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High altitude illnesses include Acute Mountain Sickness (AMS), High Altitude
Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE). All three are due
basically to lack of oxygen affecting body organs – principally the lungs and brain.
However, if given time to adjust by acclimatization, the body – in most cases – is able
to tolerate lower atmospheric oxygen levels long enough to permit limited says at
altitudes below 30,000 feet (Mount Everest is 29,029). There are no permanent
human habitations above 17,000 feet where the oxygen content is only ½ that at sea
level. High altitude illnesses are unusual below altitudes of 7,500 to 8,000 feet,
especially if ascent from lower elevations has been slow.
Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE). All three are due
basically to lack of oxygen affecting body organs – principally the lungs and brain.
However, if given time to adjust by acclimatization, the body – in most cases – is able
to tolerate lower atmospheric oxygen levels long enough to permit limited says at
altitudes below 30,000 feet (Mount Everest is 29,029). There are no permanent
human habitations above 17,000 feet where the oxygen content is only ½ that at sea
level. High altitude illnesses are unusual below altitudes of 7,500 to 8,000 feet,
especially if ascent from lower elevations has been slow.
AMS: Acute Mountain Sickness
Mild to moderate AMS is common in persons who ascend
rapidly to altitude from sea level, such as those who fly in to
vacation in Yellowstone National Park (6,500 to 7,500 feet).
Studies have shown a degree of AMS in up to 20% of skiers
who fly from low altitudes to ski resorts at 8,000 to 9,000 feet
in the Rocky Mountains.
Symptoms include:
Predisposing factors include:
Younger adults seem to be more susceptible than older
ones. Person with AMS should go no higher until the signs
and symptoms are absent to minimal.
Mild to moderate AMS is common in persons who ascend
rapidly to altitude from sea level, such as those who fly in to
vacation in Yellowstone National Park (6,500 to 7,500 feet).
Studies have shown a degree of AMS in up to 20% of skiers
who fly from low altitudes to ski resorts at 8,000 to 9,000 feet
in the Rocky Mountains.
Symptoms include:
- Headache (usually throbbing)
Nausea
Vomiting
Insomnia
Apathy
Light-headedness
Fatigue
Weakness
Shortness of breath on exertion
Decreased urine output
Predisposing factors include:
- Too rapid an ascent
Overexertion
Exposure to cold
Younger adults seem to be more susceptible than older
ones. Person with AMS should go no higher until the signs
and symptoms are absent to minimal.
HAPE: High Altitude Pulmonary Edema
HAPE occurs ten times more frequently than HACE.
Early signs and symptoms include:
HAPE occurs ten times more frequently than HACE.
Early signs and symptoms include:
- Dry cough frequently occurring at night
Increase difficulty breathing – worse on exertion
Mild chest pain – an ache beneath the breast bone
Decrease exercise tolerance
- Blue skin
Cough producing frothy pink sputum
Rapid pulse
Rapid breathing at rest
Gurgling chest sounds (heard by placing your ear on
the person’s chest)
Severe shortness of breath
HACE: High Altitude Cerebral Edema:
Cerebral edema means increased fluid in the brain causing
swelling, in turn causing increased pressure inside the
skull since the boy skull cannot expand.
Signs and symptoms include AMS symptoms – except worse
– plus the following:
Cerebral edema means increased fluid in the brain causing
swelling, in turn causing increased pressure inside the
skull since the boy skull cannot expand.
Signs and symptoms include AMS symptoms – except worse
– plus the following:
- Loss of muscle coordination and ability to balance
(ataxia);
Alteration of mental status that may progress to
unconsciousness.
Preparing for High Altitude:
Symptoms can be prevented or improved
by resting more than usual during the first
day at altitude, avoiding strenuous
exertion, getting plenty of sleep, avoiding
alcohol and increasing fluid intake. For
example, when traveling from Billings
(3,200 feet) to Granite Peak (12,799 feet)
via Froze to Death Plateau (10,000 to 12,000
feet), scheduling a rest day before the final
peak climb is wise if AMS symptoms are
present in any party member, especially if
symptoms are still present after sleep.
Above 12,000 feet, altitude gains should be
no more than 1,000 to 2,000 feet a day until
party members are well acclimatized.
People vary in their abilities to acclimatize.
The process may take from days to weeks.
Person who do not seem to be
acclimatizing within a few days should
return to their home altitude.
Symptoms can be prevented or improved
by resting more than usual during the first
day at altitude, avoiding strenuous
exertion, getting plenty of sleep, avoiding
alcohol and increasing fluid intake. For
example, when traveling from Billings
(3,200 feet) to Granite Peak (12,799 feet)
via Froze to Death Plateau (10,000 to 12,000
feet), scheduling a rest day before the final
peak climb is wise if AMS symptoms are
present in any party member, especially if
symptoms are still present after sleep.
Above 12,000 feet, altitude gains should be
no more than 1,000 to 2,000 feet a day until
party members are well acclimatized.
People vary in their abilities to acclimatize.
The process may take from days to weeks.
Person who do not seem to be
acclimatizing within a few days should
return to their home altitude.
| HOW NOT TO GET SICK |
| HOW TO TELL IF YOU'RE SICK |
| HIGH ALTITUDE ILLNESSES: AMS, HAPE & HACE |
GET DOWN NOW!
HACE AND HAPE are both life-threatening
illnesses. The most important treatment is
immediate descent – at least 2,000 feet and
preferably below the altitude at which the
first signs and symptoms developed. Start
the descent early: when you first start
thinking about it, when it’s still daylight and
while the victim can still walk. Have
someone else carry the victim’s pack. If the
victim can no longer walk, he/she should
be carried in the sitting position. Oxygen, if
available, should be given by mask at 1-2
liters per minute. But since oxygen always
runs out – do not delay preparing for
descent even if you’ve got it.
HYPERBARIC CHAMBERS.
Expeditions can carry small portable
hyperbaric chambers called Gamow Bags.
When a victim is placed within the Gamow
Bag, it can be pressurized with a hand
pump to simulate an altitude drop of over
6,000 feet within a few minutes.
MEDS.
A number of prescription drugs have been
found to hasten acclimatization – of which
acetazolamide (Diamox) is easiliy available
and can be recommended. The dose is ½ to
1 tablet (250 mg) every 12 hours for 3-4
days starting at the first sing of AMS.
Persons who have had AMS in the past
should start the drug 24 hours before
starting the trip. Side effects include
tingling in the extremities and intolerance
to carbonated beverages. Aspirin or
Tylenol can be carried for headache.
HACE AND HAPE are both life-threatening
illnesses. The most important treatment is
immediate descent – at least 2,000 feet and
preferably below the altitude at which the
first signs and symptoms developed. Start
the descent early: when you first start
thinking about it, when it’s still daylight and
while the victim can still walk. Have
someone else carry the victim’s pack. If the
victim can no longer walk, he/she should
be carried in the sitting position. Oxygen, if
available, should be given by mask at 1-2
liters per minute. But since oxygen always
runs out – do not delay preparing for
descent even if you’ve got it.
HYPERBARIC CHAMBERS.
Expeditions can carry small portable
hyperbaric chambers called Gamow Bags.
When a victim is placed within the Gamow
Bag, it can be pressurized with a hand
pump to simulate an altitude drop of over
6,000 feet within a few minutes.
MEDS.
A number of prescription drugs have been
found to hasten acclimatization – of which
acetazolamide (Diamox) is easiliy available
and can be recommended. The dose is ½ to
1 tablet (250 mg) every 12 hours for 3-4
days starting at the first sing of AMS.
Persons who have had AMS in the past
should start the drug 24 hours before
starting the trip. Side effects include
tingling in the extremities and intolerance
to carbonated beverages. Aspirin or
Tylenol can be carried for headache.
References: National Ski Patrol’s Emergency Outdoor Care, 4th Edition, Chapter 15: “Environmental
Emergencies” and Appendix D: “Principles of Wilderness Emergency Care”. Jones & Bartlett, Boston
2003.
Emergencies” and Appendix D: “Principles of Wilderness Emergency Care”. Jones & Bartlett, Boston
2003.
| TREATING HIGH ALTITUDE ILLNESSES |
Here's an interview from 2 intelligent and experienced
young climbers who recognized the signs and symptoms
of AMS and promptly took the right action:
young climbers who recognized the signs and symptoms
of AMS and promptly took the right action:
By Dr. Warren Bowman