Altitude Sickness

Question 1

mechanism for hape

Answer 1

isolated inc PA pressures - uneven hypoxic pulmonary vasoconstriction - noncardiogenic Pulm edema

Question 2

Treatment for HAPE

Answer 2

Descent and O2, add dexamethasone if neuro sx. If descent and O2 not available, hyperbaric and nifedipine. [Sildenafil/tadalefil/CPAP (2C) based only on reports or poorly controlled studies]

Question 3

key features of Lake Louise criteria for AMS

Answer 3

Headache (mandatory), GI, fatigue, dizziness, insomnia

Question 4

Which interventions actually got a 1A recommendation for prophylaxis of AMS/HACE. Who gets prophylaxis?

Answer 4

Moderate to his risk individuals get prophylaxis (past hx, ultimate height). Gradual ascent, diamox or dexamethasone. Ibuprofen if someone doesn’t want to/can’t take diamox or dexamethasone.

Question 5

Treatment of AMS/HACE

Answer 5

Iburpofen and Tylenol for HA. For moderate sx, add dexamethasone and often descent. For severe cases, descent + dexamethasone mandatory. (+O2, hyperbaric if descent not possible)

Question 6

Which interventions for prophylaxis of HAPE? Who gets meds?

Answer 6

Gradual ascent. Persons w/ prior hx get nifedipine.