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Author: Admin | 2025-04-28
As dexamethasone, tadalaphil, and sildenafil, have no studies or consensus ecommendations for use in the ED at this time. HACE Prophylaxis And Treatment There are no prospective, randomized studies on HACE treatment. As in all altitude illness, continued oxygen supplementation to maintain oxygen saturation greater than 90% is standard. All reviews ecommend dexamethasone 4 mg every six hours (8 mg loading dose if given in the field).2-4 Beyond these two therapies, other HACE care is supportive. In those cases where the patient is intubated, hyperventilation is not recommended in that they already have a respiratory alkalosis and further hyperventilation may worsen cerebral ischemia. Furosemide, mannitol, and oral glycerol have all been utilized, but there are no well designed studies to evaluate the effectiveness of these agents. Use of these agents is, at best, of indeterminate effectiveness. If these agents are utilized, care must be taken to ensure volume status is maintained. Special Conditions And Considerations High Altitude Pharyngitis And Bronchitis (HAP/B) This may be the most common condition seen at altitude.177 HAP/B was seen in 12% of Himalayan trekkers; this is 1.5 times the 8% incidence of AMS seen in the same group. In a series of climbers on Mount Aconcagua, 13 of 19 (68%) developed HAP/B.178 This condition has little literature written on it but is felt to be extremely common in those who spend over two weeks above 18,000 feet; it is felt to be a result of the hyperventilation of altitude and the very dry, cold air of altitude.179 This same review recommends that patients wear a face mask, suck on hard candy, and drink plenty of fluids to treat this condition. This condition can also cause severe coughing which may require symptomatic treatment. HAP/B can be confused with HAPE and vice versa; when treating HAP/B, one
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