Lesson 15: Altitude Sickness

Objectives Define altitude illnesses, include Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE) & High Altitude Pulmonary Edema (HAPE) List signs & symptoms of AMS, HACE, HAPE Describe emergency care for AMS, HACE, HAPE Describe situations that require evacuation Describe prevention techniques

Altitude Illness Overview Altitude illness occurs when people at high elevation do not get enough oxygen As you gain altitude air grows thinner (less air pressure) & less oxygen is inhaled Most common altitude illness is Acute Mountain Sickness (AMS) AMS commonly occurs when person recently has reached heights of 6500 – 8000 feet

Altitude Illness Overview (cont’d.) Symptoms similar to dehydration & heat illness. (If at lower altitude < 6500 feet suspect those first) High Altitude Cerebral Edema (HACE) is cause by fluid collecting in the brain tissues. If untreated can lead to death High Altitude pulmonary edema (HAPE) is caused when fluid collects in air spaces in the lungs. HAPE can be life threatening.

Checking for Acute Mountain Sickness (AMS) Acute Mountain Sickness Signs & Symptoms: Headache Loss of normal appetite Nausea, with/without vomiting Insomnia Unusual weariness & exhaustion, called “lassitude”

Caring for AMS Descend or stop ascent & wait for improvement. If illness progresses, descent is mandatory Administer oxygen, if available & trained to do so. Especially helpful during sleep Give aspirin or acetaminophen for headaches, if patient is able to swallow & has no known contraindication If prescribed & recommended by patient’s health care provider, help patient self-administer medication for altitude illness

Signs & Symptoms for High Altitude Cerebral Edema Loss of coordination or “ataxia” (e.g. can’t walk in a strain line or stand straight with feet together) Severe headache not relieved by rest/medication Bizarre changes in personality Seizures or coma

Care for HACE Severely ill patients must descend as soon as possible Provide oxygen, if available & trained to do so Keep patient from becoming chilled or overheated If prescribed & recommended, help patient self-administer medications for altitude illness Use portable hyperbaric chamber (caution: do not use in lieu of descending)

Signs & Symptoms of High Altitude Pulmonary Edema Dry cough, shortness of breath (at rest) Shortness of breath becomes more pronounced Possible chest pain Cough that becomes productive, first frothy sputum, later reddish sputum

Care for HAPE Severely ill patients must descend ASAP In addition to descent, provide oxygen, if available & trained to do so Keep patient from becoming chilled or overheated. Especially important for HAPE, since cold weather increases pulmonary artery pressures & makes HAPE worse Use portable hyperbaric chamber if available, not a substitute for descending

Guidelines for Evacuation Patient with AMS should stop ascending until symptoms resolve themselves Patient with AMS does not require evac unless condition worsens, then descent is mandatory GO FAST for any patient with HACE or HAPE. Descend at least 1000-1500 feet of elevation. Anyone with HACE or HAPE MUST be evaluated by health care provider ASAP

Preventing Altitude Illnesses Most High Altitude Illnesses are preventable Make a stage ascent, Allow body to adjust Increase altitude of overnight camps gradually If possible camp no higher than 8000 ft first night, no more than 1000’ - 1500’ increase per night If trip starts > 9000’, spend 2 nights acclimating Proceed higher during the day, but return to lower altitude during day during acclimation period

Preventing Altitude Illnesses (cont’d.) Eat high carb diet: >70% diet of carbs reduces symptoms of AMS Start high carb diet 1-2 days before starting trip Maintain appropriate exercise level until acclimated. Avoid excessive shortness of breath Stay well hydrated (higher loss of fluids at high elevations) Talk to your health care provider about possible prescription medication