Let’s Cope Up With Altitude Sickness
Travel Health | admin | December 25, 2009
Many of us have the hobby of trekking along a mountain despite of our awareness that there is less amount of oxygen as we proceed towards the peak. However, many a times, the lack of oxygen become problematic for us such that we feel difficult to breathe. At great heights, our body also exhibit physiological and indicative reactions in response to the low oxygen pressure at a really high altitude. This condition is known as acute mountain sickness or altitude sickness.
The rate of ascent and the duration of the stay at a height directly influence the prevalence of altitude sickness, which is different in different individuals. According to a research, approximately 20 percent of people notice the mild symptoms at altitude sickness at the heights of 2200 to 2500 metres above the sea level.
You are likely to develop altitude sickness if you are fond of climbing up to 3000 to 4000 metres. According to a survey, 7 out of 50,000 tourists in Nepal die due to altitude sickness. Further, the death rate is 4 percent for climbing up to 7000 metres.
Altitude Sickness Causes
The chances of being vulnerable to altitude sickness are not dependent on a person’s fitness. This means it can affect even a sportsperson or an athlete. Altitude sickness might take place if you climb to a greater height travel rapidly and stay for more than 24 hours at the height without adequate acclimatization.
When you come in contact with the ‘thinner’ air (low oxygen pressure), the body reacts to this condition in many ways. This is actually an increase in the number of factors that affect the blood’s oxygen carrying capacity and are listed below.
- Breathing and pulse rates
- Heart’s pumping
- Size and number of red blood cells
The lack of oxygen at high altitudes leads to the following changes that result in altitude sickness.
- Raised pressure in the pulmonary (lung) circulation
- Mutations in blood ph (acidity) values
- Instability in the fluid or electrolyte (salt) balance
- Outflow and spread of blood or fluid in the nearby vessels and tissues (fluid extravasation or oedema)
Altitude Sickness Symptoms
Listed below are the symptoms of altitude sickness.
A severe headache that does not disappear even on taking the standard painkillers- Nausea and frequent vomiting
- Irritating giddiness
- Difficulty with balance and direction
- Frequent visual disturbances with flickering sight and unable to determine distance
- Pressure in the chest
- Fast breathing and pulse rate
- Unable to take deep or complete breath
- Swelling underneath the skin (oedema – around the eyes, ankles, and hands)
- Confusion
- Convulsions
If these symptoms are noticed, medical care must be given and the person must be carried down to the ground or to the lowest height. Some of these symptoms might be danger signals that are encountered in the first 36 hours. Above 3000 metres, nearly 50 percent of the travelers get affected, while above 5000 metres, almost all who ascend quickly without any acclimatization are influenced. These danger signals are listed below.
- An trivial headache that fades away on taking one to two headache tablets
- Nausea
- Malaise
- Dizziness
- Difficulty in sleeping
If you encounter these symptoms at the heights until 3000 metres, take rest for some days and then move further. Beyond the heights of 3500 metres, move down to 300 to 500 metres and dwell there for two days before moving further.
Acute Mountain Sickness
Acute mountain sickness refers to two serious problems of acute altitude sickness. Both tend to occur due to dwelling for about 24 to 36 hours at a too much height, say over 3500 metres. These two complications are listed below.
- HAPE
High Altitude Pulmonary Oedema (water accumulation in the lungs) - HACE
High Altitude Cerebral Oedema (fluid accumulation on the brain)
High Altitude Pulmonary Oedema
The symptoms of HAPE are primarily serious, which are listed below.
- Difficulty in breathing
- Bubbling noise while breathing (oedema in lungs)
- Dry cough
- Pressure in the chest
- Palpitations
- Fatigue
- Color change of lips, edges of ears, and nails to blue (cyanosed because of lack of oxygen)
Listed below are guidelines to be kept in mind on encountering such symptoms.
- Bring the patient down to the lowest possible altitude quickly using a stretcher.
- Provide oxygen by nasal catheter, an oxygen mask and bottle as Continuous Positive Airways Pressure (CPAP), or Gamow-bag.
- A quick-acting calcium antagonist (nifedipine capsules 10-20 mg) can be given followed by slow-acting nifedipine tablets of 20 mg after every six hours. However, this needs the doctor’s consent.
- An injection of Dexamethasone can be given after the physician’s approval.
High Altitude Cerebral Oedema
The symptoms of HACE are primarily serious, which are listed below.
- Rigorous headaches
- Visual problems
- Light shunning
- Irritation
- Vomiting
- Vagueness
- Confusion
- Unconsciousness
- Convulsions
Listed below are guidelines to be kept in mind on encountering such symptoms.
- Bring the patient down to the lowest possible altitude quickly in a natal position (strapped lateral).
- Provide oxygen by an oxygen mask and bottle (CPAP) or Gamow-bag.
- An injection of Dexamethasone can be considered.
- Give a benzodiazepine such as diazepam to treat convulsions.
Prevention is Better than Cure
Listed below are certain tips on preventing altitude sickness.
Climb slowly at higher levels and allow stay and rest for at least two to three days at a given height after 2200 metres prior to stay at greater height at night.- Come down to the previous accustomed height if you feel uneasy or sick.
- Take plenty of liquids, three litres daily at its minimum.
- Avoid alcohol.
- Avoid being inclined to cold.
- Consider taking acetazolamide (Diamox) of 125 mg twice 1 day prior to the ascent, on the day of ascent, and 1-2 days after the ascent. However, do not forget the suggestion of slow ascent, as even this is necessary. The drug has its own side effects that include nausea, tingling hands and feet, frequent and profuse urination, rashes, and visual problems.
People Not Suitable for High Altitudes
There are certain people who should never ascend to high altitudes. These are people with:
- Chronic heart or lung diseases such as angina pectoris, asthma, and chronic bronchitis.
- Anemia.
- Untreated blood clotting disorders.
- A past of thromboses (clots).
- HAPE or HACE.
People Who Need to Careful at High Altitudes
There are certain people who should always be alert and careful at high altitudes. These are people with:
- Treated heart or lung diseases such as asthma and emphysema.
- Severe diabetes.
- High blood pressure.
- Sleep apnoea.
- HAPE or HACE.
This list also includes the pregnant women and children.
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