Use of the Gamow Bag by EMT-Basic Park Rangers for Treatment of High-Altitude Pulmonary Edema and High-Altitude Cerebral Edema

Freeman, Kimberly; Shalit, Marc; Stroh, Geoffrey

doi:10.1580/1080-6032(2004)15[198:uotgbb]2.0.co;2

Cited by 33 publications

(22 citation statements)

References 11 publications

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“…Somit dürften sowohl respiratorische als auch kardiovaskuläre Effekte zu den beobachteten Verbesserungen beigetragen haben. Für die Praxis könnte der Einsatz des CPAP-Helms mit dem verbundenen Anstieg der arteriellen Oxygenierung Symptome der akuten Bergkrankheit oder eines Höhenlungenödems bessern und somit eine Alternative zum Gamow bag darstellen [14,15]. In der Untersuchung von Davis und Mitarbeitern wird von einer dramatischen Besserung der Symptome eines Höhenlungenödems unter CPAP-Behandlung berichtet [10].…”

Section: Methodenunclassified

CPAP-Anwendung verbessert die Oxygenierung in normobarer und hypobarer Hypoxie

Koch

Punter

Gatterer

et al. 2008

Wien Med Wochenschr

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This pilot project was performed to investigate the possible application of a portable CPAP helmet (continuous positive airway pressure) to treat high altitude diseases. Arterial oxygen saturation increased from 80.6 +/- 3.4 % to 90.6 +/- 3.8 % (p < 0.01, n = 14) when using the CPAP helmet (PEEP (positive endexpiratory pressure): 10-15 cm H2O) in normobaric hypoxia (FiO2 12.9 +/- 0.4 %, corresponding to about 4300 m). Furthermore arterial oxygen saturation was enhanced (88.1 +/- 1.9 % to 93.5 +/- 3.0 %; p < 0.01, n = 11) at real altitude (3150 m) after a 20 minute application of the CPAP helmet. There was a correlation between differences in PaCO2 and arterial oxygen saturation during CPAP (R = -0.97, p < 0.01, n = 6). Further studies are needed to determine the effectiveness, its mechanisms in context with altitude diseases, and the applicability of this treatment under extreme environmental conditions.

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Section: Methodenunclassified

CPAP-Anwendung verbessert die Oxygenierung in normobarer und hypobarer Hypoxie

Koch

Punter

Gatterer

et al. 2008

Wien Med Wochenschr

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“…ideally by mechanised or animal transport) as exertion can elevate pulmonary pressures and further worsen oedema (4,5,40). 'Artificial descent' can be initiated temporarily by using a Portable Altitude Chamber (PAC) or 'Gamow' bag and this has been used successfully in cases of HAPE (48). However this should only be considered when actual descent is logistically impossible (e.g.…”

Section: © C I C E D I Z I O N I I N T E R N a Z I O N A L Imentioning

confidence: 99%

High altitude respiratory physiology and pathophysiology

Cumpstey¹

2015

SOB

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SummaryAt high altitude, reduced atmospheric pressure causes the partial pressure of oxygen to decreasecreating an environment of hypobaric hypoxia which presents a unique set of challenges for the respiratory system. Pulmonary physiological responses such as the hypoxic ventilatory drive are essential for successful acclimatisation, whilst others such as hypoxic pulmonary vasoconstriction may be implicated in the development of altitude illnesses. Pulmonary conditions are some of the most common (e.g. high altitude cough) and also the most serious illnesses seen at altitude (e.g high altitude pulmonary oedema, HAPE). Minimising the chance of developing HAPE through planning an appropriate ascent profile should be strongly encouraged as HAPE can rapidly be fatal if left untreated. Whilst pharmacological agents such as nifedipine can help with the management of HAPE, rapid descent remains the single-most important treatment option once symptomatic. Given the increasing popularity of travelling to altitude, an awareness of how hypobaric hypoxia affects chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD) is also becoming increasingly important for respiratory physicians.

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“…Use of a pressure chamber or a Gamow bag in the fi eld may be effective [54]. Aspiration is a risk in the Gamow bag, in which the patient is diffi cult to reach during pressurization, and positioning in the lateral position might be advisable [6,7]. Recommended medical treatment includes dexamethasone (8 mg followed by 4 mg every 6 h) and acetazolamide (250 mg twice daily) [54,60,61].…”

Section: Acute Mountain Sickness (Ams) and High-altitude Cerebral Edementioning

confidence: 99%

“…The mean Pa CO 2 at rest was 13.3 mmHg [5]. Hypoxia at HA can be relieved by supplemental oxygen, or by increasing the barometric pressure in a pressure chamber or a portable pressure bag (Gamow bag) [6,7], and by descending to lower altitudes [4]. An increase of the FI O 2 to ∼70 % would increase the Pa O 2 on top of Mt.…”

Section: Introductionmentioning

confidence: 99%

Physiology and pathophysiology at high altitude: considerations for the anesthesiologist

2009

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Millions of people live in, work in, and travel to areas of high altitude (HA). Skiers, trekkers, and mountaineers reach altitudes of 2500 m to more than 8000 m for recreation, and sudden ascents to high altitude without the benefits of acclimatization are increasingly common. HA significantly affects the human body, especially the cardiovascular and pulmonary systems, because of oxygen deprivation due to decreased ambient barometric pressure. Rapid ascents may lead to high-altitude diseases that sometimes have fatal consequences. Other factors, such as severe cold, dehydration, high winds, and intense solar radiation, increase the morbidity of patients at HA. Anesthesiologists working in or visiting areas of higher elevations should become familiar with the human physiology, altered pharmacology, and disease pattern of HA.

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Use of the Gamow Bag by EMT-Basic Park Rangers for Treatment of High-Altitude Pulmonary Edema and High-Altitude Cerebral Edema

Cited by 33 publications

References 11 publications

CPAP-Anwendung verbessert die Oxygenierung in normobarer und hypobarer Hypoxie

CPAP-Anwendung verbessert die Oxygenierung in normobarer und hypobarer Hypoxie

High altitude respiratory physiology and pathophysiology

Physiology and pathophysiology at high altitude: considerations for the anesthesiologist

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