ALTITUDE SICKNESS
Altitude sickness is a collection of general symptoms that are acquired by climbing or walking to a high elevation or altitude.
- The condition happens because the body does not have enough time to adapt to the lower air pressure and decreasing amount of oxygen level that occurs at high altitude.
- High altitude is defined as 8,000-12,000 feet above sea level. Very high altitude is 12,000-18,000 feet, and altitudes above 18,000 are considered extremely high altitude.
- Acute altitude sickness can happen as low as 8,000 feet but the risk for altitude sickness increases with increasing altitude.
- Anyone regardless of age, sex or health condition at a high elevation can get it. However, people with lung or heart disease may be told to avoid high altitudes.
- Altitude sickness is a general term that covers three major conditions: acute mountain sickness, High-altitude pulmonary edema (HAPE) and High-altitude cerebral edema (HACE).
- Acute mountain sickness is the mildest form and common form of altitude sickness.
- Acute mountain sickness can progress to high altitude pulmonary edema or high altitude cerebral edema both of which are potentially fatal and even life-threatening
- High altitude pulmonary edema is a buildup of fluid in the lungs. If left untreated, it can progress to respiratory collapse and ultimately death. This is the number one cause of death from altitude sickness.
- High altitude cerebral edema is the most severe form of altitude sickness. It is characterized by a buildup of fluid in the brain. It is very life-threatening and may require immediate medical care.
- 20% of hikers, skiers, and adventurers traveling to high elevations between 8,000 and 18,000 feet experience altitude sickness, the number increases to 50% at elevations above 18,000ft
CAUSES
Altitude sickness develops when a person ascends to a great height too rapidly. This is because the body’s ability to adjust to decreasing level of oxygen at higher altitudes reduces with the overall air pressure resulting in abnormally low blood levels of oxygen. The person has to breathe faster to compensate for the low oxygen, the heart rate also increases.
Since the body needs to adapt to the lower air pressure as well as the decreased oxygen levels, a gradual progression is often needed. This slower climb is known as acclimatization.
People who do not take their time acclimatizing to a new altitude before moving ahead have the highest risk of developing altitude sickness.
SYMPTOMS
The onset and severity of altitude sickness vary among individuals and depend on the rate of ascent, amount of physical activity at high altitude, individual susceptibility, and the altitude attained.
Acute mountain sickness
- Headache
- Loss of appetite
- Nausea and vomiting
- Fatigue
- Dizziness
- Insomnia
- Shortness of breath during exertion
- Rapid heart rate
- Pin and needles sensation
- Swelling of face, hands, and feet
High-altitude pulmonary edema
- Fever
- Persistent dry cough that may progress to produce pink, frothy sputum
- Panting even while at rest
High-altitude cerebral edema
- A persistent headache that does not respond to painkillers
- Gradual loss of consciousness
- Increased nausea and vomiting
- Unsteady gait or clumsiness
- Numbness
- Dizziness
DIAGNOSIS AND TREATMENT
Diagnosis is based on the patient’s signs and symptoms. The doctor will question the patient to look for symptoms of altitude sickness. The doctor will listen to your chest with the aid of a stethoscope if you have shortness of breath. Rattling or crackling sound in the lungs may be a sign of fluid buildup in them.
Recognizing these symptoms yourself may be important as there are limited medical services available while hiking up a mountain.
TREATMENT
Anyone that develops symptoms should immediately stop ascending, or go to a lower level and rest till symptoms are completely gone.
It is important to let others know of the slightest hint of symptom.
For mild or moderate cases, oxygen may be used. This is commonly provided by physicians at mountain resorts.
Painkillers such as acetaminophen or anti-inflammatory medicine such as ibuprofen can be used for headaches.
A Gamow bag may be provided where a rapid descent is impossible to evacuate people with severe symptoms, not to treat them at altitude. The Gamow bag is a portable plastic hyperbaric chamber which can be inflated with a foot pump.
Acetazolamide assist in treating acute mountain sickness
Steroids can be used to treat symptoms of pulmonary or cerebral edema