ICU SAQs · Environmental emergencies
High-altitude pulmonary oedema — the management
A CICM SAQ on HAPE — the immediate descent, the oxygen, the nifedipine, the Gamow bag.
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Prompt
A climber at 4500 m develops dyspnoea at rest, a productive cough and bilateral crackles. Outline the management.
Question
A climber at 4500 m develops dyspnoea at rest, a productive cough and bilateral crackles. Outline the management.[2]
References4ShowHide
- [1]Luks AM, Beidleman BA, Freer L, Grissom CK, Keyes LE, McIntosh SE, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention, Diagnosis, and Treatment of Acute Altitude Illness: 2024 Update Wilderness Environ Med, 2024.PMID 37833187
- [2]Stream JO, Grissom CK Update on high-altitude pulmonary edema: pathogenesis, prevention, and treatment Wilderness Environ Med, 2008.PMID 19099331
- [3]Luks AM, Auerbach PS, Freer L, Grissom CK, Keyes LE, McIntosh SE, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update Wilderness Environ Med, 2019.PMID 31248818
- [4]Bärtsch P, Maggiorini M, Ritter M, Noti C, Vock P, Oelz O Prevention of high-altitude pulmonary edema by nifedipine N Engl J Med, 1991.PMID 1922223