What Is High Altitude Sickness ?

It is difficult to determine who may be affected by altitude sickness since there are no specific factors such as age, sex, or physical condition that correlate with susceptibility. Some people get it and some people don't because some people are more susceptible than others.

Most people can ascend to 2,500 metres (8,000 feet) with little or no effect. If you have been at that altitude before with no problem, you can probably return to that altitude without problems as long as you are properly acclimatised. If you haven't been to high altitude before, you should exercise caution when doing so.

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:
A/ Acute Mountain Sickness - AMS
Mild symptoms feel like hangover / not feeling well
Headache
Fatigue/Tiredness
Nausea
Shortness of breath
Loss of appetite
Sleep Disturbance
Dizziness
B/ High Altitude Pulmonary Edema (water in the Lung) - HAPE

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.
C/ High Altitude Cerebral Edema (water in the Head) - HACE

Severe symptoms of Altitude Sickness
Severe Headache
Vomiting, Weakness,Disorientation,Loss of co-ordination,Decreasing levels of consciousness,Loss of memory,Hallucinations & Psychotic behaviour,Coma.
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.
Do 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:
First Aid Medical Kit
Equipments:
Sphygmomanometer (Blood pressure Instrument)
Syringes (20 ml, 10 ml)
Hot water bottle
Pen and writing pad
Stethoscope
Thermometer
Matchbox
Splints
Scissors
Tongue blades
Pen light
cervical collar

Bandage 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)