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Altitude Sickness . Everest Expedition 2014. Causes… . Less Oxygen Low Pressure Rapid Ascent Possible Dehydration Hypothermia . Acute Mountain Sickness. AMS – occurs above 8,000 ft elevation. Symptoms. Normally described as mild hangover Headache WITH Fatigue Nausea

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altitude sickness

Altitude Sickness

Everest Expedition 2014

causes
Causes…
  • Less Oxygen
  • Low Pressure
  • Rapid Ascent
  • Possible Dehydration
  • Hypothermia
acute mountain sickness
Acute Mountain Sickness

AMS – occurs above 8,000 ft elevation

symptoms
Symptoms

Normally described as mild hangover

  • Headache WITH
  • Fatigue
  • Nausea
  • Shortness of Breath (at rest)
  • Loss of Appetite
  • Insomnia
  • Dizziness
treatment
Treatment
  • DO NOT ASCEND FURTHER
  • Hydrate
  • Stay at altitude for 12-24 hours
    • If symptoms diminish  can ascend
    • If symptoms continue  descend
high altitude pulmonary edema
High Altitude Pulmonary Edema

HAPE – occurs above 12,000-15,000 ft

symptoms1
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)
treatment1
Treatment
  • DESCEND AS SOON AS POSSIBE 500-1,000 ft (or until symptoms diminish)
  • Hydrate
high altitude cerebral edema
High Altitude Cerebral Edema

HACE – occurs above 12,000-15,000 ft

symptoms2
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
treatment2
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
prevention
PREVENTION

THIS IS ENTIRELY PREVENTABLE

slide14
DO
  • Acclimatization – after ascend 1000m stay an extra night to acclimatize
  • DRINK WATER – 3 to 4L per day
  • Climb high sleep low
  • Above 3,000m – ascend no more than 300m a day
don t
DON’T
  • Do not make rapid ascent – too fast too high = BAD
  • No alcohol, sleeping pills, and smoking
  • Do not carry heavy packs (10-12kg is ok)
  • NEVER travel alone
medications
Medications
  • Oxygen
  • Diamox – for AMS (125 mg before dinner for sleeping if feeling suffocated)
  • Nafedipine – for HAPE
  • Steroids/Dexamethasone - for HACE
  • Hyperbolic Bag (Gammow bag)
diamox acetazolamide
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 “jhumjhum” in Nepali), excessive urination, and carbonated drinks tasting flat
  • If allergic to sulfa drugs – DO NOT TAKE THIS
four golden rules
Four Golden Rules
  • Awareness of Altitude Sickness
  • If you have mild symptoms DO NOT PROCEED (take aspirin)
  • If you have worsening symptoms GO DOWM IMMEDIATELY
  • Do NOT leave your team member behind unattended
three golden actions
Three Golden Actions
  • Go up SLOWLY
  • Drink plenty of fluids (no less than 3L a day)
  • 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
Sources
  • http://peakfreaks.com/ams.htm
  • WFR book (Solo Southeast)
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