High Altitude Sickness

What is High Altitude Sickness?
A mixture (syndrome) of problems like headache, Nausea, shortness of breathe, tiredness encountered at high altitude i.e. above 8000ft.

Cause/Factor of Altitude Sickness:
A/ Less Oxygen
B/ Low Pressure i.e. Barometric Pressure
C/ Rapid Ascent
D/ Possibly Dehydration
E/ Hypothermia

Type of Altitude Sickness:
A/ AMS: - Acute mountain Sickness
B/ HAPE: - High Altitude Pulmonary Edema
C/ HACE: - High Altitude Cerebral Edema

Symptoms of Altitude Sickness:
(Acute Mountain Sickness) 

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

High Altitude Pulmonary Edema (water in the Lung)
(Severe symptoms of Altitude Sickness)

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

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

High Altitude Cerebral Edema (water in the Head)

• 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:

• Acclimatization – after 1000m. Ascent, stay one more night for acclimatization.
• Do not make RAPID ASCENT; don’t go to fast too high.
• No alcohol, sleeping pills and smoking.
• Drink more fluid 3-4 liter a day clean water – boiled or treated/tea/coffee/soup/juice etc.
• Don 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 sleeping problem if feeling Suffocated.
• Nafedipine for HAPE.
• Steroids/Dexamethasone for HACE.
• Hyperbaric Bag – Gammow 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

Equipments:

Sphygmomanometer (Blood pressure Instrument)	Stethoscope	Scissors
Syringes (20 ml, 10 ml)	Thermometer	Tongue blades
Hot water bottle	Matchbox	Pen light
Pen and writing pad	Splints	cervical collar

 

Bandages and dressings:

Sterile gauge pads (large and small)	Band aids	Triangular Bandages
Elastic Bandages (3, 4 and 6 inches)	Adhesive Tapes	Eye pads
Cotton roll (large and small)	Q-tips	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)  

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