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
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,
- Gastrointestinal symptoms such as
anorexia to nausea
- Dizziness or light - headed - ness
(mild, moderate, service)
- Severe or more means that the individual
is suffering from AMS.
- Ingestion of sleeping
- 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
- Dyspnoea at rest
- Weakness or less
- Central cyanosis tongue, lip, nail bed)
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
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.
1. If an individual has development any sickness at
an altitude, the symptoms are due to the altitude until
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
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.