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Altitude07 - altitudes over 10,000 ft Risk factors for HAPE...

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Unformatted text preview: altitudes over 10,000 ft. Risk factors for HAPE include the altitude above sea level, the rate of ascent to that altitude, and individual susceptibility. The direct effect of hypoxia on systemic arterioles is vasodilation. In contrast, hypoxia in the lung causes vasoconstriction --> increased pulmonary vascular resistance --> right ventricle must generate a higher pressure --> pulmonary hypertension --> greatly elevated pulmonary capillary pressure --> movement of fluid from the circulatory system to the pulmonary interstitial spaces and alveoli. Symptoms - shortness of breath, severe fatigue, cough which sometimes produces a frothy and/or bloody sputum, tachycardia, severe headache, insomnia, chest tightness or congestion, blue or gray fingernails or lips, often a slight fever; may rapidly go on to unconsciousness and death. The symptoms often begin at night when shortness of breath at rest may occur. The hypoventilation and associated hypoxemia that occur during sleep may further predispose persons to HAPE --> avoid sleeping medications, alcohol, and sedatives that further depress ventilation. Treatment - descend to lower altitude immediately with or without oxygen - diuretics are quite effective if and only if fluids are replaced as rapidly as they are excreted. - Diamox is effective for prevention and treatment - Dexamethasone will improve symptoms D. High-Altitude Cerebral Edema (HACEL Accumulation of excess fluid in the brain Rare below 12,000 ft. Symptoms — loss of coordination, confusion, hallucinations, severe headache, severe weakness and fatigue, coma Treatment - same as for HAPE Treatment of altitude illness is based on four principles: (1) stop ascent in presence of symptoms; (2) descend if no improvement or if condition worsens; (3) descend immediately if HAPE, loss of coordination, or changes in consciousness are present; (4) ill persons must not be left behind alone or sent down alone. E. Other Medical Problems at Altitude Retinal hemorrhage - occurs in 50% of people going above 17,500 ft. - reversible after return to sea level. However, irreversible visual defects can occur. Low temperatures --> hypothermia, frostbite; Sunburn ...
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