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Allan,
To give a generic answer to your question is
difficult the manner in which you utilize flight physiology will be based
largely on your patients condition. High altitude basically forces you to
add another list of concerns to your overall management of the patient. I
would break it down into three primary categories. The most important
aspect to consider are the effects altitude will have on your patient before you
ever leave the ground so you can prevent a problem before it happens. Like
knowing that you will have volume changes in your ET cuff, a simple pneumothorax
can become a tension pneumo at altitude, dehydration may occur, FIO2 will
be affected and changes in O2 therapy may be needed, etc. etc. The second
need arises when your patient has a problem in flight, much like "a combative
patient is hypoxic until proven other wise". If your patient deteriorates
during a altitude change or shortly after, you need to take your physiology
knowledge and rule out the possibility that the problem is altitude related and
if so take corrective action. The third aspect, which is frequently
overlooked, is the effect flight will have on you and your fellow crew
members.
Hope this helps,
Wesley Copeland Sr., FP-C
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