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Ultrasound research in extreme environments: a high-altitude experience

Giovanni Cappa

3331044658

Ultrasound research in extreme environments: a high-altitude experience

Background

Medical research in extreme environments is rapidly progressing also thanks to the technological advances that have given us portable diagnostic devices that can be easily brought on the field.

During a brief expedition on the Mont Blanc, we were equipped with diagnostic tools including an ultrasound scanner with 3 probes (convex, linear and sector) to perform lung ultrasound and optic nerve ultrasound, searching for early signs of HAPE (high-altitude pulmonary edema) and HACE (high-altitude cerebral edema).

Our main goal was to assess possible complications connected to the examination of patients or volunteers taking part to a study, in order to better prepare researchers for larger studies involving a bigger sample size in more extreme conditions.

Material and Methods

Our group was composed of 4 people and we spent 2 days at the Torino Hut at 3375m and we did one excursion each day: the first one at approximately 3500m and the second one at 4001m. We performed lung ultrasound and optic nerve ultrasound on every member of the group before ascending the Mont Blanc and approximately every 12 hours when we were staying at high altitude. We repeated the examination also when we descended the Mont Blanc, at the end of the expedition.

Each examination included the ultrasound evaluation, measurement of blood pressure, heart rate, respiratory rate, oxygen saturation and filling out the Lake Loiuse AMS score.

Results

The first logistic problem we encountered was the study equipment: it is a consistent additional weight that must be carried in austere conditions. Secondly, performing the data collection and the ultrasound examinations proved to be time-consuming.

Lastly, a safe examination setting must be provided.

Conclusion

Expeditions must be carefully planned: if diagnostic equipment is brought, its weight must be considered, and energy sources (batteries, plugs, local availability) must be verified beforehand.

Examination times must be managed in order to not delay the expedition plan: it is advisable to have more than one examiner in the team, divide tasks and possibly to have spare equipment so that examinations can be performed simultaneously. Volunteers should sign consent before the expedition and must be properly briefed about the study and how the examination is performed.

If volunteers have to be undressed, this should happen in closed space, protected from extreme temperatures and adverse weather conditions: examinations must be planned in a building or a tent should be carried for this purpose.

Standardized methods and diagnostic scores should be developed in order to combine the results of similar researches.

The research advances in this field are essential to improve the medical care of all the people that work or do leisure activities in these environments.

Ultrasound research in extreme environments: a high-altitude experience

Orale

B. Barcella, MD, Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo University Hospital, University of Pavia, Pavia, Italy

F. Resta, MD, Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo University Hospital, University of Pavia, Pavia, Italy

S. Perlini, MD, PhD, Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo University Hospital, University of Pavia, Pavia, Italy

M. Garrone, MD, Department of Emergency Medicine, A.O. Mauriziano, Largo Filippo Turati, 62, 10128 Torino, Italy. Advanced Emergency Ultrasound SIUMB School, 10128 Torino, Italy.

 

Ambienti Impervi

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