Under pressure: Facilitating the emergency use of portable hyperbaric chambers at altitude

摘要

In this issue of Travel Medicine and Infectious Disease, Santantonio and co-workers report the results of an observational study which identifies risk factors predictive for acute mountain sickness (AMS) in a group of travellers who had attended a travel clinic [1]. AMS, if not properly managed, may progress to the potentially fatal high altitude cerebral oedema (HACE), and may co-exist with high altitude pulmonary oedema (HAPE), the latter of which is responsible for most deaths from high altitude illness. In an earlier review of the subject, Zafren asserted that death from high altitude illness is almost always avoidable [2]. Symptoms of AMS in the study by Santantonio et al. were experienced by almost half of the cohort who had reached an altitude above 2500 m. The authors comment that the majority of travellers had been informed about altitude-related health risks through non-medical sources, including the internet and friends. It is suggested that the apparent failure to provide pre-travel health advice specific for high altitude illness prevention may be related to deficient knowledge and training on the part of travel medicine practitioners. Equally, non-expert travel health providers may not routinely advise travellers on the correct management of high altitude illness, should it occur subsequently to a traveller who had sought pre-travel health advice.