Outworld Rescue & Medical Services

17/10/2024

"Readiness Be All"
--Hawk, Spencer by Robert B Parker

09/10/2024

12/04/2024

13/05/2023

We've seen a few folks who are cutting their trips short by attempting to preacclimatize at home in a hypoxic tent. These tents can simulate thin air, but not the low pressure environment that just may be a crucial factor for acclimatization. The marketing pitch goes something like this: stay home, stay at work, just sleep in a hypoxia tent at night, fly right in to base camp and start your climb, skipping that 2 week acclimatization walk.

NOT SO FAST! The Wilderness Medical Society altitude guidelines, written by a panel of experts that scour the literature, have this to say: Although the systems are marketed to be of benefit and anecdotal reports suggest they are widely used by climbers and other athletes competing at high altitude, there are no data indicating increased likelihood of summit success or improved physical performance. Any benefit that may accrue from these systems is more likely with long hypoxic exposures (>8 h per day) for at least several weeks before planned high altitude travel. In addition to the cost of the systems and power needed to run them, individuals face the risk of poor sleep, which over a long period of time could have deleterious effects on performance during an expedition. (Paraphrasing, for more information, visit this free download for the full discussion: https://www.wemjournal.org/article/S1080-6032(19)30090-0/fulltext

So do they work? There are many variables that could play into their success or failure. One is an incomplete understanding about the role of pressure in the acclimatization equation, another is that different tents may have different standards/construction, another is the protocol for use (eg what role do individual genetics play? how long should they be used in advance? how many breaks can a person take?) The bottom line is that much more research needs to be done if these devices are to be relied upon. In the meantime, the safest approach is the old fashioned one: time and gradual ascent.

06/05/2023

News 5 Live visits the "Black Hole Drop" at Ian Anderson's Caves Branch Lodge. This story was shot in late 1999 or early 2000. Winner of the Caribbean Broa...

05/04/2023

High Altitude Pulmonary Edema: A cautionary tale

Our doctors recently treated a case of high altitude pulmonary edema (HAPE) in our newly opened clinic. A young healthy patient entered complaining of shortness of breath that was initially aggravated with exertion but later persisted with rest and was associated with chest heaviness, productive cough and dizziness when walking. The patient gave a history of walking from 2700m to 5350m in 5 days (!) and had no previous history of altitude related illness.

The patient appeared pale and had obviously labored breathing. The pulse oximeter read 55% and lung auscultation revealed crackles suggesting fluid in the air spaces. A full history and examination led our team to diagnose HAPE, and the patient was immediately placed on oxygen and given nifedipine which stabilized the patient's symptoms and enabled them to facilitate transfer down to a lower altitude for further care.

Many factors can contribute to the development of HAPE, but the most preventable risk is failing to allow time for the body to acclimatize.

In general, people planning ascent above 3000 m should take at least 2 days of staged ascent to get to 3000m, and then on subsequent days not increase their sleeping elevation by more than 500m per day. A safe plan should include a rest day (ie, no ascent to higher sleeping elevation) every 3 to 4 days. The increase in sleeping elevation should be less than 500m for any given day of a trip.

For much more information about HAPE and for prevention and treatment of altitude illnesses, check out these (free download!) guidelines published by the Wilderness Medical Society at https://www.wemjournal.org/article/S1080-6032(19)30090-0/fulltext

Trek safely everyone!
Makalu E - Traders Nirvana Outdoor Gears HIMALI Himalayan Rescue Association Nepal Wilderness Medical Society

06/01/2023

22/09/2022

Dr. Elizabeth Bruyn sits in the rear of her horse drawn ambulance in the United States, 1911.