ADVANCED COURSE IN MOUNTAIN MEDICINE Program proponent and director: Ev-K2-CNR Committee Introduction The course is for physicians already enrolled in a basic course in mountain medicine and three local Nepalese doctors wishing to further their knowledge on the subject with practical field experience (Himalayan trekking). The course, comprising practical and theoretical lectures, will be carried out during a trek to / at the Pyramid LaboratoryObservatory. Theoretical Lectures - Geographic, geologic and environmental features of Himalayan mountains - physiological adaptation to high altitudes - physiology of exercise at high altitude - physiopathology of acute mountain sickness - physiopathology of high altitude cerebral edema - physiopathology of high altitude pulmonary edema - hypothermia and frostbite - preparation and supervision of a trek, including nutrition and sanitary precautions - practical traumatology Practical Lectures - first aid and use of Gamow bag - Visit to Himalayan Alpine Rescue in Pheriche - First aid during a trek and in a high altitude environment - Exercise test at high altitude (cycloergometer in the Pyramid Lab) Detailed program 1st day Departure from Italy nd 2 day Arrival in Kathmandu, transfer to Hotel: Course presentation rd 3 day Kathmandu visit. First visit at Tribhuvan-Kathmandu University th 4 day Transfer Hotel-Airport. Flight Katmandu-Lukla (2800 m). Luggage to porters and onset of trekking. Lukla-Phakding (2620 m) - 3-4 hours. th 5 day Phakding - Namche Bazar (3440 m) - 6 hours. 2nd theoretical lecture. 6th day Namche Bazar - acclimatization. Day of rest and acclimatization with 3 rd and 4th theoretical lectures. First practical lecture and visit to Khunde Hospital. th 7 day Namche Bazar - Tyangboche (3867 m) – 5-6 hours. 5th theoretical lecture. 8th day 9th day 10th day 11th day 12th day 13th day 14th day 15th day 16th day 17th day Tyangboche - Pheriche (4243 m) - 5 hours. 6th theoretical lecture and visit to the Clinic of Himalayan Rescue Association in Pheriche. Pheriche - Lobuche – Ev-K²-CNR Pyramid (5050 m) – 6-7 hours. 7Th theoretical lecture. Acclimatization in Pyramid. Visit to the lab: cycloergometer test (2 nd practical lecture) and 8th theoretical lecture. Climb to Kala Pattar (5545 m) – 7-8 hours. Excursion to see Mt. Everest via Gorak Shep (5160m). 3rd practical lecture. Pyramid - Pangboche (4067 m) — 5/6 hours. 4th practical lecture (Gamow bag) and 9th theoretical lecture. Pangboche - Namche Bazar - 5/6 hours — 10th theoretical lecture. Namche - Lukla - 7 hours — 11th theoretical lecture. Flight Lukla – Kathmandu. Transfer to hotel — 12th theoretical lecture. Visit to Kathmandu. Closure of Course. Transfer Hotel- Airport. Flight back to Italy.