts about the quality of the care.

Keith
 
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Steve-o

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Nice job Steve!

I was up there on this day. ( not sure why )
A zoo is an understatement! I estimate I passed around 1500-2000 people and 1 dog. And that IS a kind estimate. I even lost my daughter on the summit, while shooting a one minute video. I eventually found her standing about 25 feet away from me.

I figured there would be a few problems. In fact I'm surprised there was'nt more. Saw many folks heading up around 4pm with nothing more than a camera.
 

brianW

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Enjoyed the post Steve. Before moving south I could actually see the horde from my back porch and usally just avoided the place on those days. Working near a helicpoter an be a bit intimidating and at the same time very thrilling. Worked many times with them in my time in the Army and as an EMT.
 

Klutz

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Wow, better you than me. :eek: No, seriously, I'm glad that there are people like you out there helping the "hikers" that need assistance. But dealing with some of them, man I don't think I'd have the patience.
 

Tony

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Patience is a virtue

Wow, better you than me. :eek: No, seriously, I'm glad that there are people like you out there helping the "hikers" that need assistance. But dealing with some of them, man I don't think I'd have the patience.

I agree with Klutz. I've overheard some of they interactions between "hikers" and the rangers at Monadnock. I'm not saying they're perfect but IMHO, they do a great job nearly all the time, put up with A LOT, and are vastly under-appreciated.
 
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