Altitude Sickness Health Article

Diagnosis

The diagnosis for altitude sickness may be made from the observation of the individual's symptoms during travel to higher altitudes.

Treatment

Mild AMS requires no treatment other than an aspirin or ibuprofen for headache, and avoidance of further ascent. Narcotics should be avoided because they may blunt the respiratory response, making it even more difficult for the person to breathe deeply and rapidly enough to compensate for the lower levels of oxygen in the environment. Oxygen may also be used to alleviate symptoms of mild AMS.

As for HAPE and HACE, the most important course of action is descent to a lower altitude as soon as possible. Even a 1, 000-2, 000 -foot (305–610 m) descent can dramatically improve one's symptoms. If descent is not possible, oxygen therapy should be started. In addition, dexamethasone (a steroid) has been suggested in order to reduce cerebral edema.

Prognosis

The prognosis for mild AMS is good, if appropriate measures are taken. As for HAPE and HACE, the prognosis depends upon the rapidity and distance of descent and the availability of medical intervention. Descent often leads to improvement of symptoms, however, recovery times vary among individuals.

Prevention

When individuals ascend from sea level, it is recommended that they spend at least one night at an intermediate altitude prior to ascending to higher elevations. In general, climbers should take at least two days to go from sea level to 8, 000 feet (2, 438 m). After reaching that point, healthy climbers should generally allow one day for each additional 2, 000 feet (610 m), and one day of rest should be taken every two or three days. Should mild symptoms begin to surface, further ascent should be avoided. If the symptoms are severe, the individual should return to a lower altitude. Some reports indicate that acetazolamide (a diuretic) may be taken before ascent as a preventative measure for AMS.

Paying attention to diet can also help prevent altitude sickness. Water loss is a problem at higher altitudes, so climbers should drink ample water (enough to produce copious amounts of relatively light-colored or clear urine). Alcohol and large amounts of salt should be avoided. Eating frequent small, high-carbohydrate snacks (for example, fruits, jams and starchy foods) can help, especially in the first few days of climbing.

BOOKS

Crystal, R. G., ed., et al. The Lung: Scientific Foundations. Lippincott-Raven Publishers, 1997.

Kravis, T. C., C. G. Warner, and L. M. Jacobs Jr., eds. Emergency Medicine. Raven Press, 1993.

Rosen, Peter, ed., et al. Emergency Medicine: Concepts and Clinical Practice. Mosby Year Book, 1992.

PERIODICALS

Coote, J. H. "Medicine and Mechanisms in Altitude Sickness." Sports Medicine 20 (Sept. 1995): 148-159.

Kapil Gupta, MD

KEY TERMS

Cerebral—Pertaining to the brain.

Edema—Accumulation of excess fluid in the tissues of the body.

Hypoxemia—Insufficient oxygenation of the blood.

Hypoxia—A deficiency in the amount of oxygen required for effective ventilation.

Pulmonary—Pertaining to the lungs.