Protocols for the use of a portable hyperbaric chamber for the treatment of high altitude disorders

Descent remains the definitive treatment for high altitude illness. However, in alpine settings of over 8000 ft, immediate evacuation is often impossible. A portable, lightweight (7 kg) hyperbaric bag has been devised capable of withstanding a pressure of 2 psi. The author investigated the optimal period of treatment in the bag to achieve resolution of symptoms and to prevent recurrence. Observations were recorded in Pheriche, Nepal at 13 920 ft. At this altitude, inflation of the bag to 2 psi effects a descent to 8400 ft. Dramatic improvements were seen in victims with symptoms of acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and cerebral edema (HACE). AMS, HAPE and HACE patients required time frames of 2, 4, and 6 h respectively to provide resolution of symptoms without complications or deterioration. The author advocates the hyperbaric bag as an effective adjunct and temporizing measure in the treatment of HAPE and HACE.