Altitude sickness physical examination: Difference between revisions

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{{Altitude sickness}}
{{Altitude sickness}}
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==Overview==
==Overview==
During physical examination, a clinician may find that a patient presenting with altitude sickness experiences temporary signs that usually abate with time as altitude acclimitisation occurs. [[High altitude pulmonary edema]] ([[HAPE]]) and cerebral edema ([[HACE]]) are the most ominous signs that may manifestation during physical examiantion.
Physical examination of patients with altitude sickness is usually remarkable for [[headache]], [[nausea]], [[vomiting]] and [[lightheadedness]].


==Physical Examination==
==Physical Examination==
During physical examination, a clinician may find serious signs indicating more complex conditions such as [[edema]] (fluid accumulation in the tissues of the body). At very high altitude, humans can get either [[high altitude pulmonary edema]] (HAPE), or [[high altitude cerebral edema]] (HACE). Signs may include:
*Physical examination of patients with altitude sickness is usually remarkable for [[headache]], [[nausea]], [[vomiting]] and [[lightheadedness]].<ref name="pmid23908794">{{cite journal |vauthors=Taylor AT |title=High-altitude illnesses: physiology, risk factors, prevention, and treatment |journal=Rambam Maimonides Med J |volume=2 |issue=1 |pages=e0022 |date=January 2011 |pmid=23908794 |pmc=3678789 |doi=10.5041/RMMJ.10022 |url=}}</ref><ref name="pmid21718562">{{cite journal |vauthors=Murdoch D |title=Altitude sickness |journal=BMJ Clin Evid |volume=2010 |issue= |pages= |date=March 2010 |pmid=21718562 |pmc=2907615 |doi= |url=}}</ref><ref name="pmid17099095">{{cite journal |vauthors=Clarke C |title=Acute mountain sickness: medical problems associated with acute and subacute exposure to hypobaric hypoxia |journal=Postgrad Med J |volume=82 |issue=973 |pages=748–53 |date=November 2006 |pmid=17099095 |pmc=2660503 |doi=10.1136/pgmj.2006.047662 |url=}}</ref><ref name="pmid22703629">{{cite journal |vauthors=Carod-Artal FJ |title=High-altitude headache and acute mountain sickness |journal=Neurologia |volume=29 |issue=9 |pages=533–40 |date=2014 |pmid=22703629 |doi=10.1016/j.nrl.2012.04.015 |url=}}</ref>
* [[dyspnea|Severe dyspnea]] at rest
 
* Cough that is initially dry but may progress to produce pink, frothy [[sputum]].
===Appearance of the Patient===
* [[Visual impairment]]
*Patients with altitude sickness usually appear cyanotic.
* Bladder dysfunction
 
* Bowel dysfunction
===Vital Signs===
* [[Loss of coordination]]
*[[Hypothermia]] may be present
* [[paralysis|Paralysis on one side of the body]]
*[[Tachycardia]]  
* [[Confusion]]
*Tachypnea
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]
 
===Skin===
*Pale or bluish appearance
 
===HEENT===
*[[Visual impairment]]
 
===Neck===
* Neck examination of patients with altitude sickness is usually normal.
 
===Lungs===
*[[Crackles]] or [[wheezing]] may be present
 
===Heart===
* [[Cardiovascular]] examination of patients with altitude sickness is usually normal.
 
===Abdomen===
*[[Abdominal]] examination of patients with altitude sickness is usually normal.
 
===Back===
* Back examination of patients with altitude sickness is usually normal.
 
===Genitourinary===
* [[Genitourinary]] examination of patients with altitude sickness is usually normal.
 
===Neuromuscular===
* Altered mental status may be present
*[[Loss of coordination]]
 
===Extremities===
*[[Cyanosis]] may be present


==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Disease]]
[[Category:Mountaineering]]
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[[Category:Emergency medicine]]
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Latest revision as of 14:44, 19 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

Physical examination of patients with altitude sickness is usually remarkable for headache, nausea, vomiting and lightheadedness.

Physical Examination

Appearance of the Patient

  • Patients with altitude sickness usually appear cyanotic.

Vital Signs

Skin

  • Pale or bluish appearance

HEENT

Neck

  • Neck examination of patients with altitude sickness is usually normal.

Lungs

Heart

  • Cardiovascular examination of patients with altitude sickness is usually normal.

Abdomen

  • Abdominal examination of patients with altitude sickness is usually normal.

Back

  • Back examination of patients with altitude sickness is usually normal.

Genitourinary

  • Genitourinary examination of patients with altitude sickness is usually normal.

Neuromuscular

Extremities

References

  1. Taylor AT (January 2011). "High-altitude illnesses: physiology, risk factors, prevention, and treatment". Rambam Maimonides Med J. 2 (1): e0022. doi:10.5041/RMMJ.10022. PMC 3678789. PMID 23908794.
  2. Murdoch D (March 2010). "Altitude sickness". BMJ Clin Evid. 2010. PMC 2907615. PMID 21718562.
  3. Clarke C (November 2006). "Acute mountain sickness: medical problems associated with acute and subacute exposure to hypobaric hypoxia". Postgrad Med J. 82 (973): 748–53. doi:10.1136/pgmj.2006.047662. PMC 2660503. PMID 17099095.
  4. Carod-Artal FJ (2014). "High-altitude headache and acute mountain sickness". Neurologia. 29 (9): 533–40. doi:10.1016/j.nrl.2012.04.015. PMID 22703629.

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