Environmental Sports Medicine Flashcards
What is the best method of prevention for HAPE and other altitude illnesses?
Gradual ascent
What is the recommended ascent rate and general ascent recommendations?
- Ascent rate: 300-350m/day at altitudes above 2500m
- Add extra date of acclimatization for every 600-1200 above 2500m
What is main pharmacologic prophylaxis for HAPE?
CCBs: Nifedipine 30mg ER QD or BID
How is HAPE treated?
- Immediate descent at least 500-1000m
- Supplemental O2 (sufficient for mild to moderate HAPE without pre-existing CP disease along with rest)
How are scuba divers at risk for arterial gas embolism and how does it present?
- Arterial gas embolism is a life-threatening decompression illness
- Due to uncontrolled rapid ascent leading to volume expansion of lungs going from high to low pressures leading to air bubbles to develop in circulation
- Presents with seizure, stroke Sx, disorientation, or acute LOC within 5 minutes of ascent
How is arterial gas embolism treated?
Immediate recompression in a hyperbaric chamber
What is Type I decompression sickness and how is it treated?
- Due to excess nitrogen dissolving into tissue
- Joint pain, skin rash, and pruritis (“bends”)
- Tx: immediate recompression in hyperbaric chamber
What is Type II decompression sickness and how is it treated?
- Due to excess nitrogen dissolving into tissue
- Ataxia, weakness, dizziness, and respiratory distress (“chokes”)
- Tx: immediate recompression in hyperbaric chamber
How does inner ear barotrauma present and treated?
- Due to poor equilibration of pressure during descent and too vigorous of Valsalva maneuvers
- Presents with pain, vertigo and tinnitus
- Tx: rest from diving and avoidance of Valsalva
When should pts with inner ear barotrauma be referred to ENT?
symptoms of hearing loss
How does acute mountain sickness present and how can it be treated?
Px: nausea, headache, and fatigue
Tx: O2, ibuprofen, promethazine, and acetazolamide
