Everest Base Camp

35 year old female who was climbing Mount Everest (17,000 ft) for the first time. She was driven up by vehicle yesterday evening. Today, she began to have ataxic walk (like drunk) and shortness of breath. You walk her into the tent. She complains of headache is vomiting. She is short of breath and speaking in short sentences. You manually obtain a set of vitals and put a pulse ox on her. Her oxygen level is 55%. RR 31. T 36. HR 110. BP 175/80. On lung exam, you hear crackles. You will place her in a Gamow Bag and give her IM dexamethasone (8mg q6h) and 500 mg acetazolamide PO?. Her oxygen saturation will improve to 80% as soon as placed in Gamow bag. You will arrange for helicopter to come and evacuate her.

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