Early warning indicators for high altitude pulmonary edema and cerebral edema-"lung triplet" and "brain triplet"

　　Early warning indicators for high altitude pulmonary edema and brain edema-

　　When officers and soldiers enter the plateau from the plain (3000 meters and above), or enter the high-altitude area from low-altitude areas, they may cause altitude sickness due to the body's hypoxia. In severe cases, acute severe altitude sickness such as altitude pulmonary edema and cerebral edema may occur.

High altitude pulmonary edema and cerebral edema usually develop within 1-5 days, sometimes a week later.

The clinical manifestations of high altitude pulmonary edema are dyspnea, chest tightness, coughing, white or pink foamy sputum.

The patient feels fatigued or reduced in mobility.

High altitude cerebral edema usually first has symptoms of acute altitude sickness, and then obvious neurological symptoms, such as severe headache, vomiting, mental abnormalities, gait instability, trance, etc. In severe cases, it may be unconscious.

If treatment is not timely or improperly treated, it may be life-threatening.

　　When Wang Wei, a professor of the Department of Cardiovascular Medicine of the Army Special Medical Center of the Army Military Medical University, was performing medical support tasks at high altitude, he conducted statistical analysis on the early clinical manifestations and development of high altitude pulmonary edema and cerebral edema, and concluded that high altitude pulmonary edema and cerebral edema The early warning indicators of China-"lung triplet" and "brain triplet".

　　"Lung Sanlian" and "Brain Sanlian" have a total of 14 characters, that is, "cough, fever, hypoxemia, headache, vomiting, and poor spirit."

The first half sentence is "lung triplet", which is an early warning of high altitude pulmonary edema.

Hypoxemia means that the oxygen saturation in the blood is significantly reduced, especially when it is lower than 70%.

The second half sentence is "brain triptych", which is an early warning of high altitude cerebral edema.

When officers and soldiers on the plateau feel unwell, they can compare the "lung triplet" and "brain triplet" for self-diagnosis.

If it meets the above symptoms, it should be reported to the grassroots military doctor immediately to realize the early detection and treatment of the disease.

　　After receiving a report from the officers and soldiers, the grassroots military doctors should immediately deal with it.

First of all, according to the diagnostic criteria of high altitude pulmonary edema and cerebral edema, the patient's condition must be comprehensively judged.

If the patient has not yet reached the diagnostic criteria, attention should be paid to the dynamic assessment of the condition and high-risk identification. If necessary, the patient can be allowed to "stay on the watch" for oxygen and drug treatment to prevent the condition from getting worse.

Secondly, send it back while treating.

Oxygen should be given immediately during treatment, and intravenous dexamethasone, diuretics, aminophylline, mannitol and other drugs should be given according to the situation. At the same time, they should be quickly evacuated to a higher-level hospital with stronger treatment capabilities.

When conditions permit, patients can also be transferred to low altitude areas.

　　In addition to mastering the "triple of lungs" and "triple of brains," Wang Wei believes that plateau officers and soldiers should also do the following to avoid the occurrence of plateau pulmonary edema and cerebral edema.

　　One is stepped habituation.

Ladder habituation is an effective way to adapt the body to the high altitude low pressure and low oxygen environment.

Before the officers and soldiers enter the higher altitude areas, they may stay for a period of time in the lower and medium altitude areas, and finally reach the target altitude.

For example, stay for 1-2 weeks in areas around 3000 meters and 4000 meters above sea level, and then enter the plateau at 5000 meters above sea level.

Conditional units can also organize officers and soldiers to conduct adaptive training in the low-pressure oxygen chamber.

　　The second is to keep warm.

Colds are a common cause of high altitude pulmonary edema.

The troops stationed in the plateau, especially those stationed in the field and performing tasks at night, should study and judge the climatic conditions and the difficulty of guaranteeing the mission area in advance, and prepare public cold-proof heating equipment and personal cold-proof and warm clothing.

　　The third is to focus on key groups.

People who are older, overweight, have a history of altitude sickness and basic cardiopulmonary disease are at relatively high risk and should be paid special attention.

Before the troops march to the plateau, the soldiers and grassroots military doctors must grasp the physical condition of the officers and soldiers; the grassroots military doctors should make recommendations for the prevention of altitude sickness.