Altitude Mountain Sickness (AMS)

Altitude sickness

Altitude Sickness known as Acute Mountain Sickness (AMS) is particularly an important consideration while trekking in Nepal Himalaya. Altitude Sickness means the effect of altitude on those who ascend too rapidly to elevations over 3000m. The initial symptoms of AMS are as follows:

vomiting
Loss of appetite
sleeplessness
Terrible headache
Dizziness
Disorientation, drunken gait
Weakness, fatigue
Slight swelling of hands and face
Breathlessness and irregularly breathing
Reduced urine output

These symptoms are to be taken very seriously. In case of appearance of any of the above symptoms any further ascend should be reconsidered; otherwise more serious problems may occur which can even cause death sometimes within a few hours. The only cure for the Altitude Sickness is to descend to a lower elevation immediately. Acclimatization by ascending to no more than 300 to 500 meters per day above 3000 meters and the proper amount of aclamatization are the best methods for preventions of AMS.

CAUSES OF ALTITUDE SICKNESS

Less Oxygen
Low pressure , Barometric Pressure
Rapid Ascent
Possible Dehydration
Hypothermia

TYPES OF ALTUDES SICKNESS

Acute Mountain Sickness
High Altitude Pulmonary Edema
High Altitude Cerebral Edema

SYMTOMS OF AMS(ACCUT MOUNTAIN SICKNESS)

feels like a hangover and not feeling well:
Headache
Fatigue orTiredness
Nausea
Shortness of Breath
Loss of Appetite
Disturbance in Sleep
Dizziness

HIGH ALTITUDE PULMONARY EDEMA(HAPE)

Water in Lungs.
Increasing shortness of breath even at rest
Severe cough – Dry / productive
Very tired unusual fatigue while walking
High pulse rate, ie: 110
Blueness of face, lip, fingernails – that means the inability of transporting oxygen into the blood.

HIGH ALTITUDE CEREBRAL EDEMA(HACE)

Water in the head
terrible headache
Vomiting
Walking like an intoxicated (ataxia)
Mental confusion / altered mental status
Irritable – does not want to be bothered by other people
Unconsciousness or coma
Test: tandem walking test, heel to toe step. Fall off from the line.

Find out the main problem at altitude. Assume all problems are altitude sickness unless proven otherwise.

If it is an altitude problem with mild symptoms, stay at the same altitude until the symptoms are completely gone. An example – take an aspirin tablet, try to go up but not to high then then makr the decision.

PREVENTION

are worsening, descend.
Acclimatization – after a 1000m ascent, stay one more night for acclimatization No alcohol, sleeping pills and smoking.
Drink more fluid 3-4 liters a day.
clean water, boiled and filtered, or treated tea/coffee/soup/juice etc.
Do not carry heavy packs, 10-12 kgs ok.
Climb higher, always sleep lower.
Over 3000m, 300m ascent a day.
Never travel alone.

Medicines:

Oxygen
Diamox- for AMS- 125mg before dinner for sleeping problem if feeling suffocated.
Nafedipine- for HAPE
Steroids/Dexamethasone for ACE
Hyperbolic bag- Gammow bag