High‐altitude illnesses

Visits to high altitude environments continue to rise. As this trend continues, the incidence of high altitude illness has increased. Hypoxia, the primary insult to the human body in high altitudes, dramatically alters human physiology metabolically and anatomically. This delicate physiological balance can be easily tipped over and may lead to high altitude pathologies including acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). AMS is at the benign end of a spectrum of high altitude illnesses. At the most life-threatening end is HACE. However, it is HAPE that has the highest rate of death among high altitude patients. There are many temporizing treatments available but descent is the definitive solution. Many options must be considered by an EMS medical director or EMS physician, but preparation through education and training to adequately prevent and treat altitude illnesses, should they occur, are of paramount importance.