Altitude Medicine



  • Increasing altitude exposes one to a hypobaric hypoxic environment.

  • Without acclimatisation, people are at risk of high-altitude syndromes, predominantly acute mountain sickness, high-altitude pulmonary oedema or high-altitude cerebral oedema.

  • Therapy for each of these is descent to a lower altitude and supplemental oxygen.

  • Acetazolamide and dexamethasone have a role to play in prevention and treatment.

  • Hyperbaric therapy can be considered if there is a delay in evacuating the patient to a lower altitude.


Chronic Obstructive Pulmonary Disease Acute Mountain Sickness Cardiogenic Pulmonary Oedema Moderate Chronic Obstructive Pulmonary Disease Hypoxic Ventilatory Response 


  1. 1.
    Yaron M, Honigman B. High-altitude medicine. In: Marx J, Hockberger R, Walls R, editors. Rosen’s emergency medicine: concepts and clinical practice, vol. 2. 7th ed. Philadelphia: Mosby; 2010.Google Scholar
  2. 2.
    Hackett PH, Roach RC. High-altitude medicine and physiology. In: Auerbach PS, editor. Wilderness medicine. 6th ed. Missouri: Mosby; 2011.Google Scholar
  3. 3.
    Hackett PH. The cerebral etiology of high-altitude cerebral edema and acute mountain sickness. Wilderness Environ Med. 1999;10:97–109.CrossRefPubMedGoogle Scholar
  4. 4.
    Hou S-W, Lin AC-M, Wang T-L. Clinical aspects of high-altitude illness. Ann Disaster Med. 2004;2 Suppl 2:S53–60.Google Scholar
  5. 5.
    Ho M-K, Siu AY-C. High altitude medicine. Hong Kong Med Diary. 2010;15:32–4.Google Scholar
  6. 6.
    Hultgren HN, Honigman B, Theis K, Nicholas D. High-altitude pulmonary edema at a ski resort. West J Med. 1996;164:222–7.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Luks AM, McIntosh SE, Grissom CK, Auerbach PS, Rodway GW, Schoene RB, Zafren K, Hackett PH. Wilderness Medical Society practice guidelines for the prevention and treatment of acute altitude illness: 2014 update. Wilderness Environ Med. 2014;25:S4–14.CrossRefPubMedGoogle Scholar
  8. 8.
    Stream JO, Grissom CK. Update on high-altitude pulmonary edema: pathogenesis, prevention and treatment. Wilderness Environ Med. 2008;19:293–303.CrossRefPubMedGoogle Scholar
  9. 9.
    Gallagher SA, Hackett PH. High-altitude illness. Emerg Med Clin N Am. 2004;22:329–55.CrossRefGoogle Scholar
  10. 10.
    West JB. Who should not go high? High Altitude Med Biol. 2009;10(1):1–2.CrossRefGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Emergency DepartmentStanger Provincial HospitalDurbanSouth Africa
  2. 2.Department of Emergency Medicine, Nelson R Mandela School of MedicineUniversity of Kwa-Zulu NatalDurbanSouth Africa
  3. 3.Department of Emergency Medical Care and RescueDurban University of TechnologyDurbanSouth Africa

Personalised recommendations