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Some recent events cause me to wonder if dexamethasone should be in the first aid kits of those going to altitude. I'd appreciate comments on this point.

I realize this a prescription, potentially quite dangerous drug, and one would have to be fairly certain of the diagnosis.

i will carry it anytime i plan to be above 14K for any length of time (i.e. more than a day)

All you need is Viagra. Good for more than one kind of emergency.

I carried it in Ecuador and never came close to needing it. But since I have it I may continue to carry it just in case. Not like it's heavy.

I would like to see some more input on this as well. Twight recommends carrying it in his book extreme alpinism.

scottmitch wrote: Twight recommends carrying it in his book extreme alpinism.

There you have it, its recommended for "Extreme Alpinism".

For those interested there is a lot of good information on this site:

http://www.basecampmd.com/expguide/hace.shtml

Provided that dex is only used for clear-cut HACE and that parties stick to reasonable acclimatization schedules despite having it as insurance, I think it's a responsible addition to a med kit when there is any chance that people will stick around at altitudes significantly higher than those to which they're acclimatized. That includes moderate altitudes of 14K; many of us live at sea level, and if we take a couple months off from climbing to work or go to school or whatever then we dash back to the Sierra to do a weekend high traverse during which we have to bivy at 13.5K, clearly that's inviting problems. There's no reason not to carry it: it's not too expensive, the prescription is easy to get, it weighs almost nothing, it lasts a long time, and even if the party is well-acclimatized, someone else might need it. There are legal issues with administering prescription meds as a non-doctor, but my personal opinion is that if someone is suffering from HACE and there is nothing to be done, they are getting dex regardless of how hard anyone sues later.

I just filled a 'script for it to have on Denali. I think it will be something in my high-altitude kit going forward. Along with some 1000mg asprin, 250mg Diamox and a few other items. The Diamox came in handy at the hut on Orizaba for a guy we meet from France. Hmm, is that dispensing medication without a license ? Glad he was not allergic to sulfites ! Scott

ScottyP wrote:Hmm, is that dispensing medication without a license ? Glad he was not allergic to sulfites ! Scott

Here in Canada you aren't prescribing a medication if the person takes it on their own.

Yeah, I think I am pretty safe by Mexican law too!!

Just as with anything else, it depends entirely on who is carrying it, who is administering it.
One shouldn't be allowed to carry bandaids if they cant use good judgment in their application.

If you do know how to use it (when it is appropriate to use it), there's there's no reason not to carry it. Be prepared for as much as possible, whenever possible.

Moap,

I couldn't agree with Yeti more... it all comes down to the level of training of the individual using it. I am curious as to the recent circumstances that brought this issue up for you?

As for me, as far as the drug goes, it's a pretty safe drug when used short term (long term usage, beyond a few days is a VERY different story). I like it in my kit as it really is a very practical drug, it's usage for medical problems goes far beyond the treatment of HACE, many of which are encountered in the back country.

Aid kit should be in each appropriate climb up to packaging.
For example, aid kit for a 2000-meter peak and a peak 5000 meters should be different.
The dexamethasone should only be used on top of 5000 meters. But the pill is better acetazolamide be replaced.