HIGH ALTITUDE CEREBRAL EDEMA Flashcards
HACE
High Altitude Cerebral Edema
An extension of the central nervous system symptoms of Acute Mountain Sickness (AMS) and results from cerebral vasogenic edema and hypoxia.
High Altitude Cerebral Edema (HACE)
High Altitude Cerebral Edema (HACE) is an extension of the Central Nervous System symptoms of altered mental status that is a result of ____________ and ____________.
Cerebral Vasogenic Edema
Hypoxia
High Altitude Cerebral Edema (HACE) usually occurs above what elevation?
2500 meters (8250 feet)
1) Severe headaches
2) Confusion
3) Truncal ataxia
4) Urinary retention or incontinence
5) Focal deficits
6) Papilledema (Blurred/Double/Fleeting Vision)
7) Nausea and Vomiting
8) Seizures
(Notice how almost all of these symptoms are Neuro in Nature)
High Altitude Cerebral Edema (HACE)
1) How far should you immediately descend for a High altitude related Acute Mountain Sickness, HAPE, and HACE?
2) Once you descend the required amount, what should be done if symptoms are not improving?
1) Immediate descent for at least 610 meters (2000 feet)
2) Keep descending until symptoms improve
Which of the following is would be the best practice of treatment in regards to the treatment of HAPE/HACE?
A) Descend until symptoms improve
B) Descend 610 meters
C) Descend 2000 meters
D) Descend 610 feet
A) Descend until symptoms improve
(Yes you should descend 610 meters, BUT you keep descending UNTIL SYMPTOMS IMPROVE. If you descend 610 meters and nothing improves, you’re not doing anything for the patient.)
What is the treatment for a HAPE/HACE patient?
1) Descend at least 610 meters (2000 feet) until symptoms improve
2) 02 100% 2-4L/minute by mask
3) Acetazolamide (Diuretic) (250 mg orally every 8-12 hours)
4) Dexamethasone, 4-8 mg orally every 6 hours After the diuretic
5)
What should be done to treat a HACE/HAPE patient if you cannot immediately descend?
Use a Portable Hyperbaric Chamber until symptoms improve
