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Mountain Sickness

Intro

If symptoms such as headache or shortness of breath do not improve promptly with simple changes, visiting a doctor may be helpful if descent is inconvenient and a doctor is available.

Descend immediately if shortness of breath at rest, mental confusion or lethargy, or loss of muscle coordination develop. Symptoms of most people with AMS improve by the time they reach a medical facility, which is usually located at a lower altitude.

 
Self-Care at Home
  • Delay further ascent until symptoms improve.
  • Rest and stay warm.
  • Take acetaminophen (Tylenol) for headache .
  • Do not use sleeping pills or other central nervous system depressants to treat insomnia  because they can suppress breathing.
  • If symptoms continue, do not travel any higher.
  • If symptoms worsen, descend approximately 1,000-2,000 feet (300-600 meters) immediately.
  • If descent is not possible, a portable hyperbaric chamber (Gamow bag) can be used to simulate a lower altitude.
    • The higher the altitude at which a hyperbaric chamber is used, the greater the apparent descent can be simulated. (This is because portable hyperbaric chambers can increase atmospheric pressure by 2 pounds per square inch.)
    • For example, a hyperbaric chamber at 9,800 feet (3,000 meters) can simulate a descent of 4,800 feet (1,500 meters), but the same hyperbaric chamber used at 24,600 feet (7,500 meters) can simulate a descent of 7,800 feet (2,400 meters).

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Follow-up

Follow instructions regarding activity limitation, use of additional oxygen, postponement of climbing, or immediate descent, if required.

  • Take medications  as prescribed.
  • Do not drink alcohol, and avoid smoking tobacco.
  • Seek medical attention immediately if symptoms worsen or if new symptoms develop.
Prevention

Mountain sickness is preventable. The body needs time to adjust to high altitude. Physical conditioning has no bearing on this.

For people who do not know the rate at which their bodies adjust to high altitude, the following preventive measures are recommended.

  • If traveling by air to a ski area above 8,250 feet (2,500 meters), incorporate a layover of 1-2 days at an intermediate altitude.
  • Avoid physical exertion for the first 24 hours.
  • Drink plenty of fluids, and avoid alcoholic beverages.
  • Consume a high-carbohydrate diet.
  • If mountain climbing or hiking, ascend gradually once past 8,000 feet (2,400 meters) above sea level
  • Increase the sleeping altitude by no more than 1,000 feet (300 meters) per 24 hours. The mountaineer’s rule is "climb high, sleep low." This means that on layover days, a climber can ascend to a higher elevation during the day and return to a lower sleeping elevation at night. This helps to hasten acclimatization.
Outlook

The prognosis for acute mountain sickness is excellent as long as common sense is used. Descending, delaying further ascent, rest, and paying attention to the body’s symptoms are usually all that is necessary to ensure a complete recovery.

High altitude pulmonary edema (HAPE) has a good outcome if symptoms are recognized and treated early. If descent is impossible or if hyperbaric therapy, supplemental oxygen, and access to medical care are not available, HAPE can progress to respiratory failure and ultimately to death. Remember that HAPE is the number one cause of death from high altitude illness.

More than half of people with HACE who develop coma die. Of those who survive, mental impairment and coordination defects may continue to affect them. HACE can be fatal if not recognized and treated quickly.

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