Altitude sickness, also called Acute Mountain Sickness (AMS) can be deadly, and a little pre-travel preparation can help keep you safe.
A bit of knowledge and prior to leaving can mean the difference between a very pleasurable and adventurous trip and a headache-filled experience that could potentially end with a medical evacuation
Perhaps the most important tip is to follow is that
Altitude is generally divided into the following levels:
Travelers headed to high altitude should be aware of a few medical terms and conditions that they might encounter themselves or in their traveling companions.
This is the broad term for altitude sickness. Symptoms of AMS include a headache (often throbbing, worse when bending over), nausea/vomiting, fatigue and a general feeling of a hangover.
Is a life-threatening emergency that has symptoms of ataxia (walking in a stumbling manner) and changes in mental status such as confusion or lethargy. This is literally swelling of the brain. Symptoms of AMS are also usually present. This is a medical emergency!
Is a life-threatening emergency with symptoms of a cough (wet or dry), difficulty breathing with mild exertion and all the symptoms of AMS. Fluid collects in the patient's lungs. This is a medical emergency!
The definitive treatment for all mountain sickness is descent.
Treatment of high altitude sickness of all kinds centers around the prompt recognition of the symptoms and realizing that altitude could be the cause of the illness. First and foremost, upon beginning to feel ill at altitude, do not ascend any higher.
Some experts even advise descending 1,600 to 3,200ft (500 to 1,000m) for 24 hours to allow the body to acclimatize more slowly. Medical treatment of more severe forms of altitude sickness such as HACE and HAPE should be given by a person skilled in altitude medicine. A traveler who suspects HACE or HAPE should immediately descend to a lower altitude and seek advanced medical care. Some medications discussed below may aid in the treatment, but the descent is the best medicine.
Portable hyperbaric chambers known as Gamow bags can be used to simulate a lower altitude environment in
Prevent altitude sickness by making a slow and gradual ascent to altitude. Some experts advise not climbing more than 4,950 to 6,500ft (1,500 to 2,000m) in a 24-hour period when traveling above 8,200ft (2,500m). This gives the body a chance to acclimatize to the new altitude and an opportunity to observe people for symptoms of AMS. This slow and gradual ascent is easier when travelers are hiking. Modern-day travel methods such as car travel and airlines that land in cities such as Lhasa, Tibet, and Cusco, Peru can immediately put a traveler at high altitude without much time to acclimatize. Always be on the look-out for AMS symptoms if traveling to high-altitude a chance to acclimatize.
Given that a slow and gradual ascent is not always possible, a few methods can help adjust the body to the shock of suddenly being at high altitude. Some evidence supports mild exercise the day of arrival such as a short walk, to aid with acclimatization. Heavy exercise the day of arrival could be disastrous.
Alcohol or sedatives, which can mask the symptoms of AMS, should be avoided for the first few days of altitude. Staying hydrated is also important.
Certain medications can help prevent and even treat AMS. The most commonly used medication is acetazolamide. This medication is used to both prevent and treat symptoms of AMS. Often taken as a 125mg tablet, twice per day, acetazolamide is effective at preventing AMS symptoms. This medication has the potential to cause allergic reactions in people with a history of sulfa allergies and can change the way some foods or drinks taste especially carbonated beverages. Overall, the medication is very well tolerated and is a viable option for travelers looking to take precautions in preventing AMS. This medicine should be started 24 hours before making an ascent, while at altitude and for 48 hours after a descent.
Dexamethasone is a steroid that can be used as a prophylactic medicine for those unable to tolerate acetazolamide. This medicine is best used as treatment but is still an option.
Ginko Biloba has received much attention as a possible prophylactic AMS drug, but the medical literature is scant. Some research shows promise but acetazolamide is still considered superior.
Lastly, the use of coca leaves, or products that contain this plant material, should be discouraged by travelers. While having many other applications, decent prevention of AMS symptoms is not one of them. Perhaps most dangerous is the "false sense of security" that one might have by taking coca leaf products and ignoring symptoms of AMS believing they are protected.
Overall, many travelers go to altitude each day and return without problems. Keep an eye out for symptoms of altitude sickness in yourself and others around you. When traveling in the mountains, follow the golden rule of treating any
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