High Altitude Sickness
High Altitude Sickness Specialist in Corolado
What is high altitude sickness?
High altitude illness (HAI) occurs when individuals ascend to high elevations too quickly. HAI includes acute mountain sickness (AMS), high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE). HAI is caused by lower oxygen levels in the air leading to reduced oxygen levels in the blood. Travel to high-altitude can also exacerbate pre-existing medical conditions. The usual threshold altitude for HAI is 8000 feet (2500 meters) but can occur in some people who are more sensitive to lower oxygen levels at altitudes of 5000-7000 ft (1500-2100 meters).
What are the risk factors for developing HAI?
It is important to note that it is not possible to know in advance if you will become ill when traveling to a high altitude. Additionally, being physically fit does not decrease your chances of developing a high-altitude illness. Certain groups are at risk, including people who:
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Have a prior history of high-altitude illness
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Overexert themselves before adjusting to the change in altitude
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Ascend rapidly (within 1 day) from low elevation to sleeping altitudes greater than 9000 feet (2750 meters)
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Ascend rapidly (greater than 1640-3280 feet/day [greater than 500-1000 meters/day] in sleeping altitude), when already above 9000 feet (2750 meters)
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Have a medical problem that affects breathing
What are the symptoms of HAI?
Symptoms can be compared to a severe hangover and include:
Mild
- Headache
- Nausea or vomiting
- Lack of appetite
- Lightheadedness or Dizziness
- Fatigue
- Shortness of breath on exertion
- Difficulty sleeping (waking frequently)
Severe
- Shortness of breath at rest (HAPE)
- Confusion or decreased consciousness (HACE)
- Inability to walk or lack of coordination (HACE)
- Chest congestion (HAPE)
- Cough producing pink and/or frothy sputum (HAPE)
Acute Mountain Sickness
How can you prevent acute mountain sickness?
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Stay hydrated!
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If you live below 5000 feet (1500 meters), avoid ascending rapidly and try to sleep below 9000 feet (2750 meters) on the first night.
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If you plan to travel above 9800 feet (3000 meters), do not increase your sleeping altitude more than 1600 feet (500 meters) per day. Plan a day of rest for every 3300 feet (1000 meters) you ascend. Do not over-exert yourself on the day of rest.
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Pacing is very important. If you plan to ski, hike, or climb do not over-exert yourself during the first few days at altitude.
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Try to minimize use of alcohol and sleeping pills over the first two days.
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Staying or hiking at elevations about 4900 feet (1500 meters) in the weeks before you ascend may help you ascend faster.
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If you drink caffeine regularly, do not stop drinking it before or during your trip. Stopping caffeine suddenly can cause acute mountain sickness.
How do you treat acute mountain sickness?
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Headache: you can take non-prescription medications for headache, such as aspirin, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
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Nausea or vomiting: A prescription medicine such as ondansetron (Zofran) can be helpful if available.
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Descent: If symptoms do not improve or worsen over 24-48 hours, descend to an altitude where you feel better. Most people feel better after descending 1600-3300 feet (500-1000 meters).
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Oxygen: If needed, treatment with supplemental oxygen can reduce symptoms. You can use oxygen for a period of time (e.g. 1 hour), only when symptoms arise, or while sleeping. Small handheld canisters of oxygen that provide you only a few breaths is unlikely to provide sustained relief.
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Acetazolamide: can also be used to treat AMS.
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Dexamethasone: can reduce symptoms of AMS.
When should I seek help for HAI?
If your symptoms do not improve after 24-48 hours or worsen at any point, you should descend or seek help.
How do you treat High-altitude cerebral edema?
HACE is a rare, life-threatening altitude disease and a severe form of AMS. It is caused by leaky capillaries in the brain, resulting in fluid accumulation and brain swelling. It can be prevented by measures discussed above.
HACE is a medical emergency and you should immediately descend to a lower altitude. Symptoms can worsen rapidly and you might not be able to walk.
Besides descent, other treatments include:
- Supplemental oxygen
- Portable hyperbaric chamber
- Dexamethasone
How do you treat High-altitude pulmonary edema?
HAPE is a potentially fatal condition in which lung capillaries leak and fluid accumulates in the lungs. It is uncommon but can occur in people who rapidly ascend to altitude about 8200 feet (2500 meters). The best way to prevent HAPE is by slow ascent. This is particularly true if you have a history of HAPE.
HAPE is also a medical emergency and you should seek medical care or descend as soon as possible if you develop symptoms. As with HACE, symptoms can worsen rapidly and you may not be able to walk.
Besides descent, other treatments include:
- Supplemental oxygen
- Portable hyperbaric chamber
- Nifedipine (a commonly used high blood pressure medication)
- Stay warm and avoid cold temperatures
- Rest; including not carrying a pack while descending