Abstract:
OBJECTIVE:The purpose of this study was to review the patient characteristics and management of 56 cases of high altitude pulmonary edema at the Pheriche Himalayan Rescue Association Medical Aid Post, and to measure the use of medications in addition to descent and oxygen. METHODS:In a retrospective case series, we reviewed all patients diagnosed clinically with high altitude pulmonary edema during the 2010 Spring and Fall seasons. Nationality, altitude at onset of symptoms, physical examination findings, therapies administered, and evacuation methods were evaluated. RESULTS:Of all patients, 23% were Nepalese, with no difference in clinical features compared with non-Nepalese patients; 28% of all patients were also suspected of having high altitude cerebral edema. Symptoms developed in 91% of all patients at an altitude higher than the aid post (median altitude of onset of 4834 m); 83% received oxygen therapy, and 87% received nifedipine, 44% sildenafil, 32% dexamethasone, and 39% acetazolamide. Patients who were administered sildenafil, dexamethasone, or acetazolamide had presented with significantly lower initial oxygen saturations (P ≤ .05). After treatment, 93% of all patients descended; 38% descended on foot without a supply of oxygen. CONCLUSIONS:A significant number of patients presenting to the Pheriche medical aid post with high altitude pulmonary edema were given dexamethasone, sildenafil, or acetazolamide in addition to oxygen, nifedipine, and descent. This finding may be related to perceived severity of illness and evacuation limitations. Although no adverse effects were observed, the use of multiple medications is not supported by current evidence and should not be widely adopted without further study.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Jones BE,Stokes S,McKenzie S,Nilles E,Stoddard GJdoi
10.1016/j.wem.2012.07.004subject
Has Abstractpub_date
2013-03-01 00:00:00pages
32-6issue
1eissn
1080-6032issn
1545-1534pii
S1080-6032(12)00193-7journal_volume
24pub_type
杂志文章abstract:OBJECTIVE:Planning and providing emergency and primary care for a large transient population of visitors and employees in a national park can be problematic. Furthermore, planning for emergency and primary health care needs of visitors and itinerant workers in a wilderness area national park has not been well documente...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2000)011[0257:pfaaem]2.3.co;2
更新日期:2000-01-01 00:00:00
abstract::High-altitude pulmonary edema (HAPE) is a well-recognized disease entity in trekkers to the Nepal Himalayas. We present the case of a patient who had clinical features consistent with HAPE but did not descend the mountain on time, which contributed to his death. The important factors of the diagnosis, the descent, and...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2000)011[0099:atroph]2.3.co;2
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:Little is known about health care provider interest, knowledge, and beliefs regarding the health effects of human-induced environmental degradation (HIED). A survey was created and distributed to better characterize health provider beliefs about the adverse health effects of HIED. METHODS:An invitation to pa...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/08-WEME-OR-222R1.1
更新日期:2009-10-01 00:00:00
abstract::The ability to control water-borne diseases is critical for soldiers, hikers, and others who may need to drink directly from an outdoor source. Water-borne protozoan parasites that are specifically of concern are Giardia and Cryptosporidium because of their resistance to halogen disinfection. The purpose of this study...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(1997)008[0096:eoiwpt]2.3.co;2
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:The main goal was to explore the different toxin properties (proteolytic, hemorrhagic, and neurotoxic) of Leptodeira annulata ashmeadii Duvernoy's gland secretion (DGS). METHODS:To separate and characterize the different proteins present in L. annulata ashmeadii DGS, 20% sodium dodecyl sulfate-polyacrylamide...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2004)015[0082:phanac]2.0.co;2
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:Thermal sensation and the physiological responses of women (follicular phase) exposed to 17 degrees C immersion for 120 minutes were investigated. METHODS:The subjects were divided into 2 groups by percent body fat (low fat [LF] = 21% +/- 2% [mean +/- SD] vs high fat [HF] = 30% +/- 3%). A 2-way analysis of v...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2000)011[0157:tsasud]2.3.co;2
更新日期:2000-10-01 00:00:00
abstract::Families are traveling with their children in increasing frequency. Travel to Asia offers children many opportunities to learn about new cultures and history. It also offers the potential for exposure to numerous infectious agents not commonly encountered in the United States. Families must begin to prepare for travel...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章,评审
doi:10.1580/06-WEME-RA-026R2.1
更新日期:2007-10-01 00:00:00
abstract::The purpose of this case study is to examine the physiological/behavioral factors leading up to heat exhaustion in a male wildland firefighter during wildland fire suppression. The participant (24 years old, 173 cm, 70 kg, and 3 years firefighting experience) experienced heat exhaustion following 7 hours of high ambie...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2011.01.008
更新日期:2011-06-01 00:00:00
abstract::Exercise-associated hyponatremia (EAH) is defined by a serum or plasma sodium concentration below the normal reference range of 135 mmol/L that occurs during or up to 24 hours after prolonged physical activity. It is reported to occur in individual physical activities or during organized endurance events conducted in ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章,实务指引
doi:10.1016/j.wem.2014.08.009
更新日期:2014-12-01 00:00:00
abstract::We present 3 cases of severe hyponatremia occurring on a commercially guided river rafting trip on the Colorado River in Grand Canyon National Park. All 3 women appeared to have been overhydrating because of concern about dehydration and required evacuation within 24 hours of each other after the staggered onset of sy...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2014.08.007
更新日期:2015-06-01 00:00:00
abstract::A hydatid cyst is a parasitic disease caused by the tapeworm Echinococcus granulosus. It is endemic in many areas, including New Zealand, Australia, and the Mediterranean region. Pulmonary hydatid disease can be diagnosed incidentally in asymptomatic patients or may cause symptoms such as cough, chest pain, dyspnea, f...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/07-WEME-CR-1561.1
更新日期:2008-07-01 00:00:00
abstract::Recent studies in normal participants have shown that right to left shunt blood vessels in the lung open up during exercise. We describe the first field study to investigate this phenomenon at altitude. This study aimed to assess the effect of altitude and partial acclimatization on inducible right to left shunting at...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/07-WEME-BR-162.1
更新日期:2008-10-01 00:00:00
abstract::Fatalities secondary to inhalation of volcanic gases in the United States have rarely been reported. We report the deaths of 3 ski patrol members at a popular California ski resort. After a snowstorm, ski patrol members were fencing off a well-known volcanic fumarole when the snow around the vent collapsed. Two member...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/08-WEME-CR-199.1
更新日期:2009-04-01 00:00:00
abstract:INTRODUCTION:Depending on their theatre of operation, French soldiers may potentially be exposed to scorpion stings and snakebites. Following the recommendations of a French military health service (FMHS) technical committee for envenomation, the FMHS provides antivenoms appropriate to each deployment. This work aimed ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2020.01.006
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Most recreational whitewater fatalities are caused by fixed underwater entrapment or by "flush drowning," an obscure term frequently associated with high-volume rivers, continuous rapids, cold water, and a lack of prolonged underwater entrapment. Although entrapment drowning is typically associated with su...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2019.09.006
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:Physical stress (exercise and/or environmental) activates the sympathetic-adrenal-medullary (SAM) and hypothalamic-pituitary-adrenocortical (HPA) axes. The combination of ultraendurance exercise in the cold presents a unique summated stress to the body. The purpose of this study was to assess the stress hormo...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2009.12.020
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Grand Canyon National Park has seen an increase in visitors traversing the canyon from rim to rim (R2R) in a single day. R2R hikers travel over 33.8 km (21 mi) over 3300 m (11,000 ft) of elevation change and endure large temperature changes. Grand Canyon emergency medical service providers provide emergenc...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2018.08.001
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:The purposes of this experiment were to determine the repeatability of acute mountain sickness (AMS), AMS symptoms, and physiological responses across 2 identical hypoxic exposures. METHODS:Subjects (n = 25) spent 3 nights at simulated altitude in a normobaric hypoxia chamber: twice at a partial pressure of ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2013.11.007
更新日期:2014-06-01 00:00:00
abstract::Flying snakes (Genus Chrysopelea) are a group of ophisthoglyphous colubrids in South and South East Asia known for gliding in the air. Of the five species of flying snakes, Sri Lankan flying snake, Chrysopelea taprobanica, is endemic to Sri Lanka. Authenticated bites and the venom characteristics of this uncommon snak...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2013.01.008
更新日期:2013-09-01 00:00:00
abstract::We experienced a case involving prolonged cardiopulmonary resuscitation (CPR) during cardiac arrest on Mt. Fuji (3776 m), demanding lengthy exertion by the rescuers performing CPR. Considering the effects of exertion on the rescuers, we examined their percutaneous arterial oxygen saturation during simulated CPR and co...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2019.10.008
更新日期:2020-03-01 00:00:00
abstract::Despite the presence of a number of anecdotal reports in the mountaineering literature, mucociliary dysfunction at high altitude has received little scientific attention. However, the dry, cold, thin air at high altitude has the potential to undermine normal mucociliary function. This seems increasingly likely in moun...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章,评审
doi:10.1580/pr36-05.1
更新日期:2006-01-01 00:00:00
abstract::Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and n...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2015.09.006
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:This study compared 2 commercially available beverages, an oral rehydration solution (ORS; 60.9 mM Na+; 3.4% carbohydrate) and a sports drink (SDS; 18.4 mM Na+; 5.9% carbohydrate), on hydration and metabolism during submaximal exercise in the heat. METHODS:Ten male subjects completed two 90-min exercise t...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2018.01.005
更新日期:2018-06-01 00:00:00
abstract::Pig bite injuries are an infrequently described consequence of human-animal conflict. The domestic pig is thought to be a placid animal not given to unprovoked aggression. We report 2 separate cases of children managed at our institution who sustained abdominal injuries after attack by domestic pigs in rural Zimbabwe....
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2019.08.002
更新日期:2019-12-01 00:00:00
abstract:INTRODUCTION:Clinical and bacteriological features of cobra (Naja) bites are still relatively unknown in Vietnam. This study aimed to characterize the clinical and bacteriological characteristics of local wounds in patients with presumed Naja spp bite, as well as their antibiotic treatment. METHODS:A cross-sectional s...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2020.01.002
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To describe search and rescue activity performed by the National Park Service (NPS) on Denali, the highest point in North America. METHODS:A retrospective review was performed of all search and rescue (SAR) operations by the NPS from 1990 to 2008. Descriptive analysis was used to describe these cases as well...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2009.12.024
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Our objective was to determine the incidence of acute mountain sickness (AMS) and the cardiorespiratory responses, in children and their parents, after rapid ascent to 3500 m. The sample population was composed of children and their parents who ascended within 24 hours from Arica (sea level) to Putre (3500 m)...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/06-WEME-BR-084.1
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Minimal data exist regarding the activity, membership, training, and medical oversight of search and rescue (SAR) teams. OBJECTIVE:Our objective was to describe these characteristics in the Intermountain West SAR organizations. METHODS:A contact list was generated and electronic surveys were sent to SAR of...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2013.08.002
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:Portable electronic devices play an important role in the management of type 1 diabetes mellitus. Electromagnetic interference from electronic devices has been shown to impair the function of an avalanche transceiver in search mode (but not in transmitting mode). This study investigates the influence of elect...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2014.12.016
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To document changes in body composition and body mass in male and female tree planters. METHODS:Height, mass, skin-fold thickness, and limb girths were measured in 17 male and 5 female tree planters before and after 10 weeks of work. RESULTS:Significant decreases were found in body mass (80.6 +/- 10.7 kg vs...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/pr01-03.1
更新日期:2005-04-01 00:00:00