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High altitude pulmonary oedema — DipIMC MCQ

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ModerateEnvironmental MedicineHigh altitude pulmonary oedemaDipIMC

At 3,500 metres, a trekker has breathlessness at rest, cough, crackles and SpO2 72%. A portable hyperbaric chamber is available. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Descend urgently with oxygen or portable hyperbaric treatment if descent is delayed

Option E is correct because HAPE is life-threatening; descent and oxygen are key, with portable hyperbaric treatment as a bridge. Option A is less appropriate because oxygen may be supportive, but it does not address the defining time-critical problem first; option D is less appropriate because vascular access is useful, but it should not delay the immediate priority. Option C is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option B is less appropriate because delay would increase clinical risk. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: Wilderness Medical Society altitude guidance; JRCALC principles