KIN 3304 1nd Edition Lecture 31 Outline of Last Lecture I What is High Altitude II Why Can t We Breath III Getting Up There IV Why is Going Up a Mountain and coming down so Dangerous V What Challenges Do We See VI Possible TQ VII Acute Mountain Sickness VIII Another Possible TQ IX High Altitude Cerebral Edema X HACE continued Outline of Current Lecture I HAPE II At Elevation III HAPE cont IV HAPE Treatment V Comatose HAPE Patient Current Lecture I HAPE These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute a Misdiagnosed as pneumonia b Symptoms at least 2 of i Dyspnea at rest cough weak decreased function chest tightness congestion c Signs at least 2 of i Wheezing crackle in lung s cential chest turns blue cyanosis tachycardia not getting enough O2 tachypnea breathing increases II At Elevation a Hyperventilation is normal b Increased urination c Frequent awakening often to urinate i Insomnia normal probably due to cerebral hypoxia d Periodic breathing at night i Most prominent during sleep ii Apnea breath holding panic upon awakening 1 I m dying of pulmonary edema III HAPE cont a Thought to be due to patch hypoxic vasoconstriction in the pulmonary vascular bed shunting blood through a limited number of vessels b Results in high pressure vascular leak c Normal O2 saturation at rest d Try to provoke desaturation in suspected HAPE i Walk test person with HAPE will desaturate ii Fatigue healthy person will not e Patient often breathless gurgling i May cough up white or pink foamy sputum ii Frequently unable to lie flat too painful to cant breath iii Often misdiagnosed as pneumonia sounds similar Grade Symptoms Signs 1 mild Dyspnea or exertion HR at rest 90 100 Dry cough Desaturation Fatigue moving up hill 2 moderate Dyspnea or exertion HR at rest 90 100 Raspy cough Crackling breath Fatigue on walking 3 severe Dyspnea or exertion HR at rest 110 Productive cough Bilateral crackling Extreme weakness Blood in septum Stupor coma IV HAPE Treatment a Descent is urgent i Death can be in hours b May not be able to walk c Exertion raises pressure i Must carry patient d Keep warm i Decrease temperature increase PAP e Hyperbaric i 2 4 can equal recovery ii That s fast f Nifedipine i Anti hypertensive ii Increases pulmonary dilation helps BF decrease pressure pee a lot then dehydrated g Dieuretics h Oxygen i Is lifesaving V Comatose HAPE Patient a This isn t uncommon b Getting climber down depends on altitude weather patients status other climbers status also how close to summit i Try to get patient down ii If at extreme altitude probably will have to leave climber to die
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