Reflection to MRHAPE in the Mountains: Resident High Altitude Pulmonary Edema

In beginning my Physician Assistant rotation at Ebert Family Clinic I was introduced to the exciting research of Christine Ebert-Santos, MD.  The research surrounded a condition known as High Altitude Pulmonary Edema (HAPE). In growing up at altitude myself, at 6,926 feet in Jamestown Colorado, I have had some exposure to the effects of high altitude. Acute Mountain Sickness (AMS) is a condition that I am more familiar with and in reading Dr. Ebert-Santos’ research it became clear to me that HAPE is a more severe complication to those ascending to or living at altitude, especially if they develop an initial respiratory illness. In her paper Dr. Ebert-Santos describes several pediatric case studies that demonstrate the characteristics of this treatable condition. These patients presented with tachycardia (fast heart rate), tachypnea (fast breathing), decreased oxygen saturation, and rales (abnormal breath sound).  Many of the children described were seen directly after an initiating illness such as the Flu. While seen in the clinic, or during admission to the hospital, these patients were treated with oxygen. The fact that HAPE can be treated with something as simple as oxygen is noteworthy.

Through her research Dr. Ebert-Santos has demonstrated that HAPE should be considered in all pediatric patients presenting to clinics  or emergency rooms at altitude with hypoxia (decreased oxygen saturation) and a recent viral illness. Through placing HAPE in their differential diagnosis, clinicians can avoid giving excessive inhaled steroid treatments and unneeded antibiotics. Awareness of the prevalence of this disease in both travelers and residents alike ensures a decrease in the incidence of unfavorable outcomes from this potentially fatal condition.

Submitted by Kelly Kyte, Physicians Assistant Student from Red Rocks Community College Fall Rotation 2016

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