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Altitude Sickness |
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What is Altitude Sickness |
Altitude sickness often known
as acute mountain sickness (A.M.S.) in general
may occur when people ascend too quickly
normally in altitudes of over 3000 m. We ensure
minimal risk by building in rest days into our
trekking itineraries. Most people will feel some
affect of altitude, shortness of breath and
possibly light headed, this is fairly common.
Acute mountain sickness is very different and
normally involves a severe headache, sickness
and loss of awareness. In almost every potential
case there are enough warning signs to take
appropriate action. Basically, there are three
stages of altitude sickness and symptoms.
1. Normal AMS Symptoms
Should expect but not worry.
Following are the normal altitude symptoms that
you should expect but not worry about. Every
trekker will experience some or all of these, no
matter how slowly they ascend.
Periods of sleeplessness
Need more sleep than normal (often 10 hours or
more)
Occasional loss of appetite
Vivid, wild dreams especially at around
2500-3800 meters in altitude
Periodic breathing
The need to rest/catch your breath frequently
while trekking, especially above 3500 meters
Runny nose
Increasing urination while moving to/at higher
altitudes (a good sign)
Dizziness.
2. Mild AMS Symptoms - NEVER GO HIGHER
Many trekkers in the high valleys of the
Himalaya get mild AMS, admit or acknowledge that
you are having symptoms. You need have only one
of the following symptoms to be getting altitude
sickness.
Mild headache.
Nausea
Dizziness
Weakness
Sleeplessness
Dry Raspy cough
Fatigue/Tired
Loss of apatite
Runny nose
Hard to breath
What to do if a mild symptom doesn’t go way?
If you find mild symptoms developing while
walking, stop and relax (with your head out of
sun) and drink some fluids. Dink frequently.
If mild symptoms developing while walking, stop
have rest, drink some fluids and take 125-250mg
Diamox. Diamox generally takes one to four hours
to begin alleviating symptoms. Drink more water
and consider staying close by.
If symptoms develop in the evening, take
125-250mg Diamox and drink plenty of fluids
again.
If symptoms partially go away but are still
annoying it is safe to take another 250mg Diamox
6-8 hours later.
If mild symptoms continue getting worse then
descent for a few hours may be more beneficial
than staying at the same altitude. Going higher
will definitely make it worse. You trek to enjoy
not to feel sick.
3. Serious AMS Symptoms - IMMEDIATE DESCENT
Persistent, severe headache
Persistent vomiting
Ataxia (loss of co-ordination, an inability to
walk in a straight line, making the sufferer
look drunk)
Losing consciousness (inability to stay awake or
understand instructions)
Mental confusion or hallucinations
Liquid sounds in the lungs
Very persistent, sometimes watery, cough
Difficulty breathing
Rapid breathing or feeling breathless at rest
Coughing clear fluid, pink phlegm or blood (a
very bad sign)
Severe lethargy/fatigue
Marked blueness of face and lips
High resting heartbeat (over 130 beats per
minute)
Mild symptoms rapidly getting worse
Dangerous cases of AMS:
High Altitude Cerebral Edema (HACE)
This is a build-up of fluid around the brain. It
cases the first five symptoms on the mild and
severe lists previously. Coma from HACE can lead
to unconsciousness are death within 12 hours
from the onset of symptoms, but normally takes
1-2 days to develop. At the first sign of ataxia
begin treatment with medication, oxygen and
descent. Usually 4 to 8mg of dexamethasone is
given as a first does, then 4mg every six hours, Diamox every 12 hours and 2-4 liters /minute
oxygen. Descent is necessary but a PAC (portable
altitude chamber) bag will often be used first
if available.
High Altitude Pulmonary Edema (HAPE)
This is an accumulation of fluid in the lungs
and is very serious. It is responsible for all
the other mild and serious symptoms and it is
often accompanied by a mild fever. By far the
treatment is oxygen at 4 liters a minute but
using PAC (portable altitude chamber) bag
treatment is a good substitute. If there is no
PAC bag or oxygen then descent will be life
saving. HAPE can lead to unconsciousness are
death very quick.
Prevention of Acute Mountain Sickness (AMS)
Allow sufficient time for acclimatization (After
3000 meters)
Don’t make rapid Ascent. Don’t go too far too
fast
No Alcohol, Sleeping pills and Smoking
Drink more fluid 3-4 Liters a day, clean
water-boiled or treated / tea / coffee / soup /
juice etc.
Climb high and sleep low
Do not trek/travel alone, take guide/porter
Follow the advice from your guide, hotel, local,
guide book
Descent if mild symptoms rapidly getting worse.
Never leave or descent sick person along.
Avoid getting cold.
Take easy and comfortable trekking rout even it
is longer.
First Aid Kit
This is the basic list to cover the more common
ailments that afflict trekkers. Climbing group,
expeditions and trekkers going to isolated areas
will need a more comprehensive kit.
Bandage for sprains
Plasters/Band-aids
Iodine or water filter (optional)
Moleskin/Second skin - for blisters
Antiseptic ointment for cuts
Anti-bacterial throat lozenges (with antiseptic)
Aspirin/Paracetamol - general painkiller
Oral rehydration salts
Broad-spectrum antibiotic (norfloxacin or
ciprofloxin)
Anti-diarrhea medication (antibiotic)
Diarrhea stopper (Imodium - optional)
Antibiotic for Guardia or similar microbe or
bacteria
Diamox 250/500mg (for altitude sickness - can be
bought in Kathmandu)
Sterile Syringe set (anti-AIDS precaution)
Gel hand cleaner |
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