Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Descending to lower altitudes or delaying further ascent are treatments for
acute altitude sickness until symptoms are gone.
A Gamow bag may be used if descent is not feasible.
Oxygen (2-4 liters per minute) will improve oxygen saturation of blood.
Aspirin or acetaminophen (Tylenol) may be taken for headache.
For nausea, the doctor may prescribe prochlorperazine (Compazine), an antinausea medication that also enhances the body's ability to increase the breathing rate in response to low-oxygen environments.
Sleeping pills for insomnia should not be taken. They are potentially dangerous because they can slow breathing.
Acetazolamide (Diamox) may be prescribed to hasten acclimatization.
Acetazolamide is a diuretic (a drug that increases urine output) that increases kidney excretion of bicarbonate. This decreases the blood pH, thereby stimulating extra breathing, which results in higher oxygen levels in the blood.
In addition, acetazolamide corrects nighttime pauses in breathing known as periodic breathing. Acetazolamide also improves symptoms of insomnia.
Antibiotics may be given if a fever is present and pneumonia is possible.
For more severe cases of HAPE, continuous positive airway pressure (CPAP) mask ventilation can be used. Although uncomfortable to wear, the CPAP mask helps by increasing the pressure of the inhaled air.
If this intervention fails, a tube may be placed through the mouth and into the airway. This, along with assisted ventilation, is required to treat respiratory failure.
The only definitive treatment for HACE is descent.