This book is included in the Outdoor Survival - Bio-Regional Environments section.
Foreword
Following realignment and reorganization in the 1990’s, the U.S. Army will
consist of fewer units with the same requisite levels of training, technical skill and
motivation. These units will have a broader mission, however. Changes in strategic and
geopolitical considerations have increased the contingencies the Army faces worldwide
to include conducting operations other than war. To meet those contingencies, units
must be able to operate successfully in a wide range of environmental extremes,
including high-altitude mountainous terrain.
High mountain environments are inherently dangerous. They can be very
unforgiving for those without adequate knowledge, training and equipment.
Commanders and medical support personnel must understand that the interaction of
environmental conditions with mission responsibilities and individual and unit
characteristics can have profound negative impacts on the outcome of the mission.
Adequate planning and preparedness can reduce or prevent such impacts. Preparing
for and responding to environmental health hazards are critical elements to consider in
the intelligence preparation of the battlefield.
The most recent official military guidance concerning medical problems at high
terrestrial elevations is Department of the Army Technical Bulletin TB MED 288,
“Medical Problems of Man at High Terrestrial Elevations,” published in October 1975.
While that publication contains information that is still relevant and useful, much of its
content is not current. The purpose of this technical report is to provide updated
information and guidance on the prevention and treatment of medical problems likely to
be encountered by soldiers exposed to high terrestrial elevations. This information is
based on research and field studies conducted by the U.S. Army Research Institute of
Environmental Medicine as well as relevant material published in the medical literature.
It is not intended to contravene or replace established policy and doctrine of the
Department of the Army or the Surgeon General. General guidance on aspects of
military mountain operations can be found in FM 90-6, Mountain Operations and in TC
90-6-1, Military Mountaineering Training.
TABLE OF CONTENTS Foreword Table of Contents Acknowledgments Introduction Human Physiologic Responses to High Altitude Barometric Pressure and Oxygen Availability Hypobaric Hypoxia and Altitude Acclimatization Acclimatization and Military Operations Medical Problems in High-Mountain Areas Medical Problems Related to Sustained Hypoxia Acute Mountain Sickness High Altitude Pulmonary Edema High Altitude Cerebral Edema High Altitude Peripheral Edema High Altitude Retinal Hemorrhage Thromboembolic Events Subacute Mountain Sickness Immune Suppression and Poor Wound Healing Medical Problems Unrelated to Hypoxia Cold Injuries Solar Radiation Injuries High Altitude Pharyngitis and Bronchitis Lightning Injuries Carbon Monoxide Poisoning Terrain-Related Trauma and Orthopedic Problems Constipation and Hemorrhoids Infectious Diseases Pre-existing Medical Conditions Soldier-Related Factors in High Mountain Operations Reduced Physical Performance Psychological Effects of Sustained Hypoxia Sleep Disturbances Dehydration Inadequate Nutrition Pharmacologically-Active Substances Health Service Support Problems in High-Mountain Operations Impact of Mountain Environments Countermeasures for Adverse Environmental Factors APPENDIX A: Medications Treatment of Altitude Illnesses APPENDIX B: Related Reading
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