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Pulmonary edema is caused by hypoxic pulmonary vasoconstriction and increased pulmonary artery pressure. For example, if the lungs are filled with too much water, the ability to ventilate is greatly reduced. The patient may have obvious difficulty in breathing, may have air bubbles when breathing, continue to cough and may cough up water bubbles, and finally even have disturbance of consciousness.
Brain edema is after hypoxia, the water in the blood vessels migrates to the hypoxic cells and interstitial spaces, causing edema. Brain edema can cause movement imbalances, hallucinations, and disturbance of consciousness. Both diseases will be coma and die.
The team leader must be able to correctly judge whether there is pulmonary edema or brain edema when the player suffers from alpine disease.
Once there is a trace of suspicion, whether it is uncertain or not, it is absolutely necessary to drop immediately, and hesitation often causes death. Oxygen and high-pressure bags are only temporary functions at this time. If these equipments can naturally be used on the way down, they cannot be delayed due to the delay.
1. Decrease of ambient air pressure: The air is thin, and the oxygen exchange efficiency of the lungs decreases, causing the arterial oxygen to fall.
2, movement pressure drop:
When the human body moves at sea level, the oxygen in the artery will rise slightly to supply the exercise. However, at high altitudes, intra-arterial pressure will fall instead.
3, sleep pressure drop:
Sleeping at high altitudes, the respiratory oxygenation ability will significantly decrease during sleep. There is a proverb saying: "The lower the sleep, the higher the climb." Because at higher altitudes, the more pronounced the hypoxic phenomenon of sleep, the more effective the rest is.
In general, the higher the elevation of activity, the higher the speed of climbing, the greater the amount of activity, the less the height of adaptation, and the more frequent the occurrence of alpine disease in the past, the more likely it is that symptoms of "high mountain disease" will appear. The appearance of mountain sickness is not related to whether the body is strong or not strong.
The prevention of alpine disease can be started in the following directions:
First, make a high degree of adaptation:
First of all, of course, make it as highly adaptable as possible. However, if it is not someone who has experienced recurrent acute mountain sickness, it will not necessarily require height adjustment or speed restriction at most heights in Taiwan. However, a mountain that is more than 3,000 meters in height is best to rise at a height of 300 meters per day.
Second, timely replenishment of water:
In the process of mountaineering, it is important to actively replenish water because of its high activity and rapid breathing, increased water loss, and a tendency to become dull at high altitudes.
Third, drug prevention and treatment:
"Diamox" is a very weak diuretic and is also used to treat epilepsy and glaucoma. It has been widely used in acute mountain sickness and high altitude pulmonary edema for more than 10 years. It can cause "high oxygen" in one day. "Sexual metabolic acidosis" stimulates breathing. In general adaptation to the highlands, "hyperoxygenous metabolic acid-blood reactions" take five days to arrive. The correct preventive dose has been controversial for many years. The practice accepted by most doctors is: from two days before climbing. Initially, 250 mg orally was taken every 8 to 12 hours for a total of five days. Some people have some gastrointestinal discomfort with the drug, and have a blunted tongue and lower limbs. Therefore, people who rely on tactile activities (such as the blind) should be used with caution. The most important thing is that the structure of this drug is very similar to that of sulfa drugs. People who are allergic to sulfa drugs or who have kidney disease must not use it.
If the symptoms occur, there is no time to do any preventive measures. The most effective and safe method at this time is Descend. There is an interesting joke in the mountaineering community. The three strategies to deal with Takayama disease are "3D," namely, "Descend, Descend, and Descend" (falling, falling, Drop again). Once it falls, almost all people's symptoms will be relieved immediately. However, we all know that in fact, in certain circumstances, it cannot be reduced immediately, and there are many situations that do not necessarily have to fall immediately. Some things can be done immediately on the spot...
Wake up the patient and allow him to walk or sit and rest in the air. Having a good night's sleep is often the most unwise treatment.
2, to the patient's headache can give him analgesics, but to avoid the use of aspirin, because aspirin will reduce platelet coagulation and increase the chance of high-altitude retinal hemorrhage. Do not use sedative hypnotics. They have the effect of respiratory depression, coupled with sleep hypoxia, enough to make a simple acute mountain sickness become pulmonary edema or cerebral edema.
3. Oxygen can be given to the patient at this time, and symptoms can be improved almost immediately.
4. You can continue or start taking Diamox, which has therapeutic effects in addition to prevention. At high altitudes, it is more frightening to have cerebral edema and pulmonary edema, which can occur alone or with acute mountain sickness.