Médecine de haute altitude: En pratique, c'est quoi ?

Mount Everest Base Camp Medical Clinic “Everest ER”: Epidemiology of Medical Events During the First 10 Years of Operation

Pressman BA et AL. Wilderness Environ Med. 2015 Mar;26(1):4-10

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Si l'intervention dans de telles conditions nécessite évidemment une pratique réelle de la montagne en haute altitude, la spécificité de la pathologie médicale rencontrée semble être essentiellement en rapport avec l'isolement.

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Objective:

As the highest peak on the planet, Mount Everest provides a truly austere environment in which to practice medicine. We examined records of all visits to the Everest Base Camp Medical Clinic (Everest ER) to characterize the medical problems that occur in these patients.

Methods:

A retrospective analysis of medical records from the first 10 years of operation (2003–2012) was performed. Descriptive data collected included patient demographics, diagnoses, treatments, prescriptions, medications dispensed, and evacuation type, if any.

Results: In all, 2941 patients were seen for a total of 3569 diagnoses. The number of patient visits each year at the Everest ER increased at a greater rate than the total numbers of climbers attempting Mount Everest over this period. The most commonly treated patients were Nepalese, accounting for 51% of all nationalities. The most common medical diagnoses were from pulmonary causes such as high altitude cough and upper respiratory infections, comprising more than 38% of all medical diagnoses. The most common traumatic diagnoses were from dermatologic causes such as frostbite and lacerations, comprising 56% of all traumatic diagnoses. Pulmonary and dermatologic diagnoses were also the most frequent reasons for evacuation from Everest Base Camp, most commonly for high altitude pulmonary edema and frostbite, respectively.

Conclusions:

Medical professionals treating patients at extreme altitude should have a broad scope of practice and should be well prepared to deal with serious traumas from falls, cold exposure injuries, and altitude illness.