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Altitude Sickness

Altitude Sickness is caused by going high faster than ourbodies can acclimatize. Atmospheric pressure decreases as altitude increases;therefore, there is less available oxygen at high altitudes.The percentage of  O2 remains the same (about 21%). Humans adapt to the hypoxic stress over time by hyerventilating and adjusting a myriad of processes including cardiac output, PH,red blood cell production, oxygen use, just to name a few. Most problems at altitude  are preventable.

The following are guidelines:
1. Train both for endurance and strength before  going to high elevations.
2. Maintain adequate hydration and nutrition. A high carbohydrate diet(70%) may decrease AMS (acute mountain sickness)signs/symptoms by up to 30%.
3. Until acclimatized, avoid excessive exercise and  fatigue. The use of certain medicines and techniques may minimize problems.

GUIDELINES FOR TREATMENT OF ACUTE MOUNTAIN SICKNESS (AMS)
1. Do not go higher with any AMS signs/symptoms; take a rest day or descend.
2. Descend if signs/symptoms do not improve within 24 hours.
3.Descend immediately with severe AMS:high altitude pulmonary edema (HAPE), high altitude cerebral edema (HACE) and do not send affected individuals down bby themselves.

Problems/Evaluation Criteria

Treatment

MILD   AMS:

S/Sx similar to feeling hung over: headache, nausea,insomnia,fatique,lack of appetite; usually develops over 8000 feet (2500 meters) elevation.

  • Stop ascent; rest day(s)
  • Maintain adequate hydration & nutrition
  • Meds for pain, nausea & acclimatization

MODERATE TO SEVERE AMS:

More significant or unresolved mild AMS S/Sx

 

HIGH ALTITUDE PULMONARY EDEMA (HAPE)

Shortness of breath, cough, cyanosis

Rales (fluid in lungs) gurgling

Respiratory +  cardiac rate increasing

 

HIGH ALTITUDE CEREBRAL EDEMA (HACE)

Mental status changes (confusion, lethargy)

Decreased consciousness

Severe headache

vomiting

  • Same as above, but descent should be mandatory and immediate.
  • General resp. Tx (PROP)
  • Gamow Bag if available
  • Emergency meds:

 

 

 

  • General resp. Tx (prop)
  • Gamow Bag if available
  • Emergency meds
  • Consider ALS intercept

 

Medicines for Acclimatization and Rescue:

  • Acetazolamide
  • Dexamethazone
  • Nifedipine
  • Sildenifil