altitude sickness

Altitude Sickness Everest Expedition 2014

Causes…

Less OxygenLow Pressure Rapid AscentPossible DehydrationHypothermia

Acute Mountain Sickness

AMS – occurs above 8,000 ft elevation

Symptoms

Normally described as mild hangover Headache WITH Fatigue Nausea Shortness of Breath (at rest) Loss of Appetite Insomnia Dizziness

Treatment

DO NOT ASCEND FURTHERHydrateStay at altitude for 12-24 hours

If symptoms diminish can ascend If symptoms continue descend

High Altitude Pulmonary Edema

HAPE – occurs above 12,000-15,000 ft

Symptoms

Intense AMS Water in lungs Increased shortness of breath AT REST Severe/constant cough (Dry) Fatigue while walking High pulse rate (110) Blueness of face, lip, fingernails (caused by

inability to transport oxygen into the blood)

Treatment

DESCEND AS SOON AS POSSIBE 500-1,000 ft (or until symptoms diminish)

Hydrate

High Altitude Cerebral Edema

HACE – occurs above 12,000-15,000 ft

Symptoms

Intense AMS Water in the head (increased ICP) SEVERE headache Vomiting Ataxia (walking like a drunk hobo) Decreased LOC Irritable (does not want to be bothered) Overwhelming desire to sleep (DO NOT LET

SLEEP) Loss of consciousness Coma Death

Treatment

DECSEND IMMEDIATELY (1,000 ft minimum) If have pressure bag – USE IT

(carried by expedition companies) Dexamethasone (steroid drug)

Works by decreasing swelling in bony skull Dosage = 4 mg 3x a day (improvement in 6

hours) Buys time if cannot descend immediately

PREVENTIONTHIS IS ENTIRELY PREVENTABLE

DO

Acclimatization – after ascend 1000m stay an extra night to acclimatize

DRINK WATER – 3 to 4L per dayClimb high sleep lowAbove 3,000m – ascend no more than 300m a

day

DON’T

Do not make rapid ascent – too fast too high = BAD

No alcohol, sleeping pills, and smokingDo not carry heavy packs (10-12kg is ok)NEVER travel alone

Medications

OxygenDiamox – for AMS (125 mg before dinner for

sleeping if feeling suffocated)Nafedipine – for HAPESteroids/Dexamethasone - for HACEHyperbolic Bag (Gammow bag)

Diamox (Acetazolamide)

Does not mask symptoms but actually treats symptoms Works by increasing amount of alkali (bicarbonate) excreted

in the urine – making the blood more acidic. This drives ventilation (cornerstone of acclimatization)

FOR PREVENTION: 125 mg twice daily continued for 3 days after highest altitude is reached

FOR AMS TREATMENT: 250 mg twice daily for 3 days Side Effects: uncomfortable tingling of fingers, toes, and face

(called “jhum jhum” in Nepali), excessive urination, and carbonated drinks tasting flat

If allergic to sulfa drugs – DO NOT TAKE THIS

Four Golden Rules

1. Awareness of Altitude Sickness2. If you have mild symptoms DO NOT

PROCEED (take aspirin)3. If you have worsening symptoms GO DOWM

IMMEDIATELY4. Do NOT leave your team member behind

unattended

Three Golden Actions

1. Go up SLOWLY 2. Drink plenty of fluids (no less than 3L a day)3. Know the symptoms of altitude sickness and

be honest with yourself and your team members about them – this is serious and can lead to death BUT IS FULLY PREVENTABLE

Sources

http://peakfreaks.com/ams.htmWFR book (Solo Southeast)