Treatment
This is the first line and definitive treatment of nearly all HAI
What is descent
This is the body's first and most important physiologic response to altitude.
Increased ventilation
This corticosteroid is first line treatment for HACE
What is dexamethasone?
These symptoms are typically the earliest symptoms in HAPE
Decreased exercise tolerance and dyspnea at rest
What medication used for prophylaxis in AMS and HACE?
Acetazolamide and Dexamethasone
This medication is recommended as treatment for all High Altitude Emergencies
Oxygen
The symptoms must be present for AMS to be diagnosed
What is a headache
This neurologic sign is considered the most reliable indicator of HACE
What is ataxia?
Expected vital sign changes in HAPE
What is tachycardia, tachypnea, hypoxia?
70-80% of ventilatory acclimatization occurs in this time frame
3/4-7 days
Dosage of dexamethasone for AMS treatment
4mg q6h, max 2 doses
8mg followed by 4mg q6h is treatment for HACE
AMS commonly appears within this timeframe after ascent
1-6 hours of altitude exposure. Delayed presentations can occur at up to 48 hours
Severe cases of of HACE may require this intervention when descent is not possible.
Portable hyperbaric chamber (i.e. Gamow bag)
If you have these risk factors, you may require aggressive ascent profiles as well as medications
What is pulmonary HTN, hx of HAPE (50-60%), pulmonary infection, PFO, and use of respiratory depressants?
This amount of ascent per day is considered gradual above 3000m
What is 500m/day
This common medication taken by middle-age men can be used as treatment and prophylaxis of HAPE?
What is Tadalafil 10mg q12h or sildenafil 50mg q8h?
Untreated Acute Mountain Sickness increases risk of this condition
What is High Altitude Cerebral Edema
The minimum recommended descent distance when treating HACE
What is 1,000 ft or 300m?
Pathophysiology behind HAPE
Hypoxia causes pulmonary vasoconstriction, increasing pressure in lung vasculature causing leaky capillaries
Rapid ascents to this height in less than 24 hours should be given medication for acute mountain sickness prophylaxis
2500-3500M
These are the evacuation categories and HAPE should be labeled as this category
What is urgent, urgent surgical, priority, routine, convenience? HAPE falls under urgent for evacuation and this should not be delayed by medications/oxygen/hyperbaric treatment.
This score is used to grade AMS
Lake Louise AMS Score
Raised intracranial pressure from HACE can lead to these neurologic findings
CNIII and CNIV palsy
This medication is used at the same dose at both prophylaxis and treatment of HAPE. Bonus point if you can given the dosage.
What is nifedipine?
ER 30mg q12h vs immediate release 20mg q8h
You should start and continue medical prophylaxis for this length of time specifically for HAPE
Start 24hr before the ascent and continue for 7 days after