On December 4, 2024, the Honolulu Fire Department (HFD) received a 911 call at 4:59 p.m. and responded to a hiker who was having a medical emergency on the Koko Crater Trail in Hawaii Kai with 6 units staffed with 17 personnel. The first unit arrived on scene at 5:07 p.m., established command and ascended the trail on foot. The second-arriving company secured a nearby landing zone to prepare for air operations.

It was reported that a male in his 40s suffered a medical emergency and was unable to descend the trail on his own. Bystanders started Cardio Pulmonary Resuscitation (CPR) after the patient went into cardiac arrest. HFD personnel arrived at the hiker’s location at 5:19 p.m. where they conducted a medical assessment and continued CPR. The hiker was then transported via Air 1 to the landing zone where medical care was transferred to Emergency Medical Services at 5:38 p.m.