Prolonged Field Care Podcast Prolonged Field Care Podcast: High Altitude
May 9, 2025
Ian Wedmore, an emergency physician and wilderness medicine expert, dives into the crucial topic of high altitude medicine. He unveils the new Clinical Practice Guidelines for altitude-related illnesses, emphasizing the diagnosis and treatment of acute mountain sickness and high altitude pulmonary edema. Wedmore highlights the importance of technologies and prevention strategies to manage these conditions effectively in military and wilderness settings. Additionally, he discusses the key role of medications like acetazolamide and dexamethasone, alongside hydration and nutrition for successful acclimatization.
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Military-Focused Altitude Guidelines
- The new Joint Trauma System altitude CPG adapts civilian guidance for military austere operations.
- It adds stepwise, mission-focused algorithms for situations where descent isn’t immediately possible.
Why Acute Mountain Sickness Happens
- Acute mountain sickness results from ascending faster than physiologic acclimatization allows.
- Key maladaptations include increased ventilation and vascular leak leading to HACE and HAPE.
Use Lake Louise Score For Diagnosis
- Use the Lake Louise scoring system and require headache plus one other symptom to diagnose AMS.
- Remember altitude thresholds: usually ≥2,000 m (can be as low as 1,500 m) for true AMS.