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DMI Courses

DMI Courses

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 MarineCorps 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


  1. Oxygen

  2. Sleep

  3. Dehydration

  4. Nutrition

  5. Cardiac Function

  6. Cold

  7. Secondary Physiologic / Hormone effects


1100    Acute Altitude Sickness


1300    Measureable Effects of Altitude


  1. Respiratory Response

  2. Oxygen Saturation

  3. Inappropriate fluid loss


1500    Mitigation Techniques – An Inventory:  Good and Bad


  1. Acclimatization

  2. Herbals

  3. Diamox

  4. Dexamethazone

  5. Sildenafil

  6. Stimulants

  7. Supplemental Oxygen


1700    Baseline Cognitive Evaluations



Day 2: Movement to Altitude


0630    Depart Airport for Denver


1000  Arrive Denver International

  1. Ground Transport to Base (arrival at 10,400 ft)


1300    Immediate Responses to Altitude


  1. Vital Signs / Oxygen Sat

  2. Equipment Issue

  3. Cognitive Evaluation


1500    Mountain Survival 1


1600   Overland Movement


  1. Aerobic Performance at Altitude (Arrive at 13,250 ft = 4000m)


1900    Unit Level Mountain Exercise 1


2200    Altitude Effects Observaton


  1. (Overnight under field conditions at altitude)



Day 3: 11,700 ft


0700    Movement to Hut Camp, 11,700 ft


0800    Acute Mountain Sickness Observed


  1. Vital Signs / Oxygen Sat / Orthostatic changes


0900    AMS Evaluation Tools:  Lake Louise Survey


0930    Selection of Altitude Effects Mitigation Strategies


1000    Measureable Altitude Effects


  1. Hydration

  2. ABG Demonstration

  3. Sleep cycle

  4. Weight

  5. Urine output / concentration


1200    Cognitive Evaluation


1400    Mountain Survival Training 2


1430    Cold Weather Physiology


  1. Effects

  2. Adaptation


1530    Hypothermia


  1. Physics of Body Thermal Regulation

  2. Hypothermia Effects Mitigation


1630    Cold Weather Technologies


  1. Hypothermia Treatment

  2. Casualty Care in the Cold


1700    Unit Level Mountain Exercise 2


2000    Cold Water Immersion


  1. Survival Strategies

  2. Cold Water Immersion vs WInd


2200    Altitude Effects Observation



Day 4: 11,700 ft


0800    AMS Evaluation with Mitigation


0900    Diseases of Altitude


  1. HAPE

  2. HACE

  3. Retinal Hemorrhages

  4. Sickle Crisis


1000    Frostbite


1100    Performance at Altitude


  1. Cognitive

  2. Physical

  3. Aerobic Mission Performance


1200    Unit Level Mountain Exercise 3


1600    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



  1. The price for the course is $1400 (Group Pricing: For a single group of 14 or greater personnel, cost is $ 1040 per person. For a single group of 20 or greater personnel cost is $ 920 per person).

  2. We accept Purchase Orders, Contracts, Cash, Checks, Credit Cards, IMPAC Cards, EFT’s, and SF182’s