TY - JOUR
T1 - Serious altitude illness at the South Pole
AU - Rose, John S.
AU - Law, Jennifer
AU - Scheuring, Richard
AU - Ramage, Matthew H.
AU - McKeith, James J.
N1 - Funding Information:
Under a Presidential Memorandum, first signed by President Reagan and subsequently reaffirmed, the National Science Foundation, through its Office of Polar Programs, manages the U.S. Antarctic Program. Memorandum 6646 requires NSF to maintain the Program at a level that provides "an active and influential presence in Antarctica designed to support the range of U.S. Antarctic interests" including "the conduct of scientific activities in major disciplines; year-round occupation of the South Pole and two coastal stations; and availability of related necessary logistics support. Disclaimer: The contents of this paper reflect the opinions of the authors and are not necessarily those of the National Science Foundation, National Aeronautics and Space Administration, or the Air Force, the Department of Defense, or the U.S. Government. Financial Disclosure Statement: The authors have no conflicts of interest to declare.
Publisher Copyright:
© Aerospace Medical Association, Alexandria, VA.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: Gradual ascent is impractical for personnel deploying to the South Pole due to logistical challenges. Prevention of altitude illness relies on prophylactic medications such as acetazolamide and behavioral modifications including hydration and avoidance of overexertion. We present three recent cases of altitude illness that occurred in previously healthy individuals at the South Pole. CASE REPORTS: 1) A 52-yr-old woman not on prophylactics presented with headache and intractable vomiting 7 h after arriving and hiking around the station. She was treated with acetazolamide, dexamethasone, oxygen, and supportive care. Her symptoms resolved during the evacuation flight. 2) A 23-yr-old man presented with dyspnea at rest 3 d after arriving without prophylactic treatments. He had a Sao2 of 49%, wheezes and crackles on lung exam, and interstitial infiltrates on chest X-ray. His treatment included oxygen, nifedipine, acetazolamide, and dexamethasone. His symptoms resolved during the evacuation flight. 3) A 40-yr-old man presented with dyspnea after a series of strenuous workouts since his arrival 5 d prior. He had a Sao2 of 41%, and his chest X-ray was consistent with high altitude pulmonary edema. He was treated with oxygen, nifedipine, and fluids before descent to sea level, where his symptoms fully resolved 4 d later. DISCUSSION: These patients illustrate that altitude illness may develop despite medical screening, participant education, and availability of prophylactic medications based on published guidelines. These cases could be attributed to noncompliance and misinformation, bringing to light some of the challenges with managing more diverse populations that deploy to remote environments.
AB - BACKGROUND: Gradual ascent is impractical for personnel deploying to the South Pole due to logistical challenges. Prevention of altitude illness relies on prophylactic medications such as acetazolamide and behavioral modifications including hydration and avoidance of overexertion. We present three recent cases of altitude illness that occurred in previously healthy individuals at the South Pole. CASE REPORTS: 1) A 52-yr-old woman not on prophylactics presented with headache and intractable vomiting 7 h after arriving and hiking around the station. She was treated with acetazolamide, dexamethasone, oxygen, and supportive care. Her symptoms resolved during the evacuation flight. 2) A 23-yr-old man presented with dyspnea at rest 3 d after arriving without prophylactic treatments. He had a Sao2 of 49%, wheezes and crackles on lung exam, and interstitial infiltrates on chest X-ray. His treatment included oxygen, nifedipine, acetazolamide, and dexamethasone. His symptoms resolved during the evacuation flight. 3) A 40-yr-old man presented with dyspnea after a series of strenuous workouts since his arrival 5 d prior. He had a Sao2 of 41%, and his chest X-ray was consistent with high altitude pulmonary edema. He was treated with oxygen, nifedipine, and fluids before descent to sea level, where his symptoms fully resolved 4 d later. DISCUSSION: These patients illustrate that altitude illness may develop despite medical screening, participant education, and availability of prophylactic medications based on published guidelines. These cases could be attributed to noncompliance and misinformation, bringing to light some of the challenges with managing more diverse populations that deploy to remote environments.
KW - Acute mountain sickness
KW - Antarctica
KW - High altitude cerebral edema
KW - High altitude pulmonary edema
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U2 - 10.3357/AMHP.5467.2020
DO - 10.3357/AMHP.5467.2020
M3 - Article
C2 - 31852574
AN - SCOPUS:85077862222
SN - 2375-6314
VL - 91
SP - 46
EP - 50
JO - The Journal of aviation medicine
JF - The Journal of aviation medicine
IS - 1
ER -