The Use of Dexamethasone in Support of High-Altitude Ground Operations: Review of the Literature & Current Training of U.S. Special Operations Medical Members

Abstract

Abstract : Traditional altitude acclimatization is not always possible for military special forces. Therefore, pharmacologic prophylaxis is advantageous to reduce the risk of relevant high-altitude illnesses. This article reviews the effectiveness of dexamethasone on physical performance and discusses the option of using dexamethasone as prophylaxis at high altitude. We performed a literature search for 1991-2011 to identify research on dexamethasone use at high altitude. We also conducted interviews at special operations (SO) training sites for flight surgeons (FSs) and medics to assess current training in high-altitude ground operations. Past research has indicated that dexamethasone is an effective form of treatment for altitude illnesses. Also, there is U.S. Special Operations Command (USSOCOM) guidance for the use of dexamethasone as an option for prophylaxis in certain situations. Teaching in this topic is not uniform at SOFS and medics training sites, nor is formal curriculum training for all military branches uniform on dexamethasone use as a prophylaxis for high-altitude illnesses. We recommend uniform, formal Air Force, Navy, and Army curriculum training in high-altitude ground operations to include the current USSOCOM guidance in the limited use of dexamethasone as prophylaxis to prevent high-altitude illnesses be conducted during each military branch's FS and SO medics courses.