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50 passage(s) dans 11 référentiel(s).

• JTS — Altitude Emergencies in the Prehospital EnvironmentJTS
  • p. 11Altitude Emergencies in the Prehospital Environment CPG ID: 95 Guideline Only/Not a Substitute for Clinical Judgment 11 Dexamethasone: There is weak evidence showing benefit of dexamethasone in preventing HAPE and the mechanism is poorly understood. Thus, if patients ... dexamethasone 8mg orally every 12 hours, beginning on day of ascent. Prophylaxis should continue until at a stable altitude for two days.3,17,38 Acetazolamide: No robust data exists supporting the use of acetazolamide in HAPE prevention; however
  • p. 14Altitude Emergencies in the Prehospital Environment CPG ID: 95 Guideline Only/Not a Substitute for Clinical Judgment 14 R E S P O N S I B I L I T I E S The trauma team leader ... sports doctor check before authorizing patients to go at high altitudes? 6. Klocke DL, Decker WW, Stepanek J. Altitude-related illnesses. Mayo Clin Proc. 1998;73(10):988-993. 7. Luks AM, Swenson ER, Bärtsch P. Acute high
  • p. 5Altitude Emergencies in the Prehospital Environment CPG ID: 95 Guideline Only/Not a Substitute for Clinical Judgment ... Though the military population does go through robust medical screenings, altitude exposure can significantly worsen many preexisting medical conditions. Current recommendations vary greatly depending on the specific condition, with minimal effect from altitude sojourns to strict contraindications with
  • p. 7Altitude Emergencies in the Prehospital Environment CPG ID: 95 Guideline Only/Not a Substitute for Clinical Judgment ... During the mission planning phase, prioritize risk mitigation strategies. While at altitude, continue to reassess for AMS, considering differentials that may mimic AMS. Untreated AMS increases risk of HACE, whether AMS is diagnosed or not. Mild

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• IFRC — International First Aid, Resuscitation and Education Guidelines 2020IFRC — Global First Aid Reference Centre
  • p. 352International first aid, resuscitation, and education guidelines 2020 Altitude sickness Key action Take the person to a lower altitude as quickly and safely as possible. Introduction Altitude sickness occurs when people at a high altitude do not have ... enough oxygen in their blood because the air pressure is too low. As altitude increases, the air becomes thinner and less oxygen is inhaled with each breath. The term altitude sickness includes acute mountain sickness, high altitude pulmonary
  • p. 354descend on their own and it is unsafe for other group members to transport them to a lower altitude. Help may take many forms, including other hikers, search and rescue, formal evacuation teams or military assistance. • Access ... They should monitor themselves for signs and symptoms of AMS, HAPE and HACE. • Once descended to a lower altitude, a person with HAPE or HACE should not re-ascend until their symptoms have resolved and they have been
  • p. 353with 50 per cent experiencing it above 6000 m (19,685 feet). Be aware of the signs of altitude sickness if travelling above this altitude. (Hackett & Shlim, 2019.) Several altitude sickness diagnostic-scoring systems exist. The Lake Louise ... Criteria for Altitude Sickness (Roach et al., 2018) are as follows: Acute mountain sickness If the person chooses to remain at a certain altitude, AMS may improve with rest, hydration and medication. However, the symptoms will improve faster
  • p. 467Prevention and Treatment of Frostbite: 2019 Update. Wilderness & environmental medicine, 30(4), S19-S32. https://www.wemjournal.org/article/S1080-6032(19)30097-3/fulltext Altitude sickness Systematic reviews Centre for Evidence-Based Practice, Belgian Red Cross-Flanders. (2020). Evidence summary Altitude sickness – Drinking fluids. Available ... from: https://www.cebap.org/knowledge-dissemination/first-aid-evidence-summaries/ Centre for Evidence-Based Practice, Belgian Red Cross-Flanders. (2020). Evidence summary Altitude sickness – Descent. Available from: https://www.cebap.org/knowledge-dissemination/first-aid-evidence-summaries/ Simancas-Racines, D., Arevalo-Rodriguez, I., Osorio, D., Franco, J. V., Xu, Y., & Hidalgo

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• JTS — U.S. Army Aeromedical Evacuation Standard Medical Operating GuidelinesJTS
  • p. 215TABLE OF CONTENTS 215 ALTITUDE PHYSIOLOGY AND PATIENT TRANSFER ALTITUDE CONCERNS FOR AEROMEDICAL TRANSFERS: • Gas expansion occurs as altitude above sea level increases. Gas volume doubles at 18,000' mean sea level (½ sea level atmospheric pressure) and increases ... note: o Air embolism / Decompression illness - This is the only absolute contraindication to transport of patients at altitude. These patients should be transferred at sea level or in an A/C capable of cabin pressurization to sea level
  • p. 34dose: 250 mg/dose) o Severe AMS: Add Dexamethasone 4 mg IV / IO / PO • For altitude-related headache (in isolation or with AMS / HACE) consider o Acetaminophen 650-100 mg PO o Ibuprofen 600-800 mg PO Notes, Warnings ... Cautions • The treatment of choice for all altitude-related illnesses is supplemental O2 and descent - at least 300 - 1000 m. If unable to descend, a hyperbaric bag (Gamow bag) can be utilized if available. • HAPE and HACE
  • p. 216TABLE OF CONTENTS 216 ALTITUDE PHYSIOLOGY AND PATIENT TRANSFER (cont.) • Hypothermia: As altitude increases, the temperature will drop about 3.5° F per 1000 feet. This is further complicated in the H-60 due to rotor-wash, forward ... closing cabin doors / crew windows during transport. • Hypoxia: Patients are at increased risk of hypoxia during transport at altitude. If transfers are taking place in high-altitude locations, pulse oxygenation should be monitored at all times
  • p. 37TABLE OF CONTENTS 37 DECOMPRESSION SICKNESS History • Recent history of SCUBA diving • Hypobaric chamber training • High altitude parachutist training / operations > 18,000 ft (HALO, HAHO) • High altitude exposure Signs and Symptoms • The Bends (Type 1) o Pain ... speak o Inner ear disturbance’s (vestibular DCS) vertigo, nausea, vomiting. More likely associated with diving than altitude exposure Treatment • If DCS occurs while in flight descend to a lower altitude or to the ground level. • Place patient

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• JTS — Joint En Route Care GuidelinesJTS
  • p. 14most combat casualties do not require, but consider for the following: • Low SpO2 (< 90%) • Transporting casualty at increased altitude (mountainous terrain or in-flight) – For expected SpO2 at various altitudes see CPG: Altitude Emergencies in the Prehospital Environment ... page 4 (Category: “Altitude”) • Known or suspected carbon monoxide poisoning: goal SpO2 100% • Known or suspected smoke inhalation If wheezing is present (airway burns, asthma anaphylaxis, etc.), administer bronchodilators: Severity Good Better Best Mild to Moderate Albuterol inhaler
  • p. 6floor/deck. • Hypothermia and hypoxia are significant risks during flight that may affect casualty outcomes. Communicate temperature and altitude (or cabin altitude) needs with the flight crew. • Movement via catapult from an aircraft carrier can be violent, often causing ... crew prior to catapult launch. • Reassess any interventions utilizing pneumatic (air) pressure (e.g. endotracheal tube cuffs) at altitude and on descent. • Patients need hearing protection. • Consider how you will communicate with your patient if able. Consider non-traditional
• JTS — Traumatic Brain Injury Management in Prolonged Field CareJTS
  • p. 21patient with head to the front of the aircraft to minimize G-forces transmitted to the brain. **For altitudes >8000 ft, TBI patients are at risk of hypobaric hypoxia and high-altitude cerebral edema (HACE), which can worsen
  • p. 12Substitute for Clinical Judgment 12  Air transport of TBI patients requires additional considerations. For air movements that involve altitudes >8,000 ft, TBI patients are at risk for additional complications that may worsen brain injury, such as hypobaric ... hypoxia and high-altitude cerebral edema.29 Preplanning with air assets is highly recommended.  Recommended Packing List. See Appendix D.  Management of Traumatic Brain Injury Summary Table. See Appendix E. PERFORMANCE IMPROVEMENT (PI) MONITORING POPULATION OF INTEREST
  • p. 14injury. J Trauma. 2005;58(1):47–50. 29. Basnyat B, Wu T, Gertsch JH. Neurological conditions at altitude that fall outside the usual definition of altitude sickness. High Alt Med Biol. 2004;5:171–179. 30. Vaiman
• JTS — Acute Traumatic Wound Management in Prolonged Field CareJTS
  • p. 17face of the gauge (i.e., 17–21 psi). This should be no less than 35 minutes. Note: At altitudes higher than sea level, settings need to be adequately adjusted to compensate for the effect of altitude on water
• JTS — Prolonged Casualty Care GuidelinesJoint Trauma System (DoD)
  • p. 55Casualty Care Guidelines CPG ID: 91 Guideline Only/Not a Substitute for Clinical Judgment 55 Intervention Paradigm Flight Stressor/ Altitude Management  Minimum - Ear Protection and Eye Protection, if nothing available sunglasses and gauze may be used, if patient ... protection inserts, goggles.  Best - Above with gastric tube (NG/OG) or chest tube for decompression, if indicated. Depending on altitude/platform, consider bleeding air of out bags of fluid. Secure Interventions and Equipment  Minimum - Tape:  Securely tape all interventions
  • p. 73Better: Sleep system and blankets  Best: HPMK with Ready Heat or Absorbent Patient Litter System (APLS) Flight Stressor/ Altitude Management  Good: Ear Protection and Eye Protection, if nothing available sunglasses and gauze may be used, if patient ... protection inserts, goggles  Best: Above with gastric tube (NG/OG) or chest tube for decompression, if indicated. Depending on altitude/platform, consider bleeding air of out bags of fluid. Secure Interventions and Equipment  Good: Tape (securely tape all interventions
  • p. 3Prepare Documentation .....................................................................................................................................72 Prepare Report....................................................................................................................................................72 Prepare Medications ...........................................................................................................................................72 Hypothermia Management ................................................................................................................................73 Flight Stressor/ Altitude Management
• JTS — Frostbite and Immersion Foot CareJTS
  • p. 2those of African descent have increased susceptibility to cold injuries.5 Increased rates of frostbite occur at extreme high altitude secondary to ambient temperature decreases and microcirculatory changes that occur at altitudes greater than 17,00ft.6,7 EVALUATION TRAUMA
  • p. 7Hashmi M, Rashid M, Haleem A, et al. Frostbite: epidemiology at high altitude in the Karakoram mountains. Ann R Coll Surg Engl. 1998 Mar;80(2):91-5 7. Martin D, Ince M, Goedhart P, et al. Abnormal ... blood flow in the sublingual microcirculation at high altitude. Eur J Appl Physiol (2009) 106:473–478 8. McMahon A, Howe A. Cold Weather Issues in Sideline and Event Management. Current Sports Medicine Reports
• JTS — Mechanical Ventilation during Critical Care Air TransportJTS
  • p. 4Chest tubes should be left in place, particularly for patients on positive pressure ventilation. As patients climb in altitude, any residual pneumothorax may re-expand. Additionally, patients may require increasing ventilatory pressures to achieve oxygenation goals at altitude ... ventilator typically should not be extubated immediately prior to transport. The decreased partial pressure of oxygen at altitude may not be easily overcome with non-invasive oxygenation. Additionally, transport can be painful and may require higher doses
  • p. 2decrease in PO2 as the partial pressure of oxygen in the air decreases as you increase in altitude. a. Patients with marginal gas exchange will require additional support during flight. b. A cabin altitude restriction will lessen
  • p. 3mechanical ventilation strategies e. Flight characteristics i. Flight duration ii. Aircraft type iii. Patient load and complexity iv. Altitude restriction f. If in doubt about the patient’s respiratory stability for transport consult the ECMO team i. Extracorporeal ... safely transported using the Impact 731 ventilator. 1. Allows for volume control or pressure control ventilation. 2. Altitude compensated. 3. Rated for patients 5 kg and above. a. For patients 5-30 Kg a 731 infant/pediatric circuit with
  • p. 7appropriate PEEP and FiO2 4. Patients will likely require increased PEEP or FiO2, and possibly MV at altitude. Ensure that there is room to safely titrate up all vent settings by approximately 20% at altitude. 5. See below
• JTS — TBI Management and Basic Neurosurgery in the Deployed EnvironmentJTS
  • p. 11warranted for patients with borderline ICP measurements. Stresses of flight including vibration, temperature, noise, movement, light, hypoxia, and altitude have been shown to increase ICP.62,63 Delayed evacuation may improve outcomes in patients with ongoing resuscitation needs ... effect of increasing altitude on contained air within the body, including the cranium, will potentially result in expansion of pneumocephalus; this is particularly true for those who have not undergone a decompressive craniectomy prior to the flight
• Références techniques nationales PSE Juillet 2026
  • p. 300abri le plus proche et d’attendre un avis ou une intervention médicale ; • à de très hautes altitudes (> 4000 m), administrer à la victime de l’oxygène en inhalation en complément. Il ne faut en aucune manière essayer