The altitude training (13,250 feet, 4,000 meters) exceeds that of the MCMWTC.

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1 Mission Performance at High Altitude (MPHA) This is a live it, learn it course of instruction designed to teach combat leadership how to get the absolute best physical performance from their Warfighters at altitude. Course Intent This course is designed to enhance, even prepare students for the challenges they will face in the United States Marine Corps Mountain Warfare Training Center (MCMWTC). The purpose of the course is to teach medical and non-medical personnel what the effects of high altitude are, how they affect mission performance and how to recognize and mitigate them. The course is not tactics based. This program is designed for all personnel concerned with maintaining operational performance at altitude especially leaders. The technical aspects and protocols presented to any participating medical personnel enable them to provide the full range options to their units. All participants gain in their understanding of and experience the effects of altitude and the actions they may take to maximize mission success. The altitude training (13,250 feet, 4,000 meters) exceeds that of the MCMWTC. The course is designed for a minimum of ten (10) students and a maximum of (60) students. This course is conducted twelve (12) times a year. Course length is five calendar days (M-F), which includes classroom didactic, training at altitude and travel. Base Day 1: San Diego, CA 0800 Introduction: Goal = What should I know to work at altitude 0900 Physics of Altitude / Respirry Physiology 1000 Performance Factors Oxygen Sleep Dehydration

2 Nutrition Cardiac Function Cold Secondary Physiologic / Hormone effects 1100 Acute Altitude Sickness 1300 Measureable Effects of Altitude Respiratory Response Oxygen Saturation Inappropriate fluid loss 1500 Mitigation Techniques An Inventory: Good and Bad Acclimatization Herbals Diamox Dexamethazone Sildenafil Stimulants Supplemental Oxygen 1700 Baseline Cognitive Evaluations

3 Day 2: Movement to Altitude 0630 Depart Airport for Denver 1000 Arrive Denver International Ground Transport to Base (arrival at 10,400 ft) 1300 Immediate Responses to Altitude Vital Signs / Oxygen Sat Equipment Issue Cognitive Evaluation 1500 Mountain Survival Overland Movement Aerobic Performance at Altitude (Arrive at 13,250 ft = 4000m) 1900 Unit Level Mountain Exercise Altitude Effects Observaton (Overnight under field conditions at altitude) Day 3: 11,700 ft 0700 Movement to Hut Camp, 11,700 ft

4 0800 Acute Mountain Sickness Observed Vital Signs / Oxygen Sat / Orthostatic changes 0900 AMS Evaluation Tools: Lake Louise Survey 0930 Selection of Altitude Effects Mitigation Strategies 1000 Measureable Altitude Effects Hydration ABG Demonstration Sleep cycle Weight Urine output / concentration 1200 Cognitive Evaluation 1400 Mountain Survival Training Cold Weather Physiology Effects Adaptation 1530 Hypothermia Physics of Body Thermal Regulation Hypothermia Effects Mitigation

5 1630 Cold Weather Technologies Hypothermia Treatment Casualty Care in the Cold 1700 Unit Level Mountain Exercise Cold Water Immersion Survival Strategies Cold Water Immersion vs WInd 2200 Altitude Effects Observation Day 4: 11,700 ft 0800 AMS Evaluation with Mitigation 0900 Diseases of Altitude HAPE HACE Retinal Hemorrhages Sickle Crisis 1000 Frostbite 1100 Performance at Altitude

6 Cognitive Physical Aerobic Mission Performance 1200 Unit Level Mountain Exercise Return to Base 10,400 ft 1730 Movement to Billeting 1900 Dinner Day 5: Base 10,400 ft and Descent 0800 Summary / Protocol Options and Recommendations 1000 Equipment Recovery 1100 Depart Billeting for Denver Airport 1300 Arrive Denver International Airport The price for the course is $1400 (*WTA discount is available, other custom course price and discounts are available through direct coordination) We accept Purchase Orders, Contracts, Cash, Checks, Credit Cards, IMPAC Cards, EFT s, and SF182 s

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