Cardiopulmonary resuscitation (CPR) is a life-saving skill that helps a person survive during cardiac arrest, breathing problems, or sudden collapse. This becomes even more important when these emergencies happen in high-altitude areas like mountains.
During summer and winter vacations, many U.S. citizens travel to new cities or go mountain climbing for adventure. However, High-altitude environments make CPR more challenging. Thin air leads to faster fatigue, reduced cognitive function, and challenges in maintaining high-quality chest compression or providing rescue breaths.
This guide will help you understand the best ways to perform CPR at high altitude. It explains the challenges you may face and shares simple steps to improve your chances of saving someone’s life at high altitude.
Challenges of Performing CPR at High Altitude
In high-altitude zones ranging from 5,000 to over 8,000 feet, the oxygen level drops, and the human body faces greater physical stress. These conditions not only affect the victim but also make it harder for rescuers to deliver effective CPR.
Research shows that chest compression depth during CPR can decrease by up to 1 cm at high altitude due to fatigue and low oxygen levels. If you are a trekking guide, rescue worker, or trained responder, it’s essential to understand how to adapt CPR techniques to high-altitude environments to improve the chances of survival.
Here are some challenges of performing resuscitation at high altitude:
- Reduced oxygen levels (hypoxia): The thin air means less oxygen is available for both the patient and the rescuer. It became hard to provide rescue breath and CPR to the victim.
- Rapid fatigue: Rescuers get tired more quickly due to the thin air. This can reduce the quality of chest compressions during CPR.
- Cold weather complications: Cold temperatures can cause hypothermia in the victim and make the rescuer’s hands numb, making it harder to perform chest compressions properly.
- Delayed EMS response: Remote or mountainous areas often lack quick access to emergency services, like delays in EMT help.
- Device failure risks: Equipment like AEDs may not work well in freezing temperatures due to battery failure or other technical issues.
Also read: What are the Common Mistakes to Avoid During Adult CPR?
Step-by-Step Resuscitation Guide for High-Altitude Emergencies
When performing CPR at high altitudes, it’s essential to stay calm and follow proper resuscitation steps and guidelines to provide the best possible care. Many mountain climbers lose their lives due to low oxygen levels and delays in receiving timely medical assistance. Quick and effective CPR can help increase the chances of survival for victims suffering from oxygen deprivation.
Here are the key steps to follow when performing CPR in high-altitude areas:
1. Ensure Scene Safety
If someone suddenly collapses due to a heart issue, shock, or low oxygen levels at high altitude, the first and most important step is to check if the area is safe. Look for dangers such as falling rocks, avalanches, unstable snow, or uneven ground. In remote mountain areas, it’s important to keep yourself and the person safe. If the scene is dangerous, call for help and wait for trained rescuers. Once it’s safe, begin CPR as soon as possible.
2. Perform a Quick Assessment
Once the victim is in a safe place, quickly check their condition. Time is very important in high-altitude emergencies. If the assessment is delayed, conditions like Acute Mountain Sickness (AMS) or High-Altitude Pulmonary Edema (HAPE) may be mistaken for cardiac arrest or breathing problems. A fast and accurate check can help you respond with the right care.
Check if the person is responsive, try talking to them, or gently tapping their shoulder. Are they breathing? Do they have a pulse? Check these signs just as you would at sea level, but stay alert for signs that might be caused by altitude-related illness.
3. Begin High-Quality Chest Compressions
At high altitudes, CPR performance can be affected. A recent study shows that chest compression depth often drops by about 1 cm compared to sea level, mainly due to fatigue and low oxygen. This makes it even more important to follow proper AHA CPR techniques and the correct hand position while performing resuscitation.
If you are trained in CPR, start chest compressions immediately. High-quality compressions can increase the victim’s chance of survival.
- Push hard and fast (at least 100–120 compressions per minute).
- Push down at least 2 inches (5 cm) on the chest.
- Allow full chest recoil after each compression.
4. Provide Effective Rescue Breaths
It can be very challenging to perform rescue breath at high altitude. The air is thinner, which means there’s less oxygen with each breath. This makes it harder for the person to get the oxygen they need. If you have a face mask or a bag-valve mask (BVM), use it to give breaths more effectively. Try to give slow, steady breaths after every 30 chest compressions. If you have carried oxygen on a trip, then immediately apply it to the person to improve the chance of survival. The early CPR and rescue breathing are essential techniques to increase the survival rate of the victim.
5. Use AEDs at High Altitude
Automated External Defibrillators (AEDs) are one of the most important tools to carry when climbing in high-altitude areas. However, there are a few things to keep in mind when using them in such environments. Cold temperatures can drain the AED’s battery more quickly, so always make sure it’s fully charged before your trip and keep it stored in a warm, dry place. If someone collapses and needs defibrillation, apply recommended compression when using an AED as soon as possible.
6. Protect the Victim from Cold
At high altitudes, cold weather can quickly make the victim’s condition worse, especially if they are unconscious or not moving. After starting CPR, try to keep the person as warm in the recovery position as possible by covering them with blankets, jackets, sleeping bags, or any dry clothing. If possible, move them to a sheltered spot out of the wind and snow. Be careful if the person is very cold, don’t move them too much or too quickly, as it could lead to dangerous heart rhythms.
7. Prepare yourself with life-saving skills
If you’re planning a long trek or mountain climb, it’s important to prepare yourself with basic life-saving skills. In high-altitude environments, emergencies can happen without warning, and professional help might be far away. It’s necessary to prepare yourself by learning CPR, how to use an AED, and first aid, which makes a big difference in saving a life. Before your journey, consider enrolling in a Basic Life Support (BLS) course or a CPR and first aid training program from a trusted CPR training center.
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CPR is one of the most essential life-saving skills that everyone should learn. Whether you’re a healthcare provider, like a doctor, nurse, or EMT, or come from a non-medical background, such as a lifeguard, firefighter, teacher, or trekking guide, CPR training is crucial for every professional background. It prepares you to respond confidently in emergencies like choking, cardiac arrest, or breathing difficulties.
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