Emergency Medicine Journal

Tibetan Plateau Earthquake: Altitude Challenges to Medical Rescue Work

(Emerg Med J. 2012 Mar 3 [Epub Ahead of print]). Xu T, Wang Z, Li T, Et AL

Prepared by Matthew Stewart, MD, University of Utah Emergency Medicine Resident, Salt Lake City, UT, USA

This prospective cohort study evaluated the effect of rapid altitude gain on rescue workers after the Yushu earthquake in April 2010. Seventy-eight unacclimatized rescue team members traveled from Beijing to Yushu county (altitude, 150 feet and 14,400 feet, respectively). The majority arrived via 34-hour land trip (n=74) and the remainder arrived via 2.5-hour plane trip (n=4). Objective measurements taken before departure, after arrival, during rest, and after 30 minutes of work include the following: heart rate, pulse oxygen saturation (Spo₂), and acute mountain sickness (AMS) symptoms assessed by the Lake Louise Questionnaire.

The investigators found that 37.2% of the rescue workers met criteria for AMS, and 20.5% were evacuated early to lower altitudes. The most common AMS symptoms were chest tightness, headache, dizziness, and shortness of breath. Additionally, the rescue workers demonstrated hypoxia after ascent, with Spo₂ decreasing from 98.5% in Beijing to 90.3% and 79.3% at 14,400 feet (respectively during rest and activity). Limitations of the study include a small sample size, homogeneous study population, and recall bias using the Lake Louise AMS Questionnaire. The authors conclude that altitude sickness is a major concern for unacclimatized rescue workers and a high-altitude–specific disaster plan is needed that uses local acclimatized staff.