High Altitude Risk Bingo : the answers

July 10, 2010

1. The two highest : Cusco ( 3400) and Addis Abeba (2355).Addis Abeba was the home of Haile Selassie, ruler of Ethiopia and Rastafari icon , his palace is found just outside Addis at 3000 meters altitude.

Andorra La Vella (1023) is the highest European capital in the lilliput state of Andorra in the Pyrenees , and contrary to most expectations Madrid (677) is higher than Geneva (375) in Switzerland.

2. Correct answer : check that there is a pulse , and do nothing ( i.e. D) until breathing starts again, within twenty seconds.
3. Yes , he is pale , and so are you : everyone who has just arrived in Pang is , and will match the norm for home oxygen treatment for people with chronic lung disease. The pause in breathing comes from the battle between two impulses : hypoxia leads to increased breathing , but will lose everytime you blow off too much carbon dioxide and change the acidity levels in the blood. Acclimatization will make increased breathing possible by a change in acid balance , so will medicating with Diamox/azetacolamide.

4. Going backwards , from high to low : the highest capital on the list is Quito (2850) in Colombia , i.e. in the Andes. The second highest lies one thousand meters higher than Kathmandu and has a distinctive architecture that includes Ladakhi style toilets with an extra twist : separation between solids and fuels from the start :

Welcome to Sanaa (2250) on the Arabian peninsula , one of the oldest living cities in the world , the source for the oldest existing version of the Quran , that until the late 20th century included more than 50 000 Jews.

The two lowest capitals on the list lies close to the highest mountains on their continent : Kathmandu at 1280 meters is a hundred meters lower than Ulan Bator , and Dodoma (1120) is … miles away away from Kilimanjaro , the highest mountain in Africa.

5. Cue wild laughter in the ICU and ER coffee rooms : oxygen canisters like this hold around 95 % oxygen at hair spray can pressure , and this brand specifies it as lasting for around 25 breaths/inhalations. That equals around one minute of effective use for anyone under more than mild stress.

6. Highest road tunnel today : the Eisenhower Tunnel in Colorado at 3401 meters , a few meters higher than the Salang tunnel under the Hindukush range in Afghanistan. The Hindukush ( “death of the Hindus” ) remained a formidable obstacle for accessing the Afghan heartland until a Soviet aid program built the Salang tunnel in 1964 , that became the main inroad for the Soviet invasion in 1979. Both will be bested by the tunnel being built today linking Yunnan & Tibet.

7.Medical grade oxygen comes in steel or high grade composite tanks at a pressure of around 200 atmospheres , i.e. 200 times the pressure at sea level. This 2.5 liter tank thus contains 200 x 2.5 = 500 liters , which means 250 minutes of use at a flow of two liters per minute.

8. A: 1.3 %

9. C : Higher . Sherpas have the advantage of lifelong adaption , which is exploited in allowing them less acclimatization nights. They are also aware of the fact that aknowledging symtoms can mean not only losing income on their current climb , but also not getting a job on other expeditions.To add another physiological burden many have started to live where they are recruited , i.e. down in Kathmandu , which pushes them closer to lowland capacity.

10. The contenders are : the Gulmarg Gondola in kashmir, max elevation 3747.
The French cable car at Aiguille du Midi ends at 3777
The Venuzuelan Meridian cable car would be the clear winner , well over 4500 meters … if it actually ran.
The Loveland lift system in Colorado (US) : 3871 meters is surpassed only by the Jade Dragon Snow Mountain in Yunnan at 4500 meters.

11.A : combining two factors meaning lower risk : being 50+ years , and a long intercontinental flight ( cabin pressure equaling up to 2400 meters altitude) the same day.

12. Highest risk D : no known time at high altitude , young , male, competitive.

13. The lighter side of Boyles Law , which describes how gases expand with decreased surrounding pressure :
Boyles Law

The darker side : all gases expand when ascending …ooh.As in I really shouldn´t had that last curry. In medicalese HAFE : High Altitude Flatulent Emission.

14. E The only traditional medicine on the list is coca. The Soroche Pills sold in the Andes is a combination of ASA and caffeine , one of the most common hangover cures on the planet _ basically it´s just aspirin with a dash of caffeine. Rhodiola comes from the Soviet/Russian search for “adaptogens” , substances that are supposed to make us more invulnerable to environmental stress. High water intake is modern folklore on the web : the only attempt to present evidence for this strayegy is a study from Everest that showed that those with lowest fluid ( NB not water) intake had more symtoms … as in more headaches.

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