Altitude sickness
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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

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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


Altitude sickness

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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