TY - JOUR T1 - Severe high altitude pulmonary oedema: a patient managed successfully with non-invasive positive pressure ventilation in the Emergency Department JF - Emergency Medicine Journal JO - Emerg Med J SP - 243 LP - 244 DO - 10.1136/emj.2007.055822 VL - 25 IS - 4 AU - David D Gregorius AU - Ronnie Dawood AU - Katja Ruh AU - H Bryant Nguyen Y1 - 2008/04/01 UR - http://emj.bmj.com/content/25/4/243.abstract N2 - High altitude pulmonary oedema (HAPE) is a well-known potential hazard of activities at high altitudes but not a common disease presentation that most emergency physicians have experience treating. The mainstay of treatment is intuitive—early recognition with immediate descent, rest and oxygen—but what does the emergency physician do when a patient is in severe distress from HAPE even after descent to sea level? A case of severe HAPE is presented in a young man; the successful treatment strategy is outlined including non-invasive positive pressure ventilation. The role of calcium antagonists, corticosteroids and phosphodiesterase inhibitors are also discussed in the acute management of this potentially life-threatening condition. ER -