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High Altitude Sickness

When Climbing Higher

As pilgrims visit Mt. Kailash Mansarovar (4550m.) Darchen (4700m), Gosainkunda (4300m), Lhasa (3685m) or even Everest Base Camp (5800m), high altitude illness becomes a problem. Altitude illness usually occurs at an altitude above 2500m.

There are there main forms Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE), High Altitude Pulmonary Edema (HAPE). Environmental temperature decreases at an overage of 6.5 degrees Centigrade per 1000m gains in elevation. Due to the cold the amount of oxygen required to maintain the body temperature also increases.

Ultraviolet (UV) light penetration increases four per cent every 300 m gain in altitude, which increases the danger of snow blind less, sunburn and long - term skin cancer. UV lights also reflected snow and ice, which can produce temperature of 40 to 42 degrees centigrade in enclosed spaces. In tents heat exhaustion becomes a real danger. It also causes dehydration as result of hyperventilation and increased work.

AMS will be apparent within four to 36hrs of ascent to the altitude of 25,00 to 3,000m after ascent. The rate at which different individuals acclimatize is unaware and continues the ascent, it may lead to HACE.

Myalgia, high fever or diarrhea is not a part of AMS; Physical examination is equally nonspecific and usually normal. ACCORDING TO THE ACUTE Mountain Sickness (AMS) self-assessment (The Lake Louise Consensus Scoring of AMS-Canada), individual will suffer headache with at least a few hours stay at the new altitude with gain in altitude:

  • Weakness or fatigue (Mild, moderate, severe)
  • Gastrointestinal symptoms such as anorexia to nausea
  • Dizziness or light - headed - ness (mild, moderate, service)
  • Sleeping
  • Severe or more means that the individual is suffering from AMS.
Risk factors Symptoms
  • Ingestion of sleeping
  • Obesity
  • Residence altitude less then 900mm exercise
  • Age less then 40 years (blue
  • Respiratory tract infection
  • Physical exhaustion (increased respiration)
  • Low oxygen saturation (increase pulse rate)
  • Rate of ascent
  • Cold
  • Dyspnoea at rest
  • Cough
  • Weakness or less
  • Central cyanosis tongue, lip, nail bed)
  • Wheezing
  • Tachypnoea
  • Tachycardia

Requires one to three day to develop. Sometimes progression to HACE from mild AMS occurs in 12 hours also. It is an end stage of severe AMS in the event of rapid rise in altitude, either with a presence of a change in mental status and or ataxia in a person with AMS. Tandem gait test is the best like catwalk. Symptoms of HACE are worst at night. Once coma develops, mortality is over 60 percent. HACE is characterized by Ataxia, extreme lassitude and altered level of consciousness in the from of confusion, impaired thinking, drowsiness and coma.

It usually occurs within two for days of ascent to an altitude of more then 2500m, most commonly on the second night, Younger persons i.e. less then 20 years of age are more susceptible.

Golden rules
1. If an individual has development any sickness at an altitude, the symptoms are due to the altitude until proven otherwise.
2. If a person has developed any altitude symptoms, s/he should not go any higher.
3. If a person feels very ill or cannot walk heel to toe in a straight line, has short breaths at rest, descend immediately.
4. If a person has altitude illness, a responsible companion must always accompany him.


1. If there is any trouble, always stay at the same altitude until the symptoms go away, rest and drink plenty of fluid three to four liters per day. Urine should be clear.
2. Eat high carbohydrate diet (70 percent calorie). Light activity during the day is better.
3. Avoid alcohol, sleeping medication and tobacco. Don't carry pocks weighing more 10 kg.
4. Avoid exposure to the cold; ventilate tents and snow shelters when cooking.
5. Avoid about transport to above 3,048cm. Acclimatize for three nights before going any higher. Don't fly or drive to high altitudes. Always start below 3,048m.
6. If you do flu or drive don't exert yourself or move higher for the first 24 hours. If you go above 3,048m, for every 305m, take a day's rest and for every 915m, take a two three days rest.
7. If symptoms increase, return back to base as soon as possible and visit the doctor.

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