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Nepalese Diploma in Mountain Medicine
Curriculum description

Part A: Conducted in Kathmandu (10 days) as lectures, group discussion, clinical scenarios, and technical skill acquiring. It covers:

  1. High altitude and related illnesses : an introduction to basics of high altitude atmosphere, human physiological changes and adaptation to high altitude, AMS/HAPE/HACE and their pathophysiology, recent advances in the treatment of altitude illnesses, traveling to altitude with medical comorbidities, high altitude cough, pilgrims at high altitude, women and children at high altitude
  2. Practical traumatology : an introduction to the primary survey, shock assessment and management, trauma assessment and management, pain management in the wilderness, basic orthopedic procedures in the wilderness
  3. Travel health : assessment prior to travel, vaccines and disease prevention, fever in the expedition, insect and animal bites, travelers diarrhea, antibiotics use in the expedition,
  4. Mountain medicine : a basic introduction to skin problems at high altitude, eye problems in high altitude, GI physiology and nutrition/hydration at altitude, sleeping outdoors at altitude, doctor on high altitude trek/expedition, basic personal and group medical kit preparation, friction blisters and its management
  5. Helicopter rescue : an introduction to helicopter basics, helicopter marshaling and finding appropriate landing sites in the wilderness, transporting patients into the helicopter, demonstrations of longline rescue techniques
  6. Summer skills : basic rock climbing, belaying, rope knots and personal safety skills, rock anchors, rappelling, ascending victim lowering, rope rescue systems

Part B: Conducted in Manang and the Khangla glacier(5100m) in the Annapurna region(18 days) , as lectures, group discussion, and clinical scenarios and technical skills acquiring. It covers:

  1. Environmental exposures : basic pathophysiology and management of hypothermia frostbite, and cold injuries, pathophysiology and management of hyperthermia and heat strokes, lightning injuries, drowning and submersion injuries, water sanitation and waste disposal in the expedition, basic introduction to avalanche and avalanche rescue
  2. Weather in high altitude : basics of cloud formation, wind and rain mechanisms and weather predictions, survival skills in hostile and high altitude weather
  3. Search and rescue : rescue organization, disaster preparedness, communication and media in the expedition, legal aspects in the expedition, search and rescue in an avalanche, victim extraction, map reading and navigation

Winter skills: crampons and ice axe use, rope knots and safely skills, roped team travel and glacier traverse, self-arrest and self-rescue techniques, improvised lowering techniques, ice and snow anchors, ice climbing, patient transport on snow/ice, self and team crevasse rescue

UIAA/IKAR/ISMM 2019 Guidelines
Basics of Minimal time requirements (hrs) Instructors Suggested Training
Altitude and its illnesses 8 high altitude experienced doctor theory
Exercise physiology 1 physiologist or experienced doctor theory
Nutrition, fluid balance and exhaustion 1 experienced doctor or nutritionist theory
Hypothermia 4 experienced doctor theory + practical
Frostbite 2 experienced doctor theory
Submersion and immersion in water 1 experienced doctor theory
Heat and solar radiation 1 experienced doctor theory
Practical traumatology 8 experienced doctor workshop
Analgesia in the field 2 experienced doctor theory
Effects of pre-existing clinical conditions 4 experienced doctor theory
Children and mountains 1 experienced doctor (paediatrician) theory
Travel Medicine 2 experienced doctor theory
Infection control and water safety 1 experienced doctor theory + practical
Weather 1 mountain guide or meteorologist theory
Performing medical research 1 experienced doctor theory
Stress management 1 experienced doctor theory
Information technology in the mountains 1 workshop
Ethics including sports and drug use 1 discussion
Legal aspects 0.5 experienced lawyer or doctor with medico legal experience theory
International mountaineering organisations 0.5 theory
Personal first aid kit and mountaineering equipment 1 experienced doctor theory
Mountaineering techniques in summer and winter (see Appendix 1) 24 qualified mountain guides practical
Navigation and survival techniques in hostile weather in the mountains 8 mountain guide workshop + practical
Avalanche risk assessment, companion search, and medical management of victims 4 experienced doctor + mountain guide or experienced avalanche worker/ski patroller theory + practical
Introduction to improvised rescue techniques 2 experienced mountain rescue doctor, team member and/or mountain guide theory
Practical demonstration of improvised rescue techniques 4 experienced mountain rescue doctor, team member and/or mountain guide practical
Organised rescue 4 experienced mountain rescuer theory + workshop
Death in the mountains 1 experienced mountain rescue healthcare provider theory
Alpine sports accidents (base jumping, paragliding, sport climbing, mountain biking) 1 experienced mountain rescue healthcare provider theory
Additional subjects selected by the course organiser 29 theory, workshop + practical
Total number of hours 120