Post #5 of 6:

The most recent issue of the Wilderness Medicine Newsletter, Nov/Dec 2006, is dedicated to the recognition and management of high altitude illnesses.  To follow is a series of postings regarding high altitude illnesses, recognition and management.

The majority of cases of HACE occur because they continued to ascend while they still had the symptoms of Acute Mountain Sickness.
Signs & Symptoms: Severe AMS plus

Change in mentation or the ability to think and solve simple problems
Loss of coordination – ataxia, can be subtle but cannot tandem-gait walk
Possible hallucinations
Cheyne-stokes respirations
Signs of increasing Intracranial Pressure (ICP)


IMMEDIATE RAPID DESCENT at least 500 – 1000 meters
If unable to descend, place in pressure bag, Gamow, Cretec, or PAC bag
Administer O2 if available, 4-6 lpm by nasal cannula or with PEEP
Hydrate if conscious
Monitor SaO2 by pulse oximeter


Dexamethasone (Decadron), 8mg po or IM stat, then 4mg po or IM q6h
Oxygen, 4-6lpm by nasal cannula or with PEEP, titrate as needed

This blog is powered by the Wilderness Medicine Newsletter, now celebrating 20 years of publication. The WMN is published and distributed online six times each year by TMC Books, and subscriptions cost as little as $10 per year. To find out more, or to subscribe online, click here.

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