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High Altitude Cautionary Tale

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High Altitude Cautionary Tale Powered By Docstoc
					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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posted:12/11/2011
language:English
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