Deadly High Altitude Pulmonary Disorders: Acute Mountain Sickness
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Altitude Sickness in Nepal Is About 1 in 30,000 Trekkers, Or 2-3 Deaths Per Year
Shoreland Travax Medical Summary ALTITUDE ILLNESS INTRODUCTION Altitude illness occurs when one ascends more rapidly than the body can adjust ("acclimatize") to the reduced atmospheric pressure and decreased oxygen delivery to the body's cells at the higher altitude. Factors affecting acclimatization include the altitude attained, the rate of ascent, the duration of exposure, genetic predisposition, and certain preexisting conditions. (See "Acclimatization," "Risk," and "Effect of High Altitude on Preexisting Medical Conditions.") Altitude illness is generally divided into 3 syndromes: acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). See "Syndromes and Symptoms." Symptoms can range from mild to life-threatening. Although mild symptoms have been documented at relatively low altitudes of 1,200- 1,800 m (3,900-5,900 ft), serious syndromes are rarely seen below 2,500-3,000 m (8,200-9,800 ft). While death can occur from the more severe forms of altitude illness, most symptoms can be prevented or minimized by proper acclimatization and/or preventive medications. Risk and prevention strategies vary depending on the type of travel planned: travel to typical tourist destinations at relatively moderate heights or trekking in extreme high altitude situations. See "Risk of Altitude Illness" and "Prevention." ACCLIMATIZATION Acclimatization is a built-in adjustment mechanism that can optimize performance at higher altitudes. If a person ascends more rapidly than the body can adjust, symptoms occur that are referred to as altitude illness. Acclimatization seems to be determined by factors that are not known but may possibly be genetic. Some people adjust very easily to high altitude, while others cannot go above relatively moderate heights of 3,000 m (9,800 ft) without experiencing symptoms. -
Human Physiology an Integrated Approach
Gas Exchange and Transport Gas Exchange in the Lungs and Tissues 18 Lower Alveolar P Decreases Oxygen Uptake O2 Diff usion Problems Cause Hypoxia Gas Solubility Aff ects Diff usion Gas Transport in the Blood Hemoglobin Binds to Oxygen Oxygen Binding Obeys the Law of Mass Action Hemoglobin Transports Most Oxygen to the Tissues P Determines Oxygen-Hb Binding O2 Oxygen Binding Is Expressed As a Percentage Several Factors Aff ect Oxygen-Hb Binding Carbon Dioxide Is Transported in Three Ways Regulation of Ventilation Neurons in the Medulla Control Breathing Carbon Dioxide, Oxygen, and pH Infl uence Ventilation Protective Refl exes Guard the Lungs Higher Brain Centers Aff ect Patterns of Ventilation The successful ascent of Everest without supplementary oxygen is one of the great sagas of the 20th century. — John B. West, Climbing with O’s , NOVA Online (www.pbs.org) Background Basics Exchange epithelia pH and buff ers Law of mass action Cerebrospinal fl uid Simple diff usion Autonomic and somatic motor neurons Structure of the brain stem Red blood cells and Giant liposomes hemoglobin of pulmonary Blood-brain barrier surfactant (40X) From Chapter 18 of Human Physiology: An Integrated Approach, Sixth Edition. Dee Unglaub Silverthorn. Copyright © 2013 by Pearson Education, Inc. All rights reserved. 633 Gas Exchange and Transport he book Into Thin Air by Jon Krakauer chronicles an ill- RUNNING PROBLEM fated trek to the top of Mt. Everest. To reach the summit of Mt. Everest, climbers must pass through the “death zone” T High Altitude located at about 8000 meters (over 26,000 ft ). Of the thousands of people who have attempted the summit, only about 2000 have been In 1981 a group of 20 physiologists, physicians, and successful, and more than 185 have died. -
Everest and Oxygen—Ruminations by a Climber Anesthesiologist by David Larson, M.D
Everest and Oxygen—Ruminations by a Climber Anesthesiologist By David Larson, M.D. Gaining Altitude and Losing Partial Pressure with Dave and Samantha Larson Dr. Dave Larson is an obstetric anesthesiologist who practices at Long Beach Memorial Medical Center, and his daughter Samantha is a freshman at Stanford University. Together they have successfully ascended the Seven Summits, the tallest peaks on each of the seven continents, a feat of mountaineering postulated in the 1980s by Richard Bass, owner of the Snowbird Ski Resort in Utah. Bass accomplished it first in 1985. Samantha Larson, who scaled Everest in May 2007 (the youngest non-Sherpa to do so) and the Carstensz Pyramid in August 2007, is at age 18 the youngest ever to have achieved this feat. Because of varying definitions of continental borders based upon geography, geology, and geopolitics, there are nine potential summits, but the Seven Summits is based upon the American and Western European model. Reinhold Messner, an Italian mountaineer known for ascending without supplemental oxygen, postulated a list of Seven Summits that replaced a mountain on the Australian mainland (Mount Kosciuszko—2,228 m) with a higher peak in Oceania on New Guinea (the Carstensz Pyramid—4,884 m). The other variation in defining summits is whether you define Mount Blanc (4,808 m) as the highest European peak, or use Mount Elbrus (5,642 m) in the Caucasus. Other summits include Mount Kilimanjaro in Kenya, Africa (5,895 m), Vinson Massif in Antarctica (4,892 m), Mount Everest in Asia (8,848 m), Mount McKinley in Alaska, North America (6,194 m), and Mount Aconcagua in Argentina, South America (6,962 m). -
DEATH ZONE FREERIDE About the Project
DEATH ZONE FREERIDE About the project We are 3 of Snow Leopards, who commit the hardest anoxic high altitude ascents and perform freeride from the tops of the highest mountains on Earth (8000+). We do professional one of a kind filming on the utmost altitude. THE TRICKIEST MOUNTAINS ON EARTH NO BOTTLED OXYGEN CHALLENGES TO HUMAN AND NATURE NO EXTERIOR SUPPORT 8000ERS FREERIDE FROM THE TOPS MOVIES ALONE WITH NATURE FREERIDE DESCENTS 5 3 SNOW LEOS Why the project is so unique? PROFESSIONAL FILMING IN THE HARDEST CONDITIONS ❖ Higher than 8000+ m ❖ Under challenging efforts ❖ Without bottled oxygen & exterior support ❖ Severe weather conditions OUTDOOR PROJECT-OF-THE-YEAR “CRYSTAL PEAK 2017” AWARD “Death zone freeride” project got the “Crystal Peak 2017” award in “Outdoor project-of-the-year” nomination. It is comparable with “Oscar” award for Russian outdoor sphere. Team ANTON VITALY CARLALBERTO PUGOVKIN LAZO CIMENTI Snow Leopard. Snow Leopard. Leader The first Italian Snow Leopard. MC in mountaineering. Manaslu of “Mountain territory” club. Specializes in a ski mountaineering. freeride 8163m. High altitude Ski-mountaineer. Participant cameraman. of more than 20 high altitude expeditions. Mountains of the project Manaslu Annapurna Nanga–Parbat Everest K2 8163m 8091m 8125m 8848m 8611m The highest mountains on Earth ❖ 8027 m Shishapangma ❖ 8167 m Dhaulagiri I ❖ 8035 m Gasherbrum II (K4) ❖ 8201 m Cho Oyu ❖ 8051 m Broad Peak (K3) ❖ 8485 m Makalu ❖ 8080 m Gasherbrum I (Hidden Peak, K5) ❖ 8516 m Lhotse ❖ 8091 m Annapurna ❖ 8586 m Kangchenjunga ❖ 8126 m Nanga–Parbat ❖ 8614 m Chogo Ri (K2) ❖ 8156 m Manaslu ❖ 8848 m Chomolungma (Everest) Mountains that we climbed on MANASLU September 2017 The first and unique freeride descent from the altitude 8000+ meters among Russian sportsmen. -
Comparison of Health and Performance Risk for Accelerated Mars Mission Scenarios
NASA/TM-20210009779 Comparison of Health and Performance Risk for Accelerated Mars Mission Scenarios Erik Antonsen MD, PhD Baylor College of Medicine NASA Johnson Space Center, Houston, TX Mary Van Baalen, PhD; NASA Johnson Space Center, Houston, TX Integrated Medical Model Team Space Radiation Analysis Group Binaifer Kadwa, MS Lori Chappell, MS NASA Johnson Space Center, Houston, TX KBR NASA Johnson Space Center, Houston, TX Lynn Boley, RN, MS KBR Edward Semones, MS NASA Johnson Space Center, Houston, TX NASA Johnson Space Center, Houston, TX John Arellano, PhD Space Radiation Element MEI Technologies NASA Johnson Space Center, Houston, TX S. Robin Elgart, PhD University of Houston Eric Kerstman, MD NASA Johnson Space Center, Houston, TX University of Texas Medical Branch NASA Johnson Space Center, Houston, TX National Aeronautics and Space Administration Lyndon B. Johnson Space Center Houston, Texas 77058 February 2021 NASA STI Program…in Profile Since its founding, NASA has been dedicated to the CONFERENCE PUBLICATION. advancement of aeronautics and space science. The Collected papers from scientific and NASA scientific and technical information (STI) technical conferences, symposia, seminars program plays a key part in helping NASA or other meetings sponsored or co- maintain this important role. sponsored by NASA. The NASA STI program operates under the auspices of the Agency Chief Information Officer. SPECIAL PUBLICATION. Scientific, It collects, organizes, provides for archiving, and technical, or historical information from disseminates NASA’s STI. The NASA STI NASA programs, projects, and missions, program provides access to the NTRS Registered often concerned with subjects having and its public interface, the NASA Technical substantial public interest. -
Outcomes from the 2015 Round Table on Sepsis
The official daily newsletter of the 35th ISICEM Thursday 19 March 2015 Day 3 Outcomes from the 2015 Round Table on sepsis uring the opening session on Tues- day morning, Simon Finfer (Royal North Shore Hospital of Sydney and Sydney Adventist Hospital, Sydney, Australia) was joined by Steven DOpal (Memorial Hospital of Rhode Island, RI, USA) to summarize the major outcomes of the two-day Round Table discussion “This will be a on sepsis. This was a joint conference significant part of our conducted between ISICEM and the Inter- national Sepsis Forum, with representa- research agenda in the tives from every continent highlighting the future – making sure global nature of the problem. Beginning by addressing the current that our patients are state of knowledge in the epidemiology of doing well after they sepsis, Professor Finfer noted that we know leave the hospital.” surprising little, but that obtaining this data will be crucial if any meaningful strategy is Steven Opal to be developed: “To some degree we have data from developed countries, possibly far less than you would expect or think,” he said. “But there are certainly places in, notably, Africa, where we are completely devoid of data.” The reasons for this lack of data can in part be understood by an appreciation of how patient data are currently characterized and treated, with the Global Burden of Disease Project emerging as a central player in generating evidence and guiding is surprising because we believe that sepsis kills one comes into your ICU with community-acquired global health policy. more people than prostate cancer, breast cancer, pneumonia, you treat the pneumonia; maybe they “The only reference to sepsis in these sta- and many other high profile diseases. -
Mount Everest's Death Zone
Mount Everest’s Death Zone Climate change and crowds of climbers are making the world’s tallest mountain more dangerous than ever Mara Grunbaum ast year, 73-year-old Tamae Watanabe of Japan became the oldest woman to climb Mount Everest, the world’s tallest mountain. In L 2010, 13-year-old Jordan Romero of California became the youngest to reach the top. All sorts of people of varying abilities scale the massive mountain in Asia these days. That may not be a good thing—for Everest or the climbers. Last year, more than 500 people reached the top of the Himalayan mountain, which towers 8,850 meters (29,035 feet) above sea level. Hundreds more climbed partway up. While it’s a great achievement to scale Everest, it can sometimes cause problems for the climbers and the mountain itself. Everest is changing. Warming Up Why is Everest becoming more dangerous to climb? One reason is changes in its environment. Much of the mountain is covered in huge sheets of ice called glaciers. Lately, warmer temperatures in the region have been melting these glaciers. Some places that used to be covered in ice year-round are now completely ice-free in the summer. Shrinking glaciers put climbers at risk. As glaciers melt, snow, ice, and rock are more likely to tumble down the mountain in huge avalanches. These snowslides can injure or even kill climbers. “As it gets warmer, more debris tends to fall down,” says American climbing guide Freddie Wilkinson. He’s one of a number of people who think that climbing Everest is becoming too risky. -
Into the Clouds
Into the Clouds ALSO BY TOD OLSON THE LOST® SERIES: Lost in the Pacific, 1942 Lost in Outer Space Lost in the Amazon Lost in the Antarctic Into the Clouds The Race to Climb the World’s Most Dangerous Mountain TOD OLSON New York Copyright © 2020 by Tod Olson All rights reserved. Published by Scholastic Focus, an imprint of Scholastic Inc., Publishers since 1920. SCHOLASTIC, SCHOLASTIC FOCUS, and associated logos are trademarks and/ or registered trademarks of Scholastic Inc. The publisher does not have any control over and does not assume any responsibility for author or third- party websites or their content. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission of the publisher. For information regarding permission, write to Scholastic Inc., Attention: Permissions Department, 557 Broadway, New York, NY 10012. Library of Congress Cataloging-in-Publication Data Names: Olson, Tod, author. Title: Into the clouds : the race to climb the world’s most dangerous mountain / Tod Olson. Description: New York, NY : Scholastic Focus, 2020. | Audience: Age 10-14. Identifiers: LCCN 2019002127 (print) | LCCN 2019014682 (ebook) | ISBN 9781338207378 (E-book) | ISBN 9781338207361 (hardcover : alk. paper) Subjects: LCSH: K2 (Pakistan : Mountain)—Juvenile literature. | Mountaineering—Pakistan—K2 (Mountain)—Juvenile literature. Classification: LCC GB546.K13 (ebook) | LCC GB546.K13 O55 2020 (print) | DDC -
Human Factors in High-Altitude Mountaineering
Journal of Human Performance in Extreme Environments Volume 12 Issue 1 Article 1 Published online: 5-8-2015 Human Factors in High-Altitude Mountaineering Christopher D. Wickens Alion Science and Technology, [email protected] John W. Keller Alion Science and Technology, [email protected] Christopher Shaw Alion Science and Technology, [email protected] Follow this and additional works at: https://docs.lib.purdue.edu/jhpee Part of the Industrial and Organizational Psychology Commons Recommended Citation Wickens, Christopher D.; Keller, John W.; and Shaw, Christopher (2015) "Human Factors in High-Altitude Mountaineering," Journal of Human Performance in Extreme Environments: Vol. 12 : Iss. 1 , Article 1. DOI: 10.7771/2327-2937.1065 Available at: https://docs.lib.purdue.edu/jhpee/vol12/iss1/1 This document has been made available through Purdue e-Pubs, a service of the Purdue University Libraries. Please contact [email protected] for additional information. This is an Open Access journal. This means that it uses a funding model that does not charge readers or their institutions for access. Readers may freely read, download, copy, distribute, print, search, or link to the full texts of articles. This journal is covered under the CC BY-NC-ND license. Human Factors in High-Altitude Mountaineering Christopher D. Wickens, John W. Keller, and Christopher Shaw Alion Science and Technology Abstract We describe the human performance and cognitive challenges of high altitude mountaineering. The physical (environmental) and internal (health) stresses are first described, followed by the motivational factors that lead people to climb. The statistics of mountaineering accidents in the Himalayas and Alaska are then described. -
Altitude Sickness
Altitude Sickness Team River Runner hosted their National Conference and Swiftwater Rescue Training out West this year. It was a great place to visit and our hosts: TRR Boise and Pilgrim’s Cove couldn’t have been more accommodating. Several participants came from low lying areas – near sea level including myself. Some attendees and myself as well experienced: • Headache • Loss of normal appetite • Nausea • Insomnia • General Fatigue We each came up with different conclusions on why we were experiencing these symptoms, in my case possible motion sickness, dehydration, etc. None of us thought Altitude Sickness may be contributing to our malaise. It wasn’t till after the conference when several of us that live near sea level and were experiencing the above symptoms figured out that a mild form of Altitude Sickness was a highly probably diagnosis. Part of my job is Risk Management so it’s well worth considering this possibility and precautions we should consider whenever traveling to locales that can trigger these issues. Most whom take Wilderness First Aid courses are taught the magic cutoff: 2400m or roughly 8,000’ (Red Cross says 7,000’). McCall Idaho is roughly 5,000’, roughly a mile high. It turns out that the 8,000’ cutoff is actually for: • HACE – High Altitude Cerebral Edema • HAPE – High Altitude Pulmonary Edema High Altitude per Wilderness EMS is actually from 1,500m to 3,500m, or starting at 4,921’ (roughly the altitude where we were staying at). A good guide is the Lake Louise Acute Mountain Sickness (AMS) Scoring System (LLS). -
Altitude Sickness Fact Sheet
Altitude Sickness Fact Sheet At high elevation, you may experience a potentially life threatening condition called altitude sickness. This is exacerbated if you ascend in elevation quickly. At 8,000 feet, there is only ~75% of the available oxygen at sea level. Oxygen decreases ~3% with each 1000 feet in elevation. Altitude sickness is caused by the body not being able to get enough oxygen. There are three types of altitude sickness: Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema. SYMPTOMS Acute Mountain Sickness • Lack of appetite, nausea, or vomiting • Fatigue • Dizziness • Insomnia • Shortness of breath upon exertion • Nosebleed • Persistent rapid pulse • Swelling of hands, feet, and/or face High Altitude Pulmonary Edema (HAPE) • Symptoms similar to bronchitis • Persistent dry cough • Fever • Shortness of breath even at rest High Altitude Cerebral Edema (HACE) • Headache that does not respond to medication • Difficulty walking • Altered mental state (confusion, changes in alertness, disorientation, irrational behavior) • Loss of consciousness • Increased nausea • Blurred vision or retinal hemorrhage PREVENTION If your hike starts at high elevation, spend a few days adjusting to the altitude prior to any major physical exertion. It is best to sleep no more than 1,500 feet (457.2 m) higher than you did the night before. This helps the body adjust gradually to the decreased amount of oxygen. Contact your primary care physician for an evaluation prior to travelling to areas with high elevation. FIRST AID TREATMENT If you have any of these symptoms at altitude, assume that it is altitude sickness until proven otherwise. Do not ascend any further with symptoms. -
Safe Sojourns to High Altitudes: the Risks of Annual Religious Pilgrimages in Jammu and Kashmir, India- Clinical Diagnostics and Treatment
Research Article JOJ Pub Health Volume 2 Issue 1 - May 2017 Copyright © All rights are reserved by SM Kadri Safe Sojourns to High Altitudes: The Risks of Annual Religious Pilgrimages in Jammu and Kashmir, India- Clinical Diagnostics and Treatment SM Kadri1*, Saleem-ur-Rehman2, Michael W Popejoy3 and Christoph S Eberle4 1Division of Epidemiology and Public Health, Integrated Disease Surveillance Programme, India 2Department of Health Services, Fellow WHO Director, India 3Department of Health Promotion and Disease Prevention, Florida International University, USA 4National Academy of Clinical Biochemistry, Associate Fellow, USA Submission: May 04, 2017; Published: May 26, 2017 *Corresponding author: SM Kadri, Division of Epidemiology and Public Health, RFPTC Building, Barzulla, Srinagar 190005, Kashmir, India, Email: Abstract increasing prevalence for this type of illness. In The behavioral characteristics of high altitude climbers and the precautions necessary to This article addresses the clinical diagnosis and clinical treatment plan for several diseases that afflict high altitude climbers and the described; then, the common treatment regimens for climbermal adaptation for high altitude sickness are covered. The conclusion explored inprevent the discussion death from is thatthe high no one altitude need sportdie from activities high altitude are introduced; sickness iffirst; proper then. planning The clinical and manifestationsgood judgment ofare different applied diseaseto climbing complexes protocols; are and, that these rules are