Lesson 15:
Altitude Sickness
Emergency Reference Guide p. 30-33
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 selfadminister 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
Questions???
What else could you add to your
First Aid Kit?