Purpose of Review
High-altitude combat and medical evacuation pose special challenges to military operations. We aim to summarize the physiologic changes that occur at altitude, as well as review the altitude-related diseases with emphasis on the impact on the military population. Finally, the impact of high-altitude exposure during transportation of combat trauma will be reviewed.
Recent Findings
There is increasing awareness that high-altitude exposure has an impact on mission readiness and could place mission success at risk. High-altitude headache and acute mountain sickness have affected warfighters in both training and combat. Prophylaxis of altitude illness with acetazolamide has been shown to reduce symptoms of altitude exposure; dexamethasone is utilized for the same purpose.
Though not without risk, long-range high-altitude transport of critically ill trauma and medical patients has been found to be safe and effective.
Summary
Hypobaric hypoxia is the primary driving force behind the physiologic effects altitude has on the human body. When combined with the stress of combat and AE, altitude can pose a difficult obstacle when caring for critically ill patients. Awareness of altitude-related disease and its impact when caring for non-altitude-related illness is a crucial component of optimizing healthcare to wounded warriors.