scholarly journals Rescue Emergencies Due to High-Altitude Illnesses Are Rare in Switzerland

2022 ◽  
Vol 19 (2) ◽  
pp. 865
Author(s):  
Benedikt Gasser ◽  
Joel Stouder
Keyword(s):  
High Altitude ◽  
Emergency Services ◽  
Acute Mountain Sickness ◽  
Swiss Alps ◽  
Naca Score ◽  
Central Registry ◽  
Life Threatening ◽  
High Altitude Cerebral Edema ◽  
Monte Rosa ◽  
Altitude Illnesses

Background: Despite a potential high risk of acute mountain sickness (AMS) in the Swiss Alps, there is a lack of analyses concerning its relevance over longer periods. In consequence, the aim of this study is to analyze the prevalence of AMS in comparison to other causes of mountain emergencies in recent years in Switzerland. Material and Methods: Based on the central registry of mountain emergencies of the Swiss Alpine Club (SAC), all cases in the period between 2009 and 2020 were analyzed for AMS including the most severe forms of high-altitude pulmonary edema (HAPE) and high-altitude cerebral edema (HACE). Emergencies were assessed for the severity of the event with a National Advisory Committee for Aeronautics (NACA) score. Results: From a total of 4596 high-altitude mountaineering emergencies identified in the observational period, a total number of 352 cases of illnesses were detected. Detailed analysis revealed 85 cases of AMS, 5 cases of HAPE, and 1 case of HACE. The average altitude was 3845 ± 540 m. Most cases were in the canton of Valais, especially in the Monte Rosa region and the mountains of the Mischabel group (Täschhorn, Dom, Südlenz, Nadelhorn, Hohberghorn). There were only three deaths related to high-altitude illnesses; all the other events could be identified as moderate to severe but not life-threatening. Discussion: An emergency due to AMS that requires rescue is unlikely in the Swiss Alps. This does not imply that AMS is not a concern. However, the facts that the maximal altitude is relatively low and that fast self-descents often seem possible probably minimize the likelihood that mountaineers with symptoms contact emergency services.

Commercial flight and patients with intracranial mass lesions: a caveat

2006 ◽  
Vol 105 (4) ◽  
pp. 627-630 ◽  
Author(s):  
Ludvic U. Zrinzo ◽  
Matthew Crocker ◽  
Laurence V. Zrinzo ◽  
David G. T. Thomas ◽  
Laurence Watkins
Keyword(s):  
High Altitude ◽  
Acute Mountain Sickness ◽  
Neurological Deterioration ◽  
Mild Degree ◽  
Airline Passengers ◽  
Life Threatening ◽  
High Altitude Cerebral Edema ◽  
Mountain Sickness ◽  
Commercial Flight ◽  
Mass Lesions

✓The authors report two cases of neurological deterioration following long commercial flights. Both individuals harbored intracranial space-occupying lesions. The authors assert that preexisting reduced intracranial compliance diminishes an individual’s reserve to accommodate the physiological changes resulting from a commercial flight. Airline passengers are exposed to a mild degree of hypercapnia as well as conditions that simulate those of high-altitude ascents. High-altitude cerebral edema following an ascent to great heights is one facet of acute mountain sickness and can be life threatening in conditions similar to those present on commercial flights. Comparable reports documenting neurological deterioration at high altitudes in patients with coexisting space-occupying lesions were also reviewed.

Headache at High Altitude

2018 ◽  
pp. 3-7
Author(s):  
Renee N. Salas
Keyword(s):  
High Altitude ◽  
Sea Level ◽  
Laboratory Testing ◽  
Acute Mountain Sickness ◽  
Vital Signs ◽  
Medical Practitioners ◽  
High Altitude Pulmonary Edema ◽  
Life Threatening ◽  
High Altitude Cerebral Edema ◽  
Mountain Sickness

Headache is a condition that medical practitioners commonly encounter with a broad differential that ranges from the benign to the life threatening. High altitude environments have unique diseases that present with headache, which this case will outline. Providers practicing at high altitude must be facile with diagnosing these conditions such as high altitude headache and acute mountain sickness. Astute providers must also assess for high altitude cerebral edema and high altitude pulmonary edema as they can co-exist with acute mountain sickness. Given that radiographic and laboratory testing are often not available, determining a diagnosis based on history and physical is essential with the knowledge that “normal” vital signs differ from that of sea level.

scholarly journals Perforation Peritonitis at High Altitude

2018 ◽  
Vol 56 (210) ◽  
pp. 625-628 ◽  
Author(s):  
Bhawana Amatya ◽  
Paleswan Joshi Lakhey ◽  
Prativa Pandey
Keyword(s):  
High Altitude ◽  
Distal Gastrectomy ◽  
Acute Mountain Sickness ◽  
Emergency Laparotomy ◽  
Delay In Diagnosis ◽  
First Case ◽  
Life Threatening ◽  
Perforation Peritonitis ◽  
Proper Diagnosis ◽  
Mountain Sickness

Trekkers going to high altitude can suffer from several ailments both during and after their treks. Gastro-intestinal symptoms including nausea, vomiting, and abdominal pain are common in high altitude areas of Nepal due to acute mountain sickness or due to a gastro-intestinal illness. Occasionally, complications of common conditions manifest at high altitude and delay in diagnosis could be catastrophic for the patient presenting with these symptoms. We present two rare cases of duodenal and gastric perforations in trekkers who were evacuated from the Everest trekking region. Both of them had to undergo emergency laparotomy and repair of the perforation using modified Graham’s patch in the first case and distal gastrectomy that included the perforated site, followed by two-layer end-to-side gastrojejunostomy and two-layer side-to-side jejunostomy in the second case. Perforation peritonitis at high-altitude, though rare, can be life threatening. Timely evacuation from high altitude, proper diagnosis and prompt treatment are essential

scholarly journals High-Altitude Illness Death Investigation

2018 ◽  
Vol 8 (1) ◽  
pp. 83-97 ◽  
Author(s):  
Robert A. Kurtzman ◽  
James L. Caruso
Keyword(s):  
High Altitude ◽  
Cerebral Edema ◽  
Acute Mountain Sickness ◽  
Physical Conditioning ◽  
Postmortem Diagnosis ◽  
High Altitude Cerebral Edema ◽  
Diagnosis And Classification ◽  
High Altitude Illness ◽  
Death Investigation ◽  
Medical Examiners

High altitude illness (HAI) is the current accepted clinical term for a group of disorders including acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE), which occur in travelers visiting high-altitude locations. High-altitude illness is due to hypobaric hypoxia, is not associated with age or physical conditioning, and mild forms are easily treated. High-altitude cerebral edema and HAPE are medical emergencies that are fatal if not promptly treated and fortunately are uncommon. The cause of most high-altitude fatalities is not related to HAI and can be easily distinguished from HACE and HAPE; however, other causes of death may have symptoms and physical findings that overlap with HAI, making postmortem diagnosis challenging. Fatalities due to HAPE and HACE are diagnoses of exclusion. Medical examiners and coroners who work in jurisdictions with high-altitude locations should be aware of the risk factors, physiology, pathology, differential diagnosis, and classification of HAI to accurately recognize HAI as a cause of death. Medical examiners who do not work in jurisdictions with high-altitude locations may be asked to evaluate deaths that occur overseas associated with high-altitude trekking and mountaineering activities.

Mountain neurology

2019 ◽  
Vol 19 (5) ◽  
pp. 404-411 ◽  
Author(s):  
Marieke Cornelia Johanna Dekker ◽  
Mark H Wilson ◽  
William Patrick Howlett
Keyword(s):  
High Altitude ◽  
Acute Mountain Sickness ◽  
Free Standing ◽  
Mount Kilimanjaro ◽  
Northern Tanzania ◽  
Neurological Conditions ◽  
Mountain Sickness ◽  
Low Altitude ◽  
Mountain Climbers ◽  
Altitude Illnesses

Mountain climbers may develop specific illnesses that largely depend on the altitude reached and the rate of ascent. The popularity of travel to high altitude destinations, extreme tourist activities and mountain climbing means that neurologists in low-altitude countries are increasingly likely to encounter neurological problems and disorders in people exposed to high altitude. Additionally, they may have to advise patients with pre-existing neurological conditions on the risks of ascent to altitude. This article focuses on neurological-related high-altitude illnesses: acute mountain sickness and high-altitude cerebral oedema, as well as high-altitude retinopathy and other neurological disorders. This overview combines current understood pathogenesis with the experience of managing altitude-related illness at the foot of Mount Kilimanjaro in northern Tanzania, the tallest free-standing mountain in the world.

scholarly journals Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema: An enhanced view from the High Andes

2021 ◽  
Author(s):  
Gustavo Zubieta-Calleja ◽  
Natalia Zubieta-DeUrioste
Keyword(s):  
Pulmonary Edema ◽  
High Altitude ◽  
Cerebral Edema ◽  
Acute Mountain Sickness ◽  
Point Of View ◽  
La Paz ◽  
Mountain Climbing ◽  
High Altitude Pulmonary Edema ◽  
High Altitude Cerebral Edema ◽  
Mountain Sickness

Background: Travelling to high altitude for entertainment or work is sometimes associated with acute high altitude pathologies. In the past, scientific literature from the lowlander point of view was mostly based on mountain climbing. Nowadays, altitude descent and evacuation are not mandatory in populated highland cities. Methods: We present how to diagnose and treat acute high altitude pathologies based on 50 years of high altitude physiology and medical practice in hypobaric hypoxic diseases in La Paz, Bolivia (3,600m; 11,811ft), at the High Altitude Pulmonary and Pathology Institute (HAPPI – IPPA) altitudeclinic.com.Results: Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema are all medical conditions faced by some travelers. These can occasionally present after flights to high altitude cities, both in lowlanders or high-altitude residents during re-entry, particularly after spending more than 20 days at sea level.Conclusions: Acute high altitude ascent diseases can be adequately diagnosed and treated without altitude descent. Traveling to high altitude should not be feared as it has many benefits;

scholarly journals Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema: A view from the High Andes

2021 ◽  
Author(s):  
Gustavo Zubieta-Calleja ◽  
Natalia Zubieta-DeUrioste
Keyword(s):  
Pulmonary Edema ◽  
High Altitude ◽  
Cerebral Edema ◽  
Acute Mountain Sickness ◽  
Healthy Children ◽  
Number Of Children ◽  
High Altitude Pulmonary Edema ◽  
High Altitude Cerebral Edema ◽  
Potential Risks ◽  
Mountain Sickness

Healthy children and those with pre-existing conditions traveling to high altitude may experience diverse physiologic changes. Individuals who are not acclimatized and ascend rapidly are at risk of developing acute high altitude illnesses (HAI), which may occur within a few hours after arrival at high altitudes, being acute mountain sickness (AMS) the most common. In very few cases, serious complications may occur, including High Altitude Pulmonary Edema (HAPE) and very rarely High Altitude Cerebral Edema (HACE). Moreover, the number of children and adolescents traveling on commercial aircrafts is growing and this poses a need for their treating physicians to be aware of the potential risks of hypoxia while air traveling. In this article we present 50 years of medical practice at high altitude treating these pathologies succesfully with no casualties.

scholarly journals The cerebral venous system and hypoxia

2016 ◽  
Vol 120 (2) ◽  
pp. 244-250 ◽  
Author(s):  
Mark H. Wilson ◽  
Christopher H. E. Imray
Keyword(s):  
Intracranial Pressure ◽  
High Altitude ◽  
Acute Mountain Sickness ◽  
Venous Outflow ◽  
Edema Formation ◽  
Care Environment ◽  
Fluid Production ◽  
High Altitude Cerebral Edema ◽  
Blood Inflow ◽  
Mountain Sickness

Most hypobaric hypoxia studies have focused on oxygen delivery and therefore cerebral blood inflow. Few have studied venous outflow. However, the volume of blood entering and leaving the skull (∼700 ml/min) is considerably greater than cerebrospinal fluid production (0.35 ml/min) or edema formation rates and slight imbalances of in- and outflow have considerable effects on intracranial pressure. This dynamic phenomenon is not necessarily appreciated in the currently taught static “Monro-Kellie” doctrine, which forms the basis of the “Tight-Fit” hypothesis thought to underlie high altitude headache, acute mountain sickness, and high altitude cerebral edema. Investigating both sides of the cerebral circulation was an integral part of the 2007 Xtreme Everest Expedition. The results of the relevant studies performed as part of and subsequent to this expedition are reviewed here. The evidence from recent studies suggests a relative venous outflow insufficiency is an early step in the pathogenesis of high altitude headache. Translation of knowledge gained from high altitude studies is important. Many patients in a critical care environment develop hypoxemia akin to that of high altitude exposure. An inability to drain the hypoxemic induced increase in cerebral blood flow could be an underappreciated regulatory mechanism of intracranial pressure.

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