Altitude Sickness and Prevention

What is High Altitude Sickness?
A mixture (syndrome) of problems like headache, nausea, shortness of breath, tiredness encountered at high altitude i.e. above 3000 meter.

Cause / Factor of Altitude Sickness:

Less Oxygen
Low Pressure i.e. Barometric Pressure
Rapid Ascent
Possibly Dehydration
Hypothermia

Type of Altitude Sickness:
AMS: - Acute mountain Sickness
HAPE: - High Altitude Pulmonary Edema
HACE: - High Altitude Cerebral Edema

Symptoms of Altitude Sickness:
Acute Mountain Sickness - AMS
Mild symptoms feel like hangover / not feeling well
Headache
Fatigue/Tiredness
Nausea
Shortness of breath
Loss of appetite
Sleep disturbance
Dizziness
High Altitude Pulmonary Edema (water in the Lung) - HAPE
Increasing shortness of breath at rest
Severe cough- Dry /Productive
Very tired – Unusual fatigue while walking
High pulse rate i.e. 110
Blueness of face, lip, finger nails – that means inability to transport Oxygen into the blood
It can happen after 2 nights of arrival in the altitude.
High Altitude Cerebral Edema (water in the Head) - HACE

Severe symptoms of Altitude Sickness
Severe Headache
Vomiting
Walking like a drunk (Ataxia)
Mental confusion/Altered mental status
Irritable – Does not want to be bothered by other people.
Unconsciousness or Coma.
Test: Tandem walking test, Hell to toe step. Fall off from the line.

DECISION MAKING:
Find out the problem i.e. at altitude assumes all problems are altitude sickness unless proven otherwise. If it is altitude problem with mild symptoms, stay at the same Altitude until the symptoms gone. E.g. Take an Aspirin, try to go up but listen to your body. If symptoms are worsening, go down.

PREVENTION:
Acclimatization – after 1000m. Ascent, stay one more night for acclimatization.
Do not make RAPID ASCENT; don’t go to fast too high.
No alcohol, sleeping pills and smoking.
Drink more fluid 3-4 liter day clean water – boiled or treated/tea/coffee/soup/juice etc.
Do not carry heavy packs; 10-12 kegs is ok.
Climb higher sleep lower.
Over 3000m, only 400m. Ascent a day.
Do not travel alone.

TREATMENT:
DESCENT is the best medicine; do not wait for the helicopter.
Medicine
Oxygen
Diamox – for AMS- 125 Mg. Before dinner – for sleeping problem if feeling Suffocated.
Nafedipine for HAPE.
Steroids/Dexamethasone for HACE.
Hyperbaric Bag – Gamow Bag

GOLDEN RULES:
Awareness of ALTITUDE ILLNESS.
If you have mild symptoms, do not go higher, Take Aspirin.
If you have worsening symptoms, GO DOWN.
Never leave your team member behind unattended either trekker or porter

First Aid Medical Kit
This is the basic list to cover the more common ailments that affect trekkers. Climbing groups, expeditions and trekkers going to isolated areas will need a more comprehensive kit.
Sphygmomanometer (Blood pressure Instrument)
Syringes (20 ml, 10 ml)
Hot water bottle
Pen and writing pad
Stethoscope
Thermometer
Matchbox
Splints
Scissors
Tongue blades
Pen light
cervical collar
Bandage and Dressings:
Sterile gauge pads (large and small)
Band aids
Triangular Bandages
Elastic Bandages (3, 4 and 6 inches)
Adhesive Tapes
Eye pads
Cotton roll (large and small)
Q-tips
Safety pins
Medications

For pain:
Paracetamol (500mgs tablet and 125 mgs in 5 ml syrup)
Aspirin (300mgs tablets)

For Allergy:
Avil (25 mgs tablet)
Benadryl Syrup
Trexyl – (60mgs tablet, 30 mgs in 5 ml syrup)

For Infections:
Eye: Neosporin Ophthalmic Cream
Throat and Lung: Amoxicillin (125mg per 5 ml syrup, 250 mgs and 500 mgs tablets)
For Abdomen:
Metronidazole(200mgs, 400mgs tablets)
Tinidazole (500 mgs tablets)
Antacid
Oral Rehydration powder
Loperamide (2 mgs tablets)

For open wounds:
Cloxacillion and Cephalexin(125 mgs in 5 ml 250 mgs and 500 mgs tablets)
For urinary infections
Narfloxacin (200 mgs, 400 mgs tablets)

Disinfectants:
Betadine (Solution and cream)
Miconazole Cream (for fungal infection)
Silver sulphadiazine(for burn injury)