Altitude Sickness
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Transcript of Altitude Sickness
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Altitude Sickness Everest Expedition 2014
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Causes…
Less OxygenLow Pressure Rapid AscentPossible DehydrationHypothermia
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Acute Mountain Sickness
AMS – occurs above 8,000 ft elevation
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Symptoms
Normally described as mild hangover Headache WITH Fatigue Nausea Shortness of Breath (at rest) Loss of Appetite Insomnia Dizziness
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Treatment
DO NOT ASCEND FURTHERHydrateStay at altitude for 12-24 hours
If symptoms diminish can ascend If symptoms continue descend
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High Altitude Pulmonary Edema
HAPE – occurs above 12,000-15,000 ft
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Symptoms
Intense AMS Water in lungs Increased shortness of breath AT REST Severe/constant cough (Dry) Fatigue while walking High pulse rate (110) Blueness of face, lip, fingernails (caused by
inability to transport oxygen into the blood)
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Treatment
DESCEND AS SOON AS POSSIBE 500-1,000 ft (or until symptoms diminish)
Hydrate
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High Altitude Cerebral Edema
HACE – occurs above 12,000-15,000 ft
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Symptoms
Intense AMS Water in the head (increased ICP) SEVERE headache Vomiting Ataxia (walking like a drunk hobo) Decreased LOC Irritable (does not want to be bothered) Overwhelming desire to sleep (DO NOT LET
SLEEP) Loss of consciousness Coma Death
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Treatment
DECSEND IMMEDIATELY (1,000 ft minimum) If have pressure bag – USE IT
(carried by expedition companies) Dexamethasone (steroid drug)
Works by decreasing swelling in bony skull Dosage = 4 mg 3x a day (improvement in 6
hours) Buys time if cannot descend immediately
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PREVENTIONTHIS IS ENTIRELY PREVENTABLE
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DO
Acclimatization – after ascend 1000m stay an extra night to acclimatize
DRINK WATER – 3 to 4L per dayClimb high sleep lowAbove 3,000m – ascend no more than 300m a
day
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DON’T
Do not make rapid ascent – too fast too high = BAD
No alcohol, sleeping pills, and smokingDo not carry heavy packs (10-12kg is ok)NEVER travel alone
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Medications
OxygenDiamox – for AMS (125 mg before dinner for
sleeping if feeling suffocated)Nafedipine – for HAPESteroids/Dexamethasone - for HACEHyperbolic Bag (Gammow bag)
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Diamox (Acetazolamide)
Does not mask symptoms but actually treats symptoms Works by increasing amount of alkali (bicarbonate) excreted
in the urine – making the blood more acidic. This drives ventilation (cornerstone of acclimatization)
FOR PREVENTION: 125 mg twice daily continued for 3 days after highest altitude is reached
FOR AMS TREATMENT: 250 mg twice daily for 3 days Side Effects: uncomfortable tingling of fingers, toes, and face
(called “jhum jhum” in Nepali), excessive urination, and carbonated drinks tasting flat
If allergic to sulfa drugs – DO NOT TAKE THIS
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Four Golden Rules
1. Awareness of Altitude Sickness2. If you have mild symptoms DO NOT
PROCEED (take aspirin)3. If you have worsening symptoms GO DOWM
IMMEDIATELY4. Do NOT leave your team member behind
unattended
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Three Golden Actions
1. Go up SLOWLY 2. Drink plenty of fluids (no less than 3L a day)3. Know the symptoms of altitude sickness and
be honest with yourself and your team members about them – this is serious and can lead to death BUT IS FULLY PREVENTABLE
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Sources
http://peakfreaks.com/ams.htmWFR book (Solo Southeast)