Medical Aspects of an Antarctic Expedition

Mountain guiding was my full-time profession until a few years ago. Life changes (read: two kids) precipitated professional changes that had been in the works for a while. Now I get to use my experience to support the guiding and adventure travel industries via my work at Remote Medical International. But I still keep active guiding, on a limited basis.

Guiding in Antarctica gave me the unique opportunity to combine my professional “lives”. As a guide, a significant part of my responsibility is managing the safety and well-being of my team. I have to be able to manage common issues, and also have contingency plans in place should I have to manage a serious medical or logistical issue. This can be a real challenge- I’m one person, and have to rely on my own medical training and the medical kit that I can carry with me.

As an account manager at Remote Medical who provides risk management and medical support for expeditions, it’s my job to know all of the assets currently available to teams undertaking such adventures. I have used my guiding experience to inform the solutions I put together for my clients, and I’m always on the lookout for products or services that will represent upgrades for the industry. For this trip, my second to Antarctica, I got to employ state-of-the-art services for my own team. I also got to test some new gear, carry a prototype expedition medical kit that we will be offering beginning this spring, enjoy telemedicine backup, and test a communications system designed specifically for the world’s most remote and challenging locations. For me, as a real user of these types of services, I need to know what works and how it works, not only for myself but for my RMI clients who rely on me and my advice.

Our climbing objective was the summit of Vinson Massif, at over 16,000′ the high point of the Antarctic continent. It’s located in the Sentinel Range of the Ellsworth Mountains, a long, long way from definitive medical care. It’s a long way from anywhere! In a worst-case scenario it could be 2-3 weeks from the time of an incident to delivery of the patient to a US-level hospital. The common occurrence of no-fly weather in our basecamp and in the base where we access the continent via a Russian Ilyushin cargo plane coupled with extreme conditions on the mountain make managing medical care a real challenge.

The last time I guided this trip, in 2003, I felt less than 100% prepared to manage my team’s safety. I had a WFR certification, the guiding industry’s standard minimum training. Great skill set, but for an expedition this remote it felt lacking. We carried a medical kit that included wound management materials and some Rx elements, mainly for treating altitude-related illness. But I felt pretty exposed. What was I going to do if our team’s resources were overwhelmed by a medical emergency?

Specifically, my concerns were:

• Level of Medical Training I was concerned that for a remote, extended expedition such as this one I needed more training
• Medical Kit Contents Did I have an adequate kit? What would a remote site medic recommend, for example?
• Emergency Response Plan Or lack of one. My understanding of basic risk management systems was lacking.
• Liability As a guide, my understanding of legal matters that directly affected me was limited. The job carries huge responsibilities- was my employer going to be on my side if things went sideways?
• Managing and Dispensing Prescription Medications For international trips, carrying specific medications is important- epinepherine, antibiotics, and medications for managing altitude illness for example. But I’m not a pharmacist, an MD, or a lawyer- what were my responsibilities, and how could I know whether dispensing a medication was the best course of action?
• Backup For medical issues, having a second opinion with a higher level of training is invaluable. And during any incident with medical or logistical challenges, I was likely to have my hands full. What if I couldn’t reach the team at the office when they were awake or available?