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Altitude Sickness

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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  1. Altitude Sickness Everest Expedition 2014

  2. Causes… • Less Oxygen • Low Pressure • Rapid Ascent • Possible Dehydration • Hypothermia

  3. Acute Mountain Sickness AMS – occurs above 8,000 ft elevation

  4. Symptoms Normally described as mild hangover • Headache WITH • Fatigue • Nausea • Shortness of Breath (at rest) • Loss of Appetite • Insomnia • Dizziness

  5. Treatment • DO NOT ASCEND FURTHER • Hydrate • Stay at altitude for 12-24 hours • If symptoms diminish  can ascend • If symptoms continue  descend

  6. High Altitude Pulmonary Edema HAPE – occurs above 12,000-15,000 ft

  7. 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)

  8. Treatment • DESCEND AS SOON AS POSSIBE 500-1,000 ft (or until symptoms diminish) • Hydrate

  9. High Altitude Cerebral Edema HACE – occurs above 12,000-15,000 ft

  10. 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

  11. 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

  12. PREVENTION THIS IS ENTIRELY PREVENTABLE

  13. 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

  14. 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

  15. 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)

  16. 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

  17. 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

  18. 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

  19. Sources • http://peakfreaks.com/ams.htm • WFR book (Solo Southeast)

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