Summary
Coroner Darren Day and deputy coroner Wendy Kipple discuss altitude sickness deaths from a death investigation perspective. Kipple, based in Summit County, Colorado at 10,000 feet, explains the three types of altitude sickness: acute mountain sickness (headaches, nausea, not typically fatal), HACE or high altitude cerebral edema (brain swelling, hallucinations, coma), and HAPE or high altitude pulmonary edema (fluid buildup in lungs, the most common cause of death from altitude). They share cases including a four-year-old child with arterial stenosis who died within two hours of arriving at 9,800 feet in Breckenridge, and a morbidly obese woman from Texas who also tested positive for COVID. The cure for all three types is rapid descent to lower altitude. The episode emphasizes that anything above 8,000 feet is dangerous for unacclimatized visitors, and that small oxygen canisters from stores are ineffective compared to proper oxygen concentrators.
Key Points
- Three types of altitude sickness: acute mountain sickness (non-fatal), HACE (brain swelling), and HAPE (pulmonary edema, most common cause of death)
- HAPE presents as white froth from nose and mouth, similar to drowning; the most common altitude-related cause of death
- Anything above 8,000 feet is dangerous for unacclimatized people; symptoms can start above 6,000 feet
- Rapid descent to lower altitude is the primary treatment for all three types
- Gradual ascent with stopover days at intermediate altitudes like Denver is recommended
- Pre-existing conditions like cardiac issues, obesity, and respiratory disease dramatically increase risk
- Small oxygen canisters sold in stores are ineffective; proper oxygen concentrators are needed
- Scene investigation must include how long the person has been at altitude and where they traveled from
Key Moments
Three types of altitude sickness and their symptoms
Deputy coroner Wendy Kipple explains the three types of altitude sickness: acute mountain sickness (headaches, nausea), HACE or high altitude cerebral edema (brain swelling, hallucinations), and HAPE or high altitude pulmonary edema (fluid in lungs). Rapid descent is the treatment for all three.
"there's actually several different types of altitude sickness. There's acute, let me get to my, I've got acute mountain sickness."
HAPE causes dry land drowning with white froth
High altitude pulmonary edema (HAPE) is the most common cause of altitude-related death. It presents with rapid breathing, exhaustion, constant coughing, and gurgling from the chest. Victims show white froth from the nose and mouth, essentially drowning from edema buildup in their lungs.
"if somebody dies from it, a lot of times I will see kind of a white froth coming from their nose and mouth, which is kind of like a drowning. But it's dry land drowning, basically. They're drowning from the edema that's building up in their lungs."
Four-year-old dies within two hours at 9,800 feet
A child with corrected arterial stenosis was cleared to fly by his cardiologist but died within two hours of arriving at 9,800 feet in Breckenridge. The cardiologist did not understand the difference between a pressurized airplane cabin and actual high altitude exposure.
"I was like, well, there's a difference between flying in a pressurized cabin of an airplane and driving up to 9,800 feet. Yeah. And where your atmospheric pressure is much less. Because it's not the lack of oxygen. It's the lack of atmospheric pressure that helps us take in that oxygen."
