High-Altitude & Mile-High Medicine
The fundamental gas law (P1V1 = P2V2) explaining why air-filled equipment like ET tube cuffs expand during rotor-wing transport ascent.
What is Boyle's Law?
The standard Colorado protocol pediatric first-line dose for IM epinephrine in anaphylaxis (for patients under 30 kg).
What is 0.15 mg (or 0.15 mL of 1 mg/mL)?
The classic toxidrome consisting of pinpoint pupils, respiratory depression, and altered mental status.
What is Opioid toxidrome?
The physiological rule stating that mean arterial pressure (MAP) must remain above this mmHg baseline to ensure adequate renal and cerebral perfusion.
What is 65 mmHg?
i will accept 60-65
The term for the rapid, chemical oxidation process that produces heat and light, commonly represented by the Fire Tetrahedron (Fuel, Heat, Oxygen, and Chemical Chain Reaction).
What is combustion (or fire)?
The classic field treatment for severe High Altitude Pulmonary Edema (HAPE) when immediate descent or portable hyperbaric chambers aren't available.
What is supplemental oxygen (or Nifedipine/CPAP)?
This specific antiemetic is notorious for causing extrapyramidal symptoms (dystonic reactions) if administered too rapidly IV.
DAILY DOUBLE
What is Metoclopramide (Reglan) or Promethazine (Phenergan)?
The primary clinical concern following a pit viper bite (e.g., Colorado Prairie Rattlesnake) that dictates keeping the extremity neutral and avoiding tourniquets.
: What is local tissue necrosis / coagulopathy (hemotoxicity)?
This law explains why placing an unheated, shivering patient in a windy environment causes rapid temperature loss due to moving air currents.
What is Convection?
This basic building construction type (Type IV) utilizes large-dimension timber beams and lacks hidden void spaces, making it resistant to rapid collapse.
What is Heavy Timber construction?
At 10,000 feet elevation, atmospheric pressure drops significantly, leading to this primary driver of early high-altitude hyperventilation.
What is arterial hypoxia / hypoxic ventilatory response?
The chemical reversal agent/antidote indicated for severe calcium channel blocker overdose.
What is Calcium Chloride / Calcium Gluconate (or High-Dose Insulin)?
"Hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter" describes this overdose syndrome.
What is Anticholinergic toxidrome?
The specialized nerve bundle in the right atrium that acts as the primary pacemaker of the human heart.
What is the Sinoatrial (SA) node?
When advancing a hose line into a structure, this classic nozzle pattern setting provides maximum reach and thermal penetration while minimizing air entrainment.
What is a solid stream (or straight stream)?
High Altitude Cerebral Edema (HACE) is considered the end-stage, life-threatening progression of this much more common mountain illness.
What is Acute Mountain Sickness (AMS)?
Unlike Narcan, this competitive antagonist reverses benzodiazepine overdose, but carries a high risk of precipitating fatal seizures in chronic users.
What is Flumazenil (Romazicon)?
The characteristic cherry-red skin discoloration in severe Carbon Monoxide poisoning is rarely seen in live patients; this pulse oximetry finding is far more typical.
What is a falsely high/normal SpO2 reading?
The minimum Glasgow Coma Scale (GCS) score attainable by a living human patient.
What is 3?
During a primary search, this physical search technique ensures firefighters maintain orientation and don't miss room features by keeping one hand or tool in contact with an perimeter wall.
What is a wall-guided / right-hand (or left-hand) search?
This medication, often carried by mountain dwellers, is a carbonic anhydrase inhibitor used for AMS prevention by forcing renal bicarbonate excretion.
What is Acetazolamide (Diamox)?
This continuous infusion drug preferred in severe refractory asthma works by relaxing smooth muscle via calcium channel blockade and anticholinergic properties.
What is Magnesium Sulfate?
This common household medication overdose presents with early tinnitus and hyperventilation due to direct respiratory center stimulation, followed by severe metabolic acidosis.
What is Aspirin / Salicylates?
The fluid phase shift mechanism responsible for "third spacing" in severe sepsis or major burn injuries.
What is increased capillary permeability (or systemic endothelial leak)?
The sudden, explosive ignition of accumulated, superheated unburned fuel gases in an oxygen-depleted room when a fresh oxygen source is introduced.
What is a backdraft?