| Guidelines on Altitude Sickness |
| . Types of Altitude Sickness |
| . Why does it occur?
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| . Prevention |
| . AMS (Acute Mountain Sickness) |
| . in its mildest form, is the first type of symptom that most people will experience as they climb above 3000m. Acute Mountain Sickness is a group of symptoms caused by reduced oxygen. Mild headaches progressing to more serious headaches, nausea, and disturbed sleep and then progressing on to actual vomiting and dizziness. AMS can progress to either HAPE or more usually HACE, and for this reason its symptoms should be taken seriously. It occurs in some form up to 50% of those trekkers reaching 4000m.
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| HACE (High Altitude Cerebral Edema) |
| . HACE is thought to be a worsening of AMS, although this is not fully understood. Usually after exhibiting the symptoms of AMS, they then display the following: confusion, irrationality, disorientation, clumsy, unsteady and finally hallucinations. After this the casualty would then progress into Coma, and finally, if left untreated, or with continuing ascent, death would result. Smaller numbers of cases are reported for this condition (2% of those climbing to 4500m)
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| HAPE (High Altitude Pulmonary Edema) |
| . HAPE is a different condition affecting the breathing and airways, which is triggered also by reduced oxygen levels. It is a result of both a sudden rapid ascent but also of over-exertion at altitude. It manifests itself through rapid breathing, difficulty catching ones breath, and trouble in climbing hills or carrying out any kind of physical work. This progresses to breathlessness at rest and at night, another commonly reported symptom is a 'crackling noise' on breathing. Also accompanying is a phlegm laden cough that eventually contains sputum which will eventually turn blood tinged. HAPE also usually follows on from AMS as the early stage. HAPE rates are at 2% above 4000m.
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| Why Does Altitude Sickness Occur? |
| . As one reaches higher altitudes, the air pressure decreases.
As air pressure decreases, so the concentration of Oxygen decreases.
So for each lungful of air taken, the amount of Oxygen taken on is less.
As one exercises, the body is calling for more oxygen, not less.
Therefore a deficit of Oxygen is created, and as a result of this problems start
to occur at the brain and in the lungs. Here small pockets of water form - an
Edema. This can worsen, if left untreated, and can result in serious consequences.
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| Common Preventative Measures |
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. CONTROLLED ASCENT ABOVE 3000m
Do not ascend at too fast a rate above 3000m. This means in practice that ascents should ideally be of 300m per day, but certainly should not exceed more than 600m. This is especially the case where a trekker is sleeping at the high point of the day. If the trekker reaches a high point and is then returning to a lower altitude as part of the day's trekking plan, this is potentially more acceptable. BUT NEVER HURRY AN ASCENT.
Always Keep a close Eye on symptoms - watch any minor headaches very carefully for development into something more severe.
Be Aware of justifying away the symptoms! It's very very common.
Include Acclimatisation Days - slow ascent will help you to become used to the altitude.
HYDRATE, HYDRATE, HYDRATE - at altitudes of 3000m and above the air carries low levels of moisture, and this dry air is very dehydrating. Also exertion has a dehydrating effect. It is thought that staying hydrated helps to subdue the effects of AMS also. So drink anything above 3 litres of water per day. Keep track in the form of a diary.
AVOID DIURETICS - certain foods and drinks will reduce your hydration levels. Minimise Caffeine intake in Coca-Cola, Coffee and Chocolate. Also do not drink alcohol above 3000m. You can, but you risk spoiling your trip!
TAKE IT STEADY - do not run up hills, or even walk fast. Unnecessary exertion may trigger altitude sickness. you should be breathing easily at all times, and able to hold a conversation as you walk.
DON'T CARRY MORE THAN YOU NEED TO - especially when you have porters available. Make sure first that you do not carry items in your day pack that you don't need to. But also remember that your porter shouldn't be asked to carry too much, so try and reduce the amount he's carrying!
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| GOLDEN RULES WITH A CASUALTY! |
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. NEVER CONTINUE TO CLIMB with any of the major symptoms (Nausea/Sickness onwards).
DO Continue to hydrate the person
DO Descend immediately if the casualty is seriously ill
DO Consider the use of Diamox for AMS or suspected HACE. Consult the guidelines for suggested doses.
In mild cases spending an extra day acclimatising and not ascending further.
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01460 249191 E 
