The prevention, diagnosis and treatment of mountain sickness in team climbing

Since he became obsessed with climbing, he began to pay attention to mountain sickness. Although she has worked in hospitals but has never been exposed to mountain sickness, some information on mountain sickness is now compiled.

Alpine disease classification:

Alpine diseases can be divided into seven types: acute mountain sickness (AME), alpine pulmonary edema (HAPE), alpine brain edema (HACE), high mountain hypertension, alpine erythrocytosis, high mountain heart disease, and mixed chronic mountain disease. Among them, alpine pulmonary edema and alpine brain edema are acute; the combination of hyperemia of alpine erythrocytosis and chronic alpine disease is chronic; the other three types are acute and chronic. Common acute mountain sickness, high altitude pulmonary edema and high altitude brain edema.

The cause of mountain sickness:

1. Acute mountain sickness (AME) is the result of a series of hypoxic reactions that occur in a short period of time due to the reduction of atmospheric pressure and the lack of oxygen after the plains enter the plateau or enter the higher altitudes from lower altitudes. Adapted to produce.

2. High altitude alveolar edema (HAPE) is caused by hypoxia causing pulmonary hypertension and increased pulmonary blood volume, increasing the permeability of capillaries; imbalance of vasoconstriction, resulting in turbulent flow in areas with weak contractions, resulting in edema in these areas; liquid passage The arterial wall near the resistive blood vessel leaks; thrombosis occurs due to a clotting mechanism, which in turn causes pulmonary hypertension and pulmonary edema. Some people think that alpine pulmonary edema is a complication of acute high altitude disease. It is characterized by acute onset, rapid development of disease, and frequent nighttime sleep. Failure to diagnose and treat it in time can be life-threatening.

3. The cause of alpine brain edema (HACE) is due to hypoxia leading to increased cerebral blood flow, increased intracranial pressure and brain edema, and increased brain volume, resulting in compression of the brain tissue, metabolic disorders of the brain cells, dysfunction, and then Coma and death.

Prevention of mountain sickness: The prevention of mountain sickness can start from daily and before the upper plateau. Usually can strengthen the exercise, enhance physical fitness, one week before the plateau should pay attention to the law of life, do not overwork, do not stay up late, absolutely do not have upper respiratory tract infection. At the same time can be oral Rhodiola. After reaching the plateau, it is absolutely forbidden to drink alcohol. During the mountaineering process, care should be taken to ensure that nutrition and warmth are not excessively exhausted. The absolute height of daily rise should not be too great, and appropriate adaptation time should be given at appropriate altitude. Some people believe that oral compound dangshen tablets and acetazolamide can effectively prevent acute mountain sickness. Compound Dangshen Tablets were taken 2 days before the peak, 8 tablets per day, and the effective rate of prevention was 80%. Acetazolamide is taken 1 to 2 days before entering the plateau, 250 mg each time, twice daily, for 3 to 4 consecutive days. Occasionally there are some side effects, those who have sulfa allergy are cautioned or avoided.

Alpine disease diagnosis and treatment:

1. The clinical manifestations of acute mountain sickness in acute mountain sickness (AME) are complex and diverse, depending mainly on the speed and height of entry into the plateau and the adaptability of the body to a hypoxic environment. Clinical manifestations include headache, dizziness, excitement or indifferent expression, insomnia, drowsiness, lack of concentration, decreased judgment and memory, tinnitus, dizziness, weakness, numbness in hands and feet, nausea, vomiting, loss of appetite, palpitation, and shortness of breath. Treatment of patients should be bed rest, and give oxygen, while severe oral acetoamide patients can be injected with dexamethasone muscle or intravenously, while the patient was sent to low altitude areas. Oral acetamide and dexamethasone combined use better.

2. Mountain alveolar edema (HAPE) is a malignant type of alpine disease. In general, it occurs on the basis of acute altitude sickness. Therefore, it has also been suggested that high altitude pulmonary edema is a complication of acute altitude sickness, and may also worsen on the basis of upper respiratory tract infection. The symptoms are similar to those of acute mountain sickness, but they are more serious. The diagnosis should be differentiated. As the condition progresses, the patient develops severe dyspnea, with a slight foamy phlegm, initially white or light yellow, and later turns pink. More people rushed from the nose and nose. The patient was restless and a few patients were lethargic. Lips, facial bruising, elevated body temperature and infection, rapid heart rate. At the same time pay attention to the "susceptible" of high altitude pulmonary edema (people suffering from high altitude pulmonary edema are susceptible to recurrence). In the treatment of patients should be absolutely bed rest, while giving a large flow of oxygen. Oral furosemide and dexamethasone are injected. At the same time, the patient was evacuated to a low altitude area. It is worth noting that furosemide can cause a sudden loss of body fluids, which in turn can cause electrolyte disturbances. In the diet, attention should be paid to maintaining potassium intake, and the patient's drinking water should also be controlled.

3. Alpine alveolar edema (HACE) is a malignant type of alpine disease, occurring most often when it is rushed to more than 6,000 meters, or when it is excessively fatigued. The brain tissue has a high requirement for oxygen. The human brain accounts for about 2% of the body weight, but its blood requirement accounts for 1/6 of the cardiac output, and oxygen consumption accounts for 20% of the total body oxygen consumption. Therefore, the brain tissue Hypoxia is particularly sensitive. When a person is at an altitude of 4,000 meters with mild oxygen deprivation, he is shown to be in high spirits, agitated, euphoric, and as active as a lightly drunk person. When reaching an altitude of 6000-7000 meters or more, in the process of moderate to severe hypoxia, people's ability to think, analyze, judge, and memory will be weakened, and they are easily sleepy. Someone else went up to 8,000 meters above sea level and even experienced hallucinations. The clinical manifestations include the patient's loss of orientation, loss of memory, hallucinations, psychotic behavior, disturbance of consciousness, incontinence, sleepiness, and coma, in addition to symptoms of early altitude sickness. Severe coma, more complicated with cerebral hemorrhage and endanger life. Before the onset of the disease, there were more severe headaches and palpitations. Later, he developed indifferent expressions or irritability and confusion. In terms of treatment, the disease is heavy, but the process before and after the confusion is long, and we should seize the time and reduce the height. And oral furosemide intravenous mannitol, and intravenous injection of dexamethasone, strictly limit the patient's drinking water, wet towels can be cold forehead, reduce intracranial pressure.

Summary: The three major causes of mountain deaths are slumps, avalanches, and mountain diseases. Nowadays, domestic mountaineers begin to use alpine methods to climb mountains. The Algerian climbing team does not have a high degree of resilience to disasters. Therefore, it should do its best to ensure safety. The above approach takes into account the actual suffering of the climbers based on first aid in harsh environments. The method is simple and feasible, but it is necessary to thoroughly treat alpine disease in the hospital after the withdrawal. High mountain sickness is still an old saying. Attention should be paid to prevention. When the body cannot complete the climb, it should rationally give up the summit.

Author: This man outdoor weight rampant authorization Information Network article from outdoor information network

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