Page 21 - 2001 AMA Summer

tract infection at the time and are unable to do this then it may be too painful for them to tolerate pressurisation and hence unwise to put them in the bag at all. The seriousness of the situation will dictate the necessity.
Sufferers of HAPE may be unable to lie flat inside the bag for very long as the fluid that is in their lungs will redistribute and give them a distressing feeling of drowning and breathlessness. They may have to be either propped up or placed on a head up tilt, both of which may be difficult to achieve comfortably. They may be so short of breath that the lying position is com­ pletely impossible and in this situation it may be necessary to abandon the attempt, with descent, oxygen and specific drug treatments being the immediate priorities.
An assistant should be given the task of maintaining pressure inside the chamber by continued foot pumping at a rate of about 12 per minute. This will be enough to replace the air which escapes through deliberate leaks in the bag. These are present to allow the escape of stale air (with high carbon dioxide and low oxygen content) to be replaced by fresh gas on a constant basis. It is not recommended that the
casualty is evacuated whilst undergoing treatment inside the bag, even though there are carrying straps on the sides. It would be impossible to maintain constant air flow and pressurisa­ tion and would be difficult to monitor their condition.
The chamber should come with its own pressure gauge and maintaining a pressure of 104mmHg inside will be approxi­ mately equivalent to between a half and two thirds of the altitude. For example: at sea level the atmospheric pressure is 750mmHg (1 bar). At 4000m the atmospheric pressure is about 460mmHg. Pressurising the chamber will create an increase to around 564mmHg overall which is equivalent to an altitude of around 2600m. (mmHg = mil­ limetres of mercury)
It is strongly recommended that expedition leaders acquire a Gamow chamber, or equivalent, prior to taking a group to altitudes over 3500m in remote settings. Altitude related illness is a very common problem which every year claims needless lives. These chambers are easy to use, safe and effective at facilitating descent in many victims of Acute Mountain Sickness, HACE and HAPE when they are too ill to descend immediately on foot.
ROCKCLIMBINGPROFICIENCY
By W01 Ewen Martin
Removing his dark and well used sun­ glasses he reaches for a soft cloth to clean the smears that now distort his view. His eyes, narrow slits in the strong
sunlight as it reflects back at him off the many different surfaces; white rock, golden sand and azure sea. The people around him are fit and athletic with the tanned skin of a Malibu surfer, they wait as he opens his mouth to speak.
“Welcome to day 2 of your RCP course.” Today we shall climb several single pitch routes and have an introduction to gear placement.”
The golden beach and sun bleached rock is “Three Cliffs,” a popular coastal climbing area on the Gower in S. Wales. The group are 10 staff from the ATFC Arborfield and their instructors are from the L & IT Wing ATFC Arborfield.
The 5 day course included an indoor wall day, two beautiful single pitch days and
Shallow water soloing. 44.5 - S. Norway.
Continued on page 20