What to monitor in a mountain climber at 24,000 feet and then stream his data to any device on the planet with a one second delay
A climber at 24,000 feet faces many challenges and for most of these he/she is completely unaware of their risks or of their possible outcome.
In order to decrease these risks, one can monitor certain vital signs that will help us make better decisions up there. We have to decide what vital signs are useful to us, we have to be able to read them, and in real time, send them down to base camp or elsewhere in the world where somebody who is trained and is not hypoxic, can help us with the right decisions.
Aviation has faced a similar dilemma, and the cockpit on the plane that flew you to Kathmandu or Lhasa has many instruments that have evolved over time to make aviation safer. Before your pilot takes off, he also has a weather briefing that is updated while in flight, to keep him informed of the big picture.
The situation on the mountain is no different. Until recently, we were climbing with poor weather forecasts, and even today, a climber has few instruments to tell him of his real health status while making a final summit push.
WiCis-Sports is offering a solution which allows the climber to be monitored, no differently than they way one monitors an airplane. Data today can be streamed to base camp or anywhere in the planet where it can be analyzed intelligently.
What can we easily measure today AND stream? Temperature, heart rate, and hemoglobin oxygen saturation (SpO2). The WiCis-Sports App has will also send your exact geo-location (in case you are lost in a blizzard), your altitude, your bearing, and your speed. In other words, you can be in what in aviation is called IMC (instrument meteorological conditions) and still have a chance of being guided down.
Your body temperature is a crucial number to know, but perhaps for reasons that you don't know. Although your body's metabolism slows down with a decreasing temperature, something more important occurs in what is called your oxygen-hemoglobin dissociation curve. The colder you get, the less your hemoglobin likes to release oxygen (left shift) and your cells will become more oxygen starved. You also don't want to get into a situation in which you shiver (that greatly increases your oxygen consumption) further aggravating the problem. So where do you want to be on the mountain? I would say very slightly hypothermic (1 degree below normal?) since this will not give you a major shift to the left on your O2-Hgb dissociation curve, you will decrease your O2 consumption, and you will not shiver. This is simply a conjecture, but it's one that makes sense.
Heart rate is another number to follow, and again for perhaps reasons that you have not thought of. For an anesthesiologist, increased heart rate means two things: 1) decreased coronary perfusion (your heart's vessels have less time to fill since they fill in diastole, the time between each contraction) and 2) increased O2 consumption. So if you are up at 24,000 feet, and your heart rate is speeding at 160, and you either feel a slight pain in your chest or you are totally short of breath, you now understand what is going on - your heart, like your sore thigh muscles, is getting tired with not enough oxygen, and you could end up getting a heart attack or going into an awkward rhythm. All this translates into you slowing down or stopping until your heart rate is slower, its perfusing better, and your O2 consumption is down.
Oxygen saturation would seem to be very important. And it is! But here is the catch. At 24,000 feet, your saturation will probably be below 75%. Most pulse oximeters become wildly inaccurate below 70%. Also, at 70%, you are in the steep part of the O2-Hgb dissociation curve, so the slightest change in your pO2 in your blood will drastically change your saturation. What I am getting at is that if you see a number below 70% - it's probably not accurate, but it does mean that things are not looking good. If you see 70% at base camp (18K), you are probably suffering from HAPE. In short, monitor this number, but if it's low, look at it with a grain of salt...
What else would I like to look at? I think streaming EKG (electrocardiogram) signals may be very useful. We can stream EKG from base camp. But why, you may ask, do I want it from somebody at 24K? I am thinking of babies and SIDS (sudden infant death syndrome). For years we believed babies were passing away because they just stopped breathing. We now know that a certain percentage of them in fact have an arrhythmia that leads to a cardiac arrest, and of course then they stop breathing. For all I know, climbers who get into trouble in the so called "death zone" are in fact developing abnormal cardiac rhythms which then translate into HAPE. In the operating room, a common side-effect of hypoxia is arrhythmias, so I would expect to see the same at altitude. We may be able to have EKG streaming for the 2016 season - and this will provide us with a whole new way of looking at problems at altitude.
In conclusion, because we have not had continuous monitoring at altitude for the above parameters, we are simply guessing as to how one's body is about to tolerate a final summit push. Turning up the oxygen may be a solution, but with the proper monitors, turning AROUND may be another one, since if you develop an abnormal heart rhythm, this may require very different management.
Climb safely - but most importantly - make it down.
In order to decrease these risks, one can monitor certain vital signs that will help us make better decisions up there. We have to decide what vital signs are useful to us, we have to be able to read them, and in real time, send them down to base camp or elsewhere in the world where somebody who is trained and is not hypoxic, can help us with the right decisions.
Aviation has faced a similar dilemma, and the cockpit on the plane that flew you to Kathmandu or Lhasa has many instruments that have evolved over time to make aviation safer. Before your pilot takes off, he also has a weather briefing that is updated while in flight, to keep him informed of the big picture.
The situation on the mountain is no different. Until recently, we were climbing with poor weather forecasts, and even today, a climber has few instruments to tell him of his real health status while making a final summit push.
WiCis-Sports is offering a solution which allows the climber to be monitored, no differently than they way one monitors an airplane. Data today can be streamed to base camp or anywhere in the planet where it can be analyzed intelligently.
What can we easily measure today AND stream? Temperature, heart rate, and hemoglobin oxygen saturation (SpO2). The WiCis-Sports App has will also send your exact geo-location (in case you are lost in a blizzard), your altitude, your bearing, and your speed. In other words, you can be in what in aviation is called IMC (instrument meteorological conditions) and still have a chance of being guided down.
Your body temperature is a crucial number to know, but perhaps for reasons that you don't know. Although your body's metabolism slows down with a decreasing temperature, something more important occurs in what is called your oxygen-hemoglobin dissociation curve. The colder you get, the less your hemoglobin likes to release oxygen (left shift) and your cells will become more oxygen starved. You also don't want to get into a situation in which you shiver (that greatly increases your oxygen consumption) further aggravating the problem. So where do you want to be on the mountain? I would say very slightly hypothermic (1 degree below normal?) since this will not give you a major shift to the left on your O2-Hgb dissociation curve, you will decrease your O2 consumption, and you will not shiver. This is simply a conjecture, but it's one that makes sense.
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| Bluetooth Temp Monitor - 4 cm diameter |
Chest Heart rate Monitor
Oxygen saturation would seem to be very important. And it is! But here is the catch. At 24,000 feet, your saturation will probably be below 75%. Most pulse oximeters become wildly inaccurate below 70%. Also, at 70%, you are in the steep part of the O2-Hgb dissociation curve, so the slightest change in your pO2 in your blood will drastically change your saturation. What I am getting at is that if you see a number below 70% - it's probably not accurate, but it does mean that things are not looking good. If you see 70% at base camp (18K), you are probably suffering from HAPE. In short, monitor this number, but if it's low, look at it with a grain of salt...
What else would I like to look at? I think streaming EKG (electrocardiogram) signals may be very useful. We can stream EKG from base camp. But why, you may ask, do I want it from somebody at 24K? I am thinking of babies and SIDS (sudden infant death syndrome). For years we believed babies were passing away because they just stopped breathing. We now know that a certain percentage of them in fact have an arrhythmia that leads to a cardiac arrest, and of course then they stop breathing. For all I know, climbers who get into trouble in the so called "death zone" are in fact developing abnormal cardiac rhythms which then translate into HAPE. In the operating room, a common side-effect of hypoxia is arrhythmias, so I would expect to see the same at altitude. We may be able to have EKG streaming for the 2016 season - and this will provide us with a whole new way of looking at problems at altitude.
 |
| WiCis-Sports Base Camp solution streaming EKG (bottom center) |
Climb safely - but most importantly - make it down.
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