A Case of Splenic Infarction at High altitude in Sickle Cell Trait by Dr Alison Cook

Trekking in Peru 

 

A Case of  Splenic Infarction at High altitude in Sickle Cell Trait

About the author – Dr Alison Cook is a G.P. with a keen interest in expeditions and the medical issues in remote locations.  She has attended the Expedition and Wilderness Medicine course in Keswick and has worked as an expedition medic for Across the Divide Expeditions in locations diverse as Namibia and Peru.  Alison has also worked with Medecins Sans Frontieres (MSF)  in Niger.

In March 2007 an ATD client with undiagnosed sickle cell trait (SCT) suffered a splenic infarction on a high altitude expedition.  Although the phenomenon of splenic infarction in SCT at high altitude is well documented, it is a relatively rare event and therefore a worthwhile case to share amongst expedition medics.

Continue reading

Medicine in the Himalayas – Dr Kirstie Nicol

Working for the Himalayan Rescue Association in Nepal

About the writer.  Dr Kirstie Nichol is a G.P. with a keen interest in expeditions and the medical issues or remote locations.   She has attended the Expedition and Wilderness Medicine course in Keswick and the Polar Medicine training course in Alta, Northern Norway and worked as an expedition medic for Across the Divide Expeditions in locations as diverse as Kilimanjaro and Peru.

Kirstie Nichol in NepalIn 2007 I left ‘normal’ working life as a GP in Haddington behind for a while to work for the Himalayan Rescue Association in a high altitude clinic in Nepal.

The HRA is a Nepalese voluntary non-profit organisation formed in 1973 with an objective to reduce casualties in the Nepal Himalayas, especially in view of the increasing number of Nepalese and foreigners who trek up into the remote wilderness. Nepal alone now receives more than one hundred thousand trekkers from around the world every year. It can be easy to under-estimate the dangers of altitude illness; deaths from these conditions are all the more tragic because they are entirely preventable. Working at the clinic involves a mix of primary health care for local people including home visits, providing an emergency medical service for trekkers and the provision of daily lectures for trekkers emphasising the prevention, recognition and treatment of altitude illnesses. Because rescue is difficult in Nepal, prevention is a key part of the role.

Continue reading