We all enjoy the magnificent view from high summit but there are many risks in going to high altitude and it is very important to understand the risks involved in it. A classic scenario for developing high altitude illness can be explained through an easy example. If someone flies from New York City to Denver at 5000 ft, in the afternoon rents a car and drive up-to trail-head at 8000 ft, followed by a hike up to 10500 ft, the very next day there begins severe headache and feeling of nausea and weakness. Scenarios like this are not very uncommon, so it is essential to understand the physiological effects of high altitude. The concentration of oxygen at sea level is about 21% and the barometric pressure averages at 760 mm Hg. As altitude increases, the concentration remains the same but the number of oxygen molecules per breath decreases and so in order to properly oxygenate the body the breathing rate has to increase. In addition to these, for unknown reasons, high altitude and lower air pressure causes fluid to leak from the capillaries which can cause fluid build-up in both the lungs and the brain. Continuing to higher altitudes without proper acclimatization can lead to potentially serious, even life-threatening illness. Hyperbaric chambers are available and are very effective in the treatment of high altitude sickness. In hyperbaric treatment, the patients are enclosed in air impermeable bags and are inflated to a pressure higher than the ambient pressure. This affects a physiological “descent “which can be demonstrated with an altimeter inside the bag, and marked improvements in oxygen saturation are measurable with a pulse oximeter.
For the hyperbaric treatment, absolute contraindications to using the bag include lack of spontaneous respiration because one cannot ventilate the patient from outside the bag. There is a “Gamow Tent” which is about twice the diameter of the standard bag, and it can accommodate two patients at the same time. This is very helpful in treating critically ill patients with a medical person present, or treating the child in the presence of the parent. In the relative contraindications to using the bag are middle ear congestion (small risk of barotraumas), inability to protect the airway in a deeply comatose patient (consider intubations), and claustrophobia.
In the hyperbaric treatment, typical treatment protocols are put to patient into the bag, pump it up until the pop-off valves hiss, and keep the patient at pressure for an hour. Unless the bag has a CO2 scrubber system, it is needed to continue pumping several times per minute to flush fresh air through the system. So, get your hyperbaric treatment done to get relieved from the high altitude sickness.
