Activity Scenarios
A.– Background
The following activity scenarios introduces concrete ideas about new functionality and new ways of thinking about climbers' needs and how to meet them. What essential services does the system proposes to offer is the real issue these scenarios address.
In these scenarios, each climber uses EMACS - a new digital health care access
provider - to monitor their ascent. In its full fledged version EMACS integrates
a climber vital signs monitoring data with a LAN allowing video teleconferencing
with a full fledged medical team over GEO satellites, full GPS functionality,
Etc.. However, because incremental changes in a system are easier to implement
and easier for stakeholders to understand and appreciate, the new system functionality
will at first be be limited to vital signs monitoring and bio-feedback.POV analysis
was quite useful in developing activity scenarios. This in turn moved EMACS
in the direction of software design at a very early point in the project life
cycle.
Full automation of the system is a prime objective. As such, in these scenarios, EMACS is fully automated. The device only needs to be turned on to be fully functional. The assumption is that in terms of functionality, the less interaction climbers have with the device, the better. The rational behind this assumption is that climbers in an extreme environment will not be able to interact with extended system functionality. Further it has been recognized that it is precisely when climbers need the system the most that they want to minimize its functionality. This means that for users to derive most satisfaction from the system EMACS functionality has to be kept to a minimum.
In the name of coherence the activity scenarios were cross-checked for potential
consistency and completeness problems. This is why the reader will find that
the same design features are incorporated in each scenarios. This insures at
an early stage that the ideas about the new system do not conflict from one
situation to the next and work well together. As far as completeness is concerned,
a weak point here is the absence of participatory design. This constraint was
addressed from the start in the root concept but it should be pointed out again
so its importance is not lost to iterative design.
Finally these scenarios all share a common thread: none of the climbers use supplemental oxygen. This parallels the problem scenarios. The use of oxygen during ascent unnecessarily complicates the activity scenarios because it complicates the diagnosis process. The emphasis is on thorough acclimatization instead.
B.– Scenarios
* Scenario 1
Reinhart
Location: Gasherbrum I
That night Reinhart left Camp 3 on Gasherbrum I around midnight in apparent
good condition with 2 other climbers. They all had already climbed well beyond
Camp 3 twice the preceding week and were thoroughly acclimitized to the high
elevation of 7200 m (23,622 ft). Yet, about one hour later Reinhart's iPAQ began
emitting a high pitched sound. Removing his goggles he stopped to take a closer
look at his iPAQ. A flashing red light on the pulse oximeter window was sending
a clear message: his oxygen saturation level was just bellow the acceptable
level. A look at the heart rate window showed that his heart rate was quite
high but not out of range yet. He looked at the iPAQ for a while and then his
gaze shifted to Gasherbrum summit shining white under the dark blue sky, seemingly
so close. Did that meant he had to turn back? He turned the annoying alarm off
and glared at the pulsating red light. He felt good. Tired yes, but fine overall.
Ahead of him his two companions were slowly going up the slope. Should he give
up now? So close to the goal? May be the device was wrong after all. It had
been two years. He spent two years getting ready for this. Giving up now was
ridiculous. What a disappointment this would be. Reinhart took a last look at
the flashing iPAQ on his right arm, turned the alarm off and moved on. Thirty
minutes later, he had just caught up with his companions waiting for him when
another high pitched sound rang in the silence. Annoyed Reinhart was about to
disconnect the device when his friends asked him what the matter was. Reinhart
simply stared at them. He did not feel so well after all. A nasty headache was
pounding his head. Someone dropped his pack and ice axe and approached him for
a closer look at his iPAQ. Several iPAQ indicators were flashing their red warning:
ETCO2, pulse oximeter, and heart rate were all out of range. While Camp3 was
informed of the situation by Talkie Walkie, supplemental oxygen was immediately
pulled from Reinhart pack and administered. The effect on Reinhart was almost
immediate: within a few minutes he began talking again, feeling much better.
One by one the iPAQ windows switched from red to green indicating vital signs
measurements were now within normal range. The three climbers turned back and
safely returned to Camp 3. Reinhart survived what could have been a fatal HAPE
attack.
* Scenario 2
Nicklaus
Location: K2
That night well rested and in calm weather, Nicklaus left high camp on K2 for
a solo summit attempt . Everyone else was too exhausted to push on and remained
at high camp, happy to just relax and drink hot tea. In the following afternoon
however the weather changed rapidly. Dark ominous clouds enveloped the mountain
and before soon a violent snow storm was mercilessly whipping high camp. Nicklaus
had known all along there was a good chance for the weather to turn: this is
precisely what makes K2 so treacherous to climb. Which is why he did not waste
time. By 11:00 AM he had made the summit. He radioed High Camp and after snapping
a few shots he took a long last look at the scenery and prepared to go down.
A quick look at his iPAQ drew a frown on his face. All vital signs were within
range except for two: core body temperature and skin temperature. He quickly
put on two additional fleece ski masks, tighten his hood tight and grabbed one
of his thermos bottle. The tea was still hot and he immediately felt better.
Now, he had to move. Fast. Soon the wind shifted and began blowing from the
south. Nicklaus stopped to look at the sky; he knew this was bad news. When
the storm struck Nicklaus kept going, keeping a weary eye on his iPAQ. His body
temperature was better now but skin temperature at the toes was borderline.
Steadily going down, he longed for the warmth of a sleeping bag, hot tea, and
the company of his friends waiting for him at high camp. The wind was howling
now. He never heard the high pitched sound of the iPAQ but he felt its strong
vibrations. Through his goggles he could only see the flashing red color of
the skin temperature windows. It's only then that he realized he was shivering
with cold. His toes surely must have been there down his legs but he could not
feel them anymore. High camp could not be much further and he began to push
on. But he knew this was the wrong course of action. And the constant vibration
of the iPAQ alert mechanism on his arm kept reminding him that something should
be done, the sooner the better. Kicking steps in the snow was still possible
but before long ice formation would make it difficult at best. Now was the time
to act. Dropping his pack and securing it with an ice axe he began digging with
his aluminum shovel. Slowly he managed to dig a snow cave for shelter deep within
the slope so it would not collapse. Inside all was calm, and he slipped into
his sleeping bag, insulating himself from the snow with his gear. For several
hours he massaged his toes, slowly bringing them back to life. Exhausted, he
finally fell asleep. When he woke up an eery silence enveloped the mountain.
He knew the stormed had past. He looked at his watch: he had slept for twelve
hours. A look at his iPAQ brought more good news: all vital signs were in range
and temperature measurements were normal. He called High Camp to reassure them,
and got out. Outside the sun shone brightly and in down bellow in the distance
he could see the yellow tents from High Camp. He was alive. He had made it.
* Scenario 3
Ingvar
Location: Everest Northeast Ridge
Ingvar was leading but did not feel good; and this intermittent raspy cough
was irritating. Sure, for each step he took, he inhaled and exhaled 15 times,
but this was nothing out of the ordinary at this elevation. His chest felt tight,
but then again everything is painful beyond 25,000 ft. You just go on. And that
is exactly what he intended to do, just one step after another, like in a never
ending mantra. Stopping for a moment to catch his breath he watched the other
climbers coming up slowly up the ridge. It was not before passing the first
step that his iPAQ broke the monotony of the sound of his crampons crunching
through the snow crust. A quick glance at his iPAQ showed his heart rate indicator
was soaring well over 100. The pulse oxymetry window glowing green, indicated
a low level of oxygen saturation still within acceptable range. Ingvar just
shrugged. He could not remember how to turn the device off, so he sat down and
waited for the other. Looking at his vital signs the team physician was worried
and asked Ingvar to get up and walk up with about one hundred yards. Soon enough
the iPAQ broke the silence again: this time the pulse oxymetry window was glowing
red. Quick desaturation was a sure sign of HAPE, a deadly condition easily eluding
diagnostic. Ingvar was immediately hook up to an oxygen tank. Slowly most vital
signs indicator began regressing from their alarming level. Pulse oxymetry remained
high for a long time but eventually subsidized as well. Camp 4 was called in
for help in evacuating Ingvar. That day Ingvar barely survived the most vicious
form of AMS: HAPE.