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Medical problems dealing with low pressure at high altitudes. Rule #1 - - It’s OK to get AMS, but it is not OK to die! High Altitude Over 8000-10000 ft. (2500-3000 m) Can also get to extreme altitude above 20000 ft (6000 m) Altitude gain is what’s really important What it does Drops atmospheric pressure Elevation Pb mmHG Patm O2 Sea level 760 150 5000 ft. (1500 m) 634 123 8000 ft. (2500 m) 560 107 13000 ft. (4000 m) 462 87 14600 ft. (4500 m) 433 81 18000 ft. (5500 m) 379 69 21300 ft. (6500 m) 330 59 295000 ft. (9000 m) 230 38 Effects on the body Hypoxia—due to drop in oxygen pressure Drop in CO2 concentration Diuresis Periodic breathing while asleep Acute Mountain Sickness (AMS) Occurs within 8 to 96 hours of arrival Affects ½ of people at 14000 ft. Can happen at 6000 ft. Headache, poor sleep, loss of appetite, fatigue, nausea, vomiting, loss of coordination, coughing, shortness of breath, irregular breathing, reduced urine output, weakness Risk factors: physical exertion, age > 50 yrs, living below 3000 ft., rapid ascent AMS Treatment Rest Hydrate If you get worse • Descend 1000 ft or elevation of last good sleep Drugs: • aspirin • acetazolamide (Diamox)* • dexamethasone (Decadron) Hyperbaric chamber High Altitude Pulmonary Edema (HAPE) Leaking of body fluids into lungs, probably due to increased artery pressure POTENTIALLY FATAL Hacking cough, reduced exertion tolerance, increased pulse and breathing rate Crackling to bubbling noise in lungs; frothy sputum, fever, cyanosis Generally affects young, healthy people HAPE Treatment DESCEND!! With assistance. • 3000 ft. • At elevation of last good sleep Oxygen Nifedipine Nitric Oxide Hyperbaric Chamber High Altitude Cerebral Edema (HACE) Leaking of body fluids into brain, failure of blood-brain barrier POTENTIALLY FATAL Deteriorating coordination, headache, loss of energy Test with standard DUI techniques Loss of consciousness -> Coma HACE Treatment DESCEND!!!! Must have assistance! • 3000 ft. or elevation of last good sleep Oxygen Dexamethasone Hyperbaric Chamber Rule # 2 - - If you have HACE or HAPE – descend. Never send a climber down alone. How to avoid altitude disease (1) ASCEND SLOWLY! • 1000 ft./day • especially above 10000 ft. • Don’t try to acclimate above 18000 ft. • Rest every 3 days • Climb high, sleep low Hydrate-- “clear and copius” Take it easy; listen to your body How to avoid altitude disease (2) Herbs/supplements: Garlic, cloves, horsebalm, reishi, ginko biloba, Drugs • Aspirin • acetazolamide (Diamox)—prevents periodic breathing of sleep (also a diuretic) • dexamethasone (Decadron) • Nifedipine or sameterol—prevents HAPE Why do it?
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