Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
CPR at High Altitude
In the most recent issue of Wilderness & Environmental Medicine appears an article by Dr. Hajime Narahara and colleagues, entitled “Effects of Cardiopulmonary Resuscitation at High Altitudes on the Physical Condition of Untrained and Unacclimatized Rescuers” (WEM 2012;23:161). The study underlying the article was prompted by the authors experiencing a case of prolonged cardiopulmonary resuscitation (CPR) while being on Mt. Fuji in Japan. They then studied the effects of CPR at 2700 meters and 3700 meters above sea level upon the rescuers in male (mean age 35 years, with range 24 to 48 years) volunteers.
The results were that CPR for 5 minutes at 3700 meters significantly reduced arterial blood oxygen saturation and stressed heart rate and blood pressure parameters. They therefore recommended using mechanical devices to implement CPR wherever possible.
No doubt about it – CPR is a workout, and now we know that it’s more of a physical stressor at high altitude. I don’t know how practical it is to have a mechanical chest compression or ventilation device at high altitude, but it’s wise to be advised that one’s endurance performing CPR is not going to be very good at high altitude. So, a single or even a couple of rescuers are going to be at a disadvantage. Just as it takes a team of foot pumpers to maintain the pressure in a Gamow (hyperbaric) bag at high altitude (because they become fatigued) one should anticipate needing to frequently change out rescuers involved in the CPR process when you are up high.
Fortunately, CPR doesn’t go on for hours at high altitude (or anywhere else, for that matter, unless the victim is hypothermic). As the age of trekkers and climbers increases, when there are episodes of cardiac arrest and bystanders are called upon to assist with resuscitation, these elders may not have the stamina needed to continue CPR for very long. It’s likely that these data can be extrapolated to any short duration, high intensity exercise, whether that be a carry, sprint to shelter, or hauling a heavy load on a rope.
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