Education And Debate

How To Do It: Doctor on a mountaineering expedition

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6989.1248 (Published 13 May 1995) Cite this as: BMJ 1995;310:1248
  1. Christine H D A'Court, research fellowa,
  2. Rodney H Stables, research fellowb,
  3. Simon Travis, consultant gastroenterologistc
  1. a Intensive Therapy Unit, John Radcliffe Hospital, Oxford OX3 9DU
  2. b Royal Brompton National Heart and Lung Hospital, London SW3 6NP
  3. c Gastroenterology Unit, Derriford Hospital, Plymouth PL6 8DH
  1. Correspondence to: Dr Travis.
  • Accepted 23 January 1995

Doctors are welcome members on mountaineering expeditions to remote areas, but practical advice on how to prepare and what kit to take can be difficult to find. This article is a ragbag of useful advice on diverse topics. It explains the necessary preparation, provides tips for a healthy expedition, and summarises the common disorders encountered at high altitude. The comprehensive drug and equipment lists and first aid kit for climbers were used for the 1992 Everest in winter expedition. They are there to be sacrificed to personal preference and the experience and size of individual expeditions.

An offer to be the doctor on a high altitude expedition presents exciting opportunities for travel to remote areas, but practical advice can be difficult to find. In this article we offer guidelines based on our experience from large and small expeditions lasting up to three months to the Andes, Alaska, the Arctic, and Everest in winter.

Preparing for the expedition

COMMUNICATING WITH EXPEDITION MEMBERS

Write to expedition members in good time with advice on vaccination. Full courses of hepatitis A, hepatitis B, or rabies vaccine take seven months, while booster typhoid, tetanus, poliomyelitis, or meningococcal vaccine or hepatitis A immunoglobulin should be given more than two weeks before departure. Specific advice on malaria prophylaxis and vaccination can be obtained from the Travel Clinic, Battenburg Avenue, North End, Portsmouth (telephone 01705 664235) or the Hospital for Tropical Diseases in London (0171 387 4411) or Liverpool (0151 708 9393).

Issue a brief questionnaire about previous medical history, particularly asthma, peptic ulcer, diabetes, and heart disease. Do not assume good health, especially if friends or relatives of the expedition members are joining the trek to base camp. Advise members to have a pre-expedition dental check up, since a lost filling or dental abscess challenges doctors with no dental experience. Ensure members have medical insurance …

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