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Year : 2023  |  Volume : 4  |  Issue : 1  |  Page : 86-87

High altitude/trauma emergency training for medical personnel deployed at medical facility on chardham yatra route

Department of Physiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Date of Submission14-Nov-2022
Date of Decision23-Jan-2023
Date of Acceptance04-Feb-2023
Date of Web Publication26-Apr-2023

Correspondence Address:
Dr. Jayanti Pant
Department of Physiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JME.JME_142_22

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How to cite this article:
Mohan L, Pant J. High altitude/trauma emergency training for medical personnel deployed at medical facility on chardham yatra route. J Med Evid 2023;4:86-7

How to cite this URL:
Mohan L, Pant J. High altitude/trauma emergency training for medical personnel deployed at medical facility on chardham yatra route. J Med Evid [serial online] 2023 [cited 2023 Jun 7];4:86-7. Available from: http://www.journaljme.org/text.asp?2023/4/1/86/374713

In view of the beginning of Chardham Yatra after a gap of almost 2 years due to the COVID-19 pandemic, the Department of Physiology and Department of Trauma Surgery and Critical Care, AIIMS, Rishikesh jointly organized a workshop on 'High Altitude/Trauma emergency training for medical personnel deployed at various medical facilities on Chardham Yatra Route' from 29th to 30th April 2022 at All India Institute of Medical Sciences, Rishikesh (Uttarakhand). The workshop was financially supported by the Department of Medical Health and Family Welfare, Uttarakhand.

The 2-day workshop was aimed to provide training on high altitude-related medical illnesses and trauma and their management to the doctors deputed by the Department of Medical Health and Family Welfare, Uttarakhand before their posting at various medical centres on the Chardham Yatra route so that these medical personnel could provide standard treatment and care effectively to the pilgrims and tourists. A total of 50 participants registered for the conference who were the medical personnel deployed by Directorate of Medical Health and Family Welfare, Uttarakhand and doctors working for Swami Vivekananda Charitable hospital, Uttarakhand.

The programme began with pre-course test of the registered participants. The inauguration of the event was initiated by lamp lighting ceremony followed by welcome address by the chairperson of the workshop and address by Director and Dean Academics, AIIMS Rishikesh, respectively. The speakers of the workshop included national and international experts who have been providing healthcare services and conducting research at high altitude since many years.

The 1st day of workshop started with a session on 'High altitude environment' by Prof. Latika Mohan, who discussed about various challenges to human survival at high altitude areas. These challenges may be in form of hypoxia, decreased atmospheric pressure, extreme cold and dry weather with bare minimum healthcare facilities. All these predispose to extremely difficult conditions; however, natives have been able to survive successfully through various adaptation mechanisms, which were discussed in the session. Thereafter, Col. S. P. Singh delivered lecture on the process of acclimatisation at high altitude. He also discussed about the protocols for the non-dwellers which needs to be followed at such altitude.

Prof. Latika Mohan discussed about 'High Altitude Pulmonary Edema' in the next session, which was followed by session on 'High Altitude Cerebral Edema' and 'Acute Mountain Sickness' along with hands-on training on correct usage of pulse oximeters and use of Lake –Louis symptom questionnaire by Col. S. P. Singh. These medical conditions were discussed in detail along with the treatment protocol for the same which has to be adopted at high altitude-based health centres by the on duty medical personnel.

The post-lunch session was based on initial assessment and management of trauma in field settings by the team of Trauma surgery and critical care, AIIMS Rishikesh and they provided hands on training to the participants about the management and care of most common traumatic injuries which happen at high altitude regions [Figure 1].
Figure 1: (a and b) Images of hands on training sessions during the workshop

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The 2nd day of the workshop began with feedback and discussion of the sessions of 1st day which was followed by session on 'Air evacuation at high altitude' by Col. Shailja OS Karki. She discussed the practices adopted by the team of health care providers who are actively working in air evacuation of the patients at high altitude areas. She discussed the various precautions which are to be followed for such evacuation and mentioned that air evacuation is not simply picking the patient and bringing him/her to the higher centre but it requires a team of highly trained medical personnel who are proficient in such evacuation.

Col. S. P. Singh conducted hands-on training on methods of oxygen delivering systems and demonstrated the use of the various equipments. This was followed by sessions on hypothermia and prolonged field care by Craig Nuttall. He discussed the outcome of the research conducted by him where he demonstrated the effects of exposure to cold and the human adaptation at high altitude. Thereafter, Prof. Latika Mohan delivered lecture on other cold injuries and pre-existing diseases such as chronic obstructive pulmonary disease, diabetes mellitus, cardiovascular disorders, childhood ailments, asthma and chronic renal diseases which might be worsened on the exposure to high altitude.

Col. S. P. Singh further discussed about the sleep disorders, cognitive dysfunctions and gastrointestinal disorders associated with exposure to high altitude and its management.

The post-lunch sessions included discussion about eye ailments by Dr. Neeti Gupta. She mentioned the precautions and preventive measures for eye care which must be practiced at high altitude.

Dr. Manu Malhotra discussed about the problem of dry nose and epistaxis at high altitude and its management. This was followed by a post-course test of the participants. An online feedback was obtained from the participants at the end of the programme and the participants gave a very positive response with a request to conduct the training programme every year. The post-course test results showed a significant improvement in the response of the participants as compared to the pre-course test results.

The workshop concluded with vote of thanks proposed by Organising secretary of the workshop followed by the distribution of the certificates to the participants.

The workshop provided the participants with an opportunity for exploring the various conditions through which they would face during their services at the pilgrimage route. It is pertinent to understand that high altitude poses with several problems and pilgrims who are already suffering from cardiorespiratory disorders and are elderly need to observe special precautions. Nowadays, due to the availability of helicopter services to the pilgrimage, people do not get sufficient time for acclimatisation and land up in medical emergencies. Pilgrims who are residents of low altitude areas are prone to the medical emergencies on exposure to the extreme climatic conditions at high altitude locations of the pilgrimage shrines. Further, due to COVID-19 pandemic, people who have suffered with respiratory problems need special precaution and healthcare providers have to take additional care while treating such patients.

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Conflicts of interest

There are no conflicts of interest.


  [Figure 1]


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