ulcer, colitis, hernia, back problems, etc. Lab data should
include a CBC, urinalysis, blood sugar, BUN or creatinine,
resting cardiogram. Testing of pulmonary function, a recent
chest x-ray and an exercise EKG are appropriate, if history
indicates. A published protocol that you may find helpful
for cardiac evaluation of travelers to altitude is included
with this form.
If you have any questions concerning the difficulty and
environmental factors on any trip or the specific risks to
your patient, please call Mountain Travel-Sobek at 1-800-
The Mountain Travel-Sobek material provides the consumer with incentive to correctly
answer questions, provides information to both the consumer and the physician to
encourage a focused and educated examination, and provides alerts to the company
concerning chronic and acute medication conditions. It will still be essential for the
company to provide consultation to the consumer concerning alternate trips if it detects
inappropriate results in the history and physical.
Hultgren in the Journal of Wilderness Medicine published the evaluation of travelers to
high altitude used by Mountain Travel-Sobek in 1990.
This guideline is the current
standard for this evaluation and is reprinted below:
Suggested approach to evaluation of individuals for
trekking or high altitude travel
1). Asymptomatic without evidence of coronary disease, no risk factors
for coronary disease. Risk category: Low. Treadmill test optional.
2). Asymptomatic, with one or more risk factors for coronary disease.
Treadmill test indicated.
Treadmill test negative or minimally positive. Risk category: LOW
Treadmill test strongly positive; thallium scan indicated.
Thallium scan normal. Risk category: LOW.
Thallium scan strongly positive. Risk category: HIGH.
Coronary arteriography indicated.
3). Known coronary artery disease, such as history of prior infarct, ECG
evidence of prior infarct, history of unstable angina, presence of unstable
angina, prior bypass surgery or angioplasty. Treadmill indicated.
Treadmill test strongly positive. Risk category: HIGH
Treadmill negative or minimally positive. Risk category: Low
Hultgren HW: Coronary heart disease and trekking. J Wilderness Med, 1990; 1:154-161