Thought question: what would be different practicing medicine at higher altitudes?

[ohiovolffemtp]

In the past 8 months, I've switched from practicing EM in the midwest at elevations between 500-750' above sea level to the mountains of Colorado at between 7500-8000' with nearby mountains rising above 14,000'.   The patient population includes both year-round residents and vacationers.    Besides needing to acclimatize myself, I've had to learn the effects of higher altitude on patients and their disease processes.

So, as a thought problem for PA's in training, what do you think are some of the differences you should expect between practicing at elevations closer to sea level vs higher, in particular with respect to:

• Vital signs: which ones, and why
• Lab reference values: which ones, and why
  • what "abnormals" might be more or less abnormal
• Disease processes: which ones could be more affected
• Treatment changes:
  • prescribing
  • what patients you admit vs send home
• Patient demographics: who's most affected by changes in altitude

Let's let the PA-S's out there have first cut at these questions before the experienced PA's out there chime in.