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High Altitude Sickness

Lack of oxygen is the main cause for altitude sickness. Though problems normally occur 8000ft or above, it can also happen as low as 5000ft in winter due to cold and stress.

Altitudes are defined as:-

High Altitude: 8000 – 14000ft

Very High Altitude: 14000 – 18000ft

Extreme Altitude: Above 18000ft

There are six factors that affect the INCIDENCE & SERVERITY of altitude illness

1. The faster you ascend the greater the risk

2. High fat and high protein diet increase the risk

3. The higher you sleep the greater the risk

4. The longer you stay the greater the risk.

5. Hard exertion without rest increases the risk 6.

Some people are inherently more susceptible to fall ill.

Three common Types of Altitude illness

1. Acute Mountain Sickness This happens if you make a rapid ascent to 8000ft or above without acclimatizing. It can also happen if you make abrupt ascent to higher altitude with partially acclimatizing or without proper rest. You may have Anyone or more symptoms which start 6-72 hours after ascent.

Symptoms : Headache Confusion Nausea, Vomitting Loss of Apetite Collection of fluids in hands and face Bluish appearance in fingerbed nails and around the mouth Dizziness or uneasy feeling Disturbed sleep (breathing stopping for 5-50 seconds)

Precautions: Ascend Rationally: - Not more than 1000ft at a time after 6000ft. Acclimatize before further ascent. If Symptoms develop: - Stop ascends immediately Don’t hide symptoms: - Inform group leader or us as soon as you notice any symptoms Treatment: Drink plenty of fluid, limit exercise & activity, take aspirin but no sleeping pills, no alcohol, no cigarettes, if symptoms develop, monitor them closely.

Descend 2000-3000ft immediately if symptoms worsen or you develop symptoms of HAPE or HACE. 1. High Altitude Pulmonary Edema (HAPE) Is less common but more serious than AMS. There is abnormal fluid collection in lungs. Hape normally occurs above 8000ft and is more common in young males. You may have any two or three symptoms which normally start 24-96 hours after ascent. Signs and Symptoms of Hape Symptoms of Acute mountain sickness. Fatigue with / without fever. Shortness of breath on Exertion (Climbing) Tightness of chest or congestion because of collection of fluid in the lungs. Dry cough Disturbed sleep (Breathing stopping for 5-50 seconds) Increased heart rate and respiratory rate. Treatment of Hape Descend 2000-3000ft immediately or keep descending till you feel better. It could worsen and become fatal. Do not make mistake symptoms for flu, Bronchitis or Pneumonia. Keep person warm as cold aggravates hape. Signs and Symptoms as Hape  “Worsens” Symptoms of Very Acute mountain sickness. Fatigue & weakness. Shortness of breath without Exertion (Walking) Rales or rattling sound can be heard With  A STETHOSCOPE  because of collection of fluid in the lungs. Harsh irritating cough Inability to co-ordinate voluntary muscular movement. Treatment of as Hape  “Worsens” Descend NOW & keep descending till symptoms improve & consult doctor. You may require oxygen or hospitalization. NEVER LEAVE A PERSON WITH ALTITUDE SICKNESS ALONE. DESCEND – DESENCD – DESEND (Any Delay could be Fatal) Signs and Symptoms as Hape  Becomes “Severe” Symptoms of Severe mountain sickness. Extreme Fatigue & weakness. Shortness of breath while resting (lying down) Rales or rattling sound can be heard Without A STETHOSCOPE because of collection of fluid in the lungs. Productivity FROTHY Cough (sputum) often blood smeared or something or white, pinkish or rusty in colour. Discharge of pinkish fluid from nose (very late sign). Treatment of as Hape  Becomes “Severe” THIS IS A MEDICAL EMERGENCY. Give 100% oxygen at 4-6 Litres per minute and use portable hyperbaric chamber if available. These can be lifesaving. Descend immediately by ambulance, car, stretcher, helicopter etc. Exertion Like walking could also be fatal. Hospitalization is necessary & urgent. Sudden death can happen within hours. 1. High Altitude Cerebral Edema (HACE) Is swelling of the brain due to damage of brain tissue. This is caused by HYPOXIA (lack of oxygen). HACE is rare but can be sudden and severe. Immediate descent and hospitalization is essential. Sudden collapse and death can happen within hours. Symptoms Severe lassitude Hallucinations Vision disturbances Change in level of consciousness Acute mountain sickness. Headache, Nausea and Vomitting Bluish appearance in fingerbed nails and around the mouth Inability to co-ordinate voluntary muscular movement, this is evident first in lower exteremity and then in upper. Paralysis Seizures Staggering gait. Treatment of HACE DESCEND – DESENCD – DESEND Waiting can result in sudden death. Give oxygen and evacuate to hospital. Golden rule for altitude illness Ascend rationally, sleep low, take high carbohydrate diet and drink plenty of fluids. If you feel unwell at altitude, it is altitude illness until proven otherwise. If you get symptoms stop ascent immediately. If symptoms worsen or you develop symptoms of HAPE or HACE DESCEND – DESCEND – DESCEND THIS IS THE ONLY DEFINITIVE TREATMENT.