Altitude Sickness Emergency Guide: Symptoms, Care, Prevention

1. Lesson 15:Altitude Sickness Emergency Reference Guide p. 30-33

2. Objectives • Define altitude illnesses, include Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE) & High Altitude Pulmonary Edema (HAPE) • List signs & symptoms of AMS, HACE, HAPE • Describe emergency care for AMS, HACE, HAPE • Describe situations that require evacuation • Describe prevention techniques

3. Altitude Illness Overview • Altitude illness occurs when people at high elevation do not get enough oxygen • As you gain altitude air grows thinner (less air pressure) & less oxygen is inhaled • Most common altitude illness is Acute Mountain Sickness (AMS) • AMS commonly occurs when person recently has reached heights of 6500 – 8000 feet

4. Altitude Illness Overview(cont’d.) • Symptoms similar to dehydration & heat illness. (If at lower altitude < 6500 feet suspect those first) • High Altitude Cerebral Edema (HACE) is cause by fluid collecting in the brain tissues. If untreated can lead to death • High Altitude pulmonary edema (HAPE) is caused when fluid collects in air spaces in the lungs. HAPE can be life threatening.

5. Checking for Acute Mountain Sickness (AMS) • Acute Mountain Sickness Signs & Symptoms: • Headache • Loss of normal appetite • Nausea, with/without vomiting • Insomnia • Unusual weariness & exhaustion, called “lassitude”

6. Caring for AMS • Descend or stop ascent & wait for improvement. If illness progresses, descent is mandatory • Administer oxygen, if available & trained to do so. Especially helpful during sleep • Give aspirin or acetaminophen for headaches, if patient is able to swallow & has no known contraindication • If prescribed & recommended by patient’s health care provider, help patient self-administer medication for altitude illness

7. Signs & Symptoms for High Altitude Cerebral Edema • Loss of coordination or “ataxia” (e.g. can’t walk ina strain line or stand straight with feet together) • Severe headache not relieved by rest/medication • Bizarre changes in personality • Seizures or coma

8. Care for HACE • Severely ill patients must descend as soon as possible • Provide oxygen, if available & trained to do so • Keep patient from becoming chilled or overheated • If prescribed & recommended, help patient self-administer medications for altitude illness • Use portable hyperbaric chamber (caution: do not use in lieu of descending)

9. Signs & Symptoms of High Altitude Pulmonary Edema • Dry cough, shortness of breath (at rest) • Shortness of breath becomes more pronounced • Possible chest pain • Cough that becomes productive, first frothy sputum, later reddish sputum

10. Care for HAPE • Severely ill patients must descend ASAP • In addition to descent, provide oxygen, if available & trained to do so • Keep patient from becoming chilled or overheated. Especially important for HAPE, since cold weather increases pulmonary artery pressures & makes HAPE worse • Use portable hyperbaric chamber if available, not a substitute for descending

11. Guidelines for Evacuation • Patient with AMS should stop ascending until symptoms resolve themselves • Patient with AMS does not require evac unless condition worsens, then descent is mandatory • GO FAST for any patient with HACE or HAPE. Descend at least 1000-1500 feet of elevation. • Anyone with HACE or HAPE MUST be evaluated by health care provider ASAP

12. Preventing Altitude Illnesses • Most High Altitude Illnesses are preventable • Make a stage ascent, Allow body to adjust • Increase altitude of overnight camps gradually • If possible camp no higher than 8000 ft first night, no more than 1000’ - 1500’ increase per night • If trip starts > 9000’, spend 2 nights acclimating • Proceed higher during the day, but return to lower altitude during day during acclimation period

13. Preventing Altitude Illnesses (cont’d.) • Eat high carb diet: • >70% diet of carbs reduces symptoms of AMS • Start high carb diet 1-2 days before starting trip • Maintain appropriate exercise level until acclimated. Avoid excessive shortness of breath • Stay well hydrated (higher loss of fluids at high elevations) • Talk to your health care provider about possible prescription medication

14. Questions???What else could you add to your First Aid Kit?