Considerations for resuscitation at high altitude in elderly and untrained populations and rescuers

Abstract With the development of transportation technologies, elderly people with chronic diseases are increasingly enjoying trekking and tours of nature resorts that include mountain highlands. Because of problems related to circulation, respiration, metabolism, and/or the musculoskeletal system in...

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Bibliographic Details
Published in:The American journal of emergency medicine 2014-03, Vol.32 (3), p.270-276
Main Authors: Suto, Takashi, MD, PhD, Saito, Shigeru, MD, PhD
Format: Article
Language:English
Subjects:
Aged
Altitude
Carbon
Cardiopulmonary resuscitation
Cardiopulmonary Resuscitation - instrumentation
Cardiopulmonary Resuscitation - methods
Compressed air
CPR
Diabetes
Emergency
Emergency medical care
Heart
Heart Arrest - etiology
Heart Arrest - therapy
Heart rate
Humans
Hypertension
Musculoskeletal system
Older people
Physical Fitness
Recreation
Rescue Work
Risk Factors
Sea level
Studies
Travel
Trekking
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Summary:Abstract With the development of transportation technologies, elderly people with chronic diseases are increasingly enjoying trekking and tours of nature resorts that include mountain highlands. Because of problems related to circulation, respiration, metabolism, and/or the musculoskeletal system in this population, the impact of high altitude on cardiopulmonary function is increased. Alpine accidents, therefore, tend to be more common in this population, and cases of cardiopulmonary arrest (CPA) at high altitudes seem to be increasing. However, relatively few studies have described cardiopulmonary resuscitation (CPR) at high altitudes. Although insufficient studies are available to standardize CPR guidelines at high altitude at this time, the aim of this review is to summarize previous studies relevant to physiologic changes after exposure to high-altitude environments and exercise, which may be a risk factor for CPA in elderly trekkers. In addition, we summarize our previous studies that described the effect of CPR procedures on cardiopulmonary function in untrained rescuers. The available data suggest that prolonged CPR at high altitudes requires strenuous work from rescuers and negatively affects their cardiopulmonary physics and subjectively measured fatigue. Alpine rescue teams should therefore be well prepared for their increased physical burden and difficult conditions. Elderly travelers should be made aware of their increased risk of CPA in alpine settings. The use of mechanical devices to assist CPR should be considered wherever possible.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2013.11.007