Podcast 625: High Altitude Cerebral Edema (HACE)

Podcast 625: High Altitude Cerebral Edema (HACE)

Contributor: Tom Seibert, MD

Educational Pearls:

  • High altitude cerebral edema (HACE) is the end stage of acute mountain sickness and is diagnosed when patients develop neurologic dysfunction, ataxia, and altered mental status.
  • The pathophysiology of HACE is thought to be due to increased cerebral blood flow and increased capillary permeability causing vasogenic edema and brain swelling
  • HACE is linked to extreme altitude
  • Rapid descent should be done as soon as possible for this potentially fatal condition
  • Oxygen can be supportive
  • Dexamethasone is also typically indicated (8mg initially followed by 4 mg every 6 hours)

Editor's note: HACE can occur at altitudes as low as 8000 feet so don't automatically assume it can't/doesn't happen in the US

References

Jensen JD, Vincent AL. High Altitude Cerebral Edema. 2020 Aug 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 28613666.

Hackett PH, Yarnell PR, Weiland DA, Reynard KB. Acute and Evolving MRI of High-Altitude Cerebral Edema: Microbleeds, Edema, and Pathophysiology. AJNR Am J Neuroradiol. 2019 Mar;40(3):464-469. doi: 10.3174/ajnr.A5897. Epub 2019 Jan 24. PMID: 30679208; PMCID: PMC7028681.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

Jaksot(1145)

Episode 905: Oseltamivir (Tamiflu) for Influenza

Episode 905: Oseltamivir (Tamiflu) for Influenza

Contributor: Aaron Lessem MD Educational Pearls:  Oseltamivir (Tamiflu) is an antiviral medication used commonly to treat influenza Trials show that the medication reduces the duration of illness ...

27 Touko 20242min

Episode 904: Cardiovascular Risks of Epinephrine

Episode 904: Cardiovascular Risks of Epinephrine

Contributor: Aaron Lessen MD Educational Pearls: Epinephrine is essential in the treatment of anaphylaxis, but is epinephrine dangerous from a cardiovascular perspective? A 2024 study in the Journal o...

20 Touko 20242min

Episode 903: Treating Precipitated Opioid Withdrawal

Episode 903: Treating Precipitated Opioid Withdrawal

Contributor: Aaron Lessen MD Educational Pearls: Opioid overdoses that are reversed with naloxone (Narcan), a mu-opioid antagonist, can precipitate acute withdrawal in some patients Treatment of o...

13 Touko 20242min

Episode 902: Liver Failure and Cirrhosis

Episode 902: Liver Failure and Cirrhosis

Contributor: Travis Barlock MD Educational Pearls: How do you differentiate between compensated and decompensated cirrhosis? Use the acronym VIBE to look for signs of being decompensated. V-Volume ...

6 Touko 20243min

Episode 901: Underdosing in Status Epilepticus

Episode 901: Underdosing in Status Epilepticus

Contributor: Aaron Lessen MD Educational Pearls: Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus Some ED protocols only give 2 mg initially The maximum r...

29 Huhti 20242min

Episode 900: Ketamine Dosing

Episode 900: Ketamine Dosing

Contributor: Travis Barlock MD Educational Pearls: Ketamine is an NMDA receptor antagonist with a wide variety of uses in the emergency department. To dose ketamine remember the numbers 0.3, 1, and 3....

22 Huhti 20242min

Episode 899: Thrombolytic Contraindications

Episode 899: Thrombolytic Contraindications

Contributor: Travis Barlock MD Educational Pearls: Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes Use of anticoagulants with INR > 1.7 or  PT >15 Warfarin will reliably i...

15 Huhti 20243min

Episode 898: Takotsubo Cardiomyopathy

Episode 898: Takotsubo Cardiomyopathy

Contributor: Ricky Dhaliwal, MD Educational Pearls: Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a temporary heart condition that can mimic the symptoms of a heart attack, inc...

10 Huhti 20243min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
radio-antro
utelias-mieli
filocast-filosofian-perusteet
rss-sosiopodi
ihanat-ipanat
mielipaivakirja
rss-bios-podcast
rss-duodecim-lehti
rss-ammamafia
rss-laakaripodi
rss-opeklubi