One of the adages in medicine is "No one should die without the benefit of Steroids". While a joke, is partially true.
Remember that the problem that we are talking about here, is LIKELY to cause the death of the person in a short period of time. LIKELY. The potential side effects of a single 4mg dose of dex is, for all practical purposes, none. A person suffering from HACE or HAPE will be very difficult to obtain a history from. The administering of dex would be covered by good sam laws.
Placing a med on a rock, then leaving.....bad idea. By placing the med, you have affirmatively attended to the person, and you are legally required to stay around until relieved by a higher provider, the patient dismisses you. Remember the clinical entity we're talking about is dire, with the person LIKELY to die shortly without intervention. If you leave, you lose your protection.
