High Altitude Sickness

A mixture (syndrome) of problems like headache, Nausea, shortness of breath, tiredness may encounter at high altitude i.e. above 3000m.
Cause / Factor of Altitude Sickness:

  • A/ Less Oxygen
  • Low Pressure i.e. Barometric Pressure
  • Rapid Ascent
  • Possibly Dehydration
  • Hypothermia

Type of Altitude Sickness

  • AMS: - Acute mountain Sickness
  • HAPE: - High Altitude Pulmonary Edema
  • HACE: - High Altitude Cerebral Edema

Symptoms of Altitude Sickness

A. Acute Mountain Sickness - AMS

  • Mild symptoms feel like hangover / not feeling well
  • Headache
  • Fatigue/Tiredness
  • Nausea
  • Shortness of breath
  • Loss of appetite
  • Sleep Disturbance
  • Dizziness

B. High Altitude Pulmonary Edema (water in the Lung) - HAPE

  • Increasing shortness of breath at rest
  • A severe cough- Dry /Productive
  • Very tired – Unusual fatigue while walking
  • High pulse rates i.e. 110
  • Blueness of face, lip, fingernails – that means inability to transport Oxygen into the blood

It can happen after 2 nights of arrival in the altitude.

C. High Altitude Cerebral Edema (water in the Head) - HACE

  • Severe symptoms of Altitude Sickness
  • Severe Headache
  • Vomiting
  • Walking like a drunk (Ataxia)
  • Mental confusion/Altered mental status
  • Irritable – Does not want to be bothered by other people.
  • Unconsciousness or Coma.

Test: Tandem walking test, Hell to toe step. Fall off from the line.

Decision Making

Find out the problem i.e. at altitude assume all problems are altitude sickness unless proven otherwise. If it is altitude problem with mild symptoms, stay at the same Altitude until the symptoms gone. E.g. Take an Aspirin, try to go up but listen to your body. If symptoms are worsening, go down.

Prevention

  • Acclimatisation – after 1000m. Ascent, stay one more night for acclimatisation.
  • Do not make RAPID ASCENT; don’t go to fast too high.
  • No alcohol, sleeping pills and smoking.
  • Drink more fluid 3-4 litre a day likewise; clean water – boiled or treated/tea/coffee/soup/juice etc.
  • Do not carry heavy packs; 10-12 k.g is ok.
  • Climb higher sleep lower.
  • Over 3000m, 300m. Ascent a day.
  • Do not travel alone.

Treatment

  • DESCENT is the best medicine; do not wait for the Helicopter
  • Medicine
  • Oxygen
  • Diamox – for AMS- 125 Mg. Before dinner – for the sleeping problem if feeling Suffocated.
  • Nifedipine for HAPE.
  • Steroids/Dexamethasone for HACE.
  • Hyperbaric Bag – Gamow Bag

Golden Rules

Awareness of ALTITUDE ILLNESS

  • If you have mild symptoms, do not go higher, Take Aspirin.
  • If you have worsening symptoms, GO DOWN.
  • Do not leave your team member behind unattended either trekker or porter.
  • First Aid Medical Kit
  • Equipment:

First Aid Medical Kit

Equipment

  1. Sphygmomanometer (Blood pressure Instrument)
  2. Syringes (20 ml, 10 ml)
  3. Hot water bottle
  4. Pen and writing pad
  5. Stethoscope
  6. Thermometer
  7. Matchbox
  8. Splints
  9. Scissors
  10. Tongue blades
  11. Penlight
  12. cervical collar

Bandage and Dressings

  1. Sterile gauze pads (large and small)
  2. Band-aids
  3. Triangular Bandages
  4. Elastic Bandages (3, 4 and 6 inches)
  5. Adhesive Tapes
  6. Eye pads
  7. Cotton roll (large and small)
  8. Q-tips
  9. Safety pins

Medications

For pain

  • Paracetamol (500mgs tablet and 125 mgs in 5 ml syrup)
  • Aspirin (300mgs tablet)

For Allergy

  • Avil (25 mgs tablet)
  • Benadryl Syrup
  • Trexyl – (60mgs tablet, 30 mgs in 5 ml syrup)

For Infections

Eye: Neosporin Ophthalmic Cream
Throat and Lung: Amoxicillin (125mg per 5 ml syrup, 250 mgs and 500 mgs tablets)

For Abdomen

  • Metronidazole(200mgs, 400mgs tablets)
  • Tinidazole (500 mgs tablets)
  • Antacid
  • Oral Rehydration powder
  • Loperamide (2 mgs tablets)

For open wounds

  • Cloxacillion and Cephalexin(125 mgs in 5 ml 250 mgs and 500 mgs tablets)
  • For urinary infections
  • Narfloxacin (200 mgs, 400 mgs tablets)

Disinfectants

  • Betadine (Solution and cream)
  • Miconazole Cream (for fungal infection)
  • Silver sulphadiazine(for burn injury)