Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update

Andrew M Luks; Paul S Auerbach; Luanne Freer; Colin K Grissom; Linda E Keyes; Scott E McIntosh; George W Rodway; Robert B Schoene; Ken Zafren; Peter H Hackett

doi:10.1016/j.wem.2019.04.006

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update

Wilderness Environ Med. 2019 Dec;30(4S):S3-S18. doi: 10.1016/j.wem.2019.04.006. Epub 2019 Jun 24.

Authors

Affiliations

¹ Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA. Electronic address: aluks@uw.edu.
² Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA.
³ Yellowstone National Park, WY; Midway Atoll National Wildlife Refuge, Honolulu, HI; Everest ER, Himalayan Rescue Association, Kathmandu, Nepal.
⁴ Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Salt Lake City, UT; Division of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT.
⁵ Department of Emergency Medicine, University of Colorado, Denver, CO; Boulder Community Health, Boulder, CO.
⁶ Division of Emergency Medicine, University of Utah, Salt Lake City, UT.
⁷ University of California, Davis School of Nursing, Sacramento, CA.
⁸ Division of Pulmonary and Critical Care Medicine, Sound Physicians, St. Mary's Medical Center, San Francisco, CA.
⁹ Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA; Himalayan Rescue Association, Kathmandu, Nepal.
¹⁰ Altitude Research Center, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.

PMID: 31248818
DOI: 10.1016/j.wem.2019.04.006

Abstract

To provide guidance to clinicians about best preventive and therapeutic practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. Recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to prevention and management of each form of acute altitude illness that incorporate these recommendations. This is an updated version of the original WMS Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness published in 2010 and subsequently updated as the WMS Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness in 2014.

Keywords: acetazolamide; acute mountain sickness; dexamethasone; high altitude; high altitude cerebral edema; high altitude pulmonary edema; nifedipine.

Publication types

Practice Guideline

MeSH terms

Altitude Sickness / prevention & control*
Altitude Sickness / therapy
Brain Edema / prevention & control*
Brain Edema / therapy
Humans
Mountaineering
Practice Patterns, Physicians'*
Pulmonary Edema / prevention & control*
Pulmonary Edema / therapy
Societies, Medical
Wilderness Medicine / standards*