High-altitude medicine
ZONE OF KNOWLEDGE
CARBON MONOXIDE POISONING
Using a gas burner inside a tent is very dangerous and is not recommended by the manufacturers of burners or tents.
The main hazards are:
➤ carbon monoxide poisoning
➤ fire
However, in practice, climbers often take this risk.
When there is strong wind and frost outside, cooking outdoors is impossible. Without melting snow and preparing food, a climber has no chance of functioning in the mountains.
Lack of food and water leads to:
➤ dehydration
➤ energy exhaustion
➤ hypothermia
➤ frostbite
Therefore, in practice, climbers choose the lesser evil – cooking in the tent.
EPIDEMIOLOGY
In the United States, from 1999 to 2004, carbon monoxide was responsible for about 16,000 deaths, of which 16% were unintentional deaths not related to fires.
PATHOPHYSIOLOGY
Carbon monoxide is a colorless and odorless gas that has about 250 times greater affinity for hemoglobin than oxygen.
When combined with hemoglobin, it forms carboxyhemoglobin, which:
➤ impairs oxygen transport
➤ leads to organ hypoxia
In high mountains, poisoning is particularly dangerous because the reduced atmospheric pressure and lower oxygen levels cause symptoms of hypoxia to appear more quickly.
SYMPTOMS
Symptoms of carbon monoxide poisoning are very diverse, making diagnosis difficult.
They may include:
➤ headache
➤ fatigue
➤ exertional dyspnea
➤ chest pain
➤ abdominal pain
➤ nausea and vomiting
➤ weakness
➤ confusion
➤ balance and memory disturbances
➤ drowsiness
➤ hallucinations
➤ anxiety
➤ vision disturbances
➤ fainting
➤ seizures
➤ incontinence of urine and feces
➤ coma
Accelerated heart rate is also often observed:
➤ increased heart rate
➤ rapid breathing
Symptoms such as:
➤ headache
➤ balance disturbances
➤ consciousness disturbances
are identical to those in HACE.
Carbon monoxide poisoning should be particularly suspected when similar symptoms occur simultaneously in several people in one room.
HACE rarely occurs simultaneously in several people.
Untreated carbon monoxide poisoning can lead to death.
TREATMENT
The most important thing is to immediately stop exposure.
One should:
➤ remove the source of carbon monoxide
➤ take poisoned individuals out of the room
➤ ventilate the tent or room
Half-life of carbon monoxide:
➤ 3–4 hours when breathing atmospheric air
➤ 30–90 minutes when breathing 100% oxygen
➤ 15–23 minutes in a hyperbaric chamber (2.5 atm)
LITERATURE
• Johnson C., Anderson S.R., Dallimore J. et al.: Oxford handbook of expedition and wilderness medicine. Oxford University Press, 2008
• Forgey W.W.: Wilderness Medical Society: Practice guidelines for wilderness emergency care. Falcon, 2006
• West J.B., Schoene R.B., Milledge J.S.: High altitude medicine and physiology. Hodder, 2007
• Traveling in High Mountains –www.medex.org.uk
• Hackett P.H., Roach R.C.: High altitude cerebral edema. High Alt. Med. Biol., 2004
• Shochat G.N., Lucchesi M.: Carbon Monoxide Toxicity in Emergency Medicine. Medscape
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WANT TO KNOWMORE?
If you want to better prepare health-wise for trekking or a high-altitude expedition, you can find the extended version of the guide in the ebook"High Altitude Medicine in Practice – A Guide for Trekking and Expeditions" >>
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You will also learn practical knowledge about emergency procedures in the mountains in the online training"High Altitude First Aid" >> - designed for those planning trips to high altitudes.
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Detailed contents of the expedition first-aid kit and a complete guide to preparing an expedition first-aid kit and personal rescue kit can be found in the ebook"Expedition First Aid Kit – A Complete Medical Guide" >>
PLANNING A TREKOR A HIGH-ALTITUDE EXPEDITION?
If you want to check whether your health allows you to safely participate in a trek or high-altitude expedition, it is worth taking advantage ofa medical consultation >> ora telemedicine expedition package >>
This way, you can assess health risks in advance, prepare appropriately for the trip, and increase safety while at high altitude.
The company was established in 2004. The goal of MedEverest is education in the field of mountain medicine and the dangers of high altitudes. I deal with all medical aspects of staying at high altitude. I organize medical support for trekking and high-altitude expeditions.
Specialist Medical Practice Medeverest Robert Szymczak based in Gdańsk (80-360), at ul. Bolesława Krzywoustego 19F, NIP: 5841943576, REGON: 220148318.
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