Orange Home-Care Clinic, Fukui City, Fukui Prefecture, Japan.
School of Medicine, Shiga University of Medical Science, Otsu City, Shiga Prefecture, Japan.
Wilderness Environ Med. 2023 Sep;34(3):383-387. doi: 10.1016/j.wem.2023.05.008. Epub 2023 Jul 10.
With the recent development of neonatal medicine, the number of children with medical complexities (CMCs) is increasing. Outdoor activities are important for their psychosocial development, and the principles of accessibility should be addressed. We report the experience of 2 CMCs' high-altitude mountaineering with the necessary support. The participants were a 3-y-old girl with cerebral palsy, symptomatic epilepsy, and a ventriculoperitoneal shunt (Child A) and a 6-y-old girl who underwent bilateral Glenn operations at 11 mo for hypoplastic left heart syndrome (Child B). The support staff consisted of 4 doctors, 1 nurse, 5 nonmedical staff , 3 members from a mountaineering association, and 2 people from an oxygen company. The climbing schedule was 2 days. On the first day, we took a bus to a hut at an altitude of 2450 m and stayed overnight to acclimatize to the altitude. On the second day, we took the beginner's route, which took 3 h to climb 500 m, and our team made an attempt on the summit. During the attempt, Child B panicked. Although her lung sounds did not raise suspicions of pulmonary edema, we decided to leave the mountain with her because her transcutaneous oxygen saturation decreased. Child A had no apparent health problems and made it to the summit. Although CMCs' alpine climbing requires careful planning and staffing considering the risk of high-altitude sickness, our case suggests the feasibility of such activities with CMCs as part of accessibility.
随着新生儿医学的发展，患有复杂疾病的儿童（CMC）数量不断增加。户外活动对他们的心理社会发展很重要，应考虑可达性原则。我们报告了 2 例 CMC 在必要支持下进行高山登山的经验。参与者为 1 名 3 岁女孩，患有脑瘫、症状性癫痫和脑室腹膜分流术（儿童 A），1 名 6 岁女孩因左心发育不全综合征在 11 个月时接受双侧 Glenn 手术（儿童 B）。支持人员包括 4 名医生、1 名护士、5 名非医疗人员、3 名登山协会成员和 2 名氧气公司人员。登山计划为 2 天。第一天，我们乘公共汽车到海拔 2450 米的小屋过夜，以适应海拔高度。第二天，我们走了一条初级路线，花了 3 个小时爬了 500 米，我们的团队试图登顶。在尝试过程中，儿童 B 感到恐慌。虽然她的肺部声音没有引起肺水肿的怀疑，但由于她的经皮血氧饱和度下降，我们决定带她离开山区。儿童 A 没有明显的健康问题，并成功登顶。虽然 CMC 高山登山需要仔细规划和人员配备，以考虑到高原病的风险，但我们的案例表明，对于 CMC 来说，这种活动具有可达性。
