Medical problems dealing with low pressure at high altitudes'

1
Medical problems dealing with low pressure at
high altitudes.
2
Rule 1 - -Its OK to get AMS, but it is not OK
to die!
3
High Altitude

• Over 8000-10000 ft. (2500-3000 m)
• Can also get to extreme altitude above 20000 ft
  (6000 m)
• Altitude gain is whats really important

4
What it does

• Drops atmospheric pressure

5
Effects on the body

• Hypoxiadue to drop in oxygen pressure
• Drop in CO2 concentration
• Diuresis
• Periodic breathing while asleep

6
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 gt 50 yrs,
  living below 3000 ft., rapid ascent

7
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

8
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

9
HAPE Treatment

• DESCEND!! With assistance.
• 3000 ft.
• At elevation of last good sleep
• Oxygen
• Nifedipine
• Nitric Oxide
• Hyperbaric Chamber

10
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 -gt Coma

11
HACE Treatment

• DESCEND!!!! Must have assistance!
• 3000 ft. or elevation of last good sleep
• Oxygen
• Dexamethasone
• Hyperbaric Chamber

12
Rule 2 - -If you have HACE or HAPE
descend.Never send a climber down alone.
13
How to avoid altitude disease (1)

• ASCEND SLOWLY!
• 1000 ft./day
• especially above 10000 ft.
• Dont 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

14
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 sameterolprevents HAPE

15
Why do it?