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Altitude Sickness

 January 10, 2020      By Kabindra Bhatta
Altitude Sickness

Altitude sickness is the regional illness which happens in the higher altitude i.e. above 2,400 meter and also known as mountain sickness. Altitude sickness mostly affects hikers, trekkers and mountain climbers, especially for those travelers, who travels at higher altitude.
Actually, there are three kinds of altitude sickness which are listed below
 
AMS (Acute Mountain Sickness)
AMS is a common and mildest form of sickness which gives a symptom of hangover, dizziness, muscle ache, nausea, headache and vomiting.
 
HAPE (High Altitude Pulmonary Edema)
HAPE directly impacts on lungs i.e. buildup fluid in the lungs which is very dangerous and makes problem in breathing.
 
HACE (High Altitude Cerebral Edema)
HACE is the critical form of altitude sickness which directly affects in brain by building fluid. It is a serious case and life threatening so medical attention is needed soon.
 
Symptoms of altitude sickness
The range of symptoms starts from mild to life-threatening also symptoms may vary upon the speed of the traveler and how hard they exert themselves. Altitude sickness directly affects in lungs, muscles, nervous system and heart.
Mild to moderate altitude sickness symptoms are headache, nausea, vomiting, problem in breathing, dizziness, fatigue, rapid pulse rate and loss of appetite whereas, more severe symptoms are inability of attention, confusion, blood in cough, cyanosis (blue color skin), congestion, pale complexion and unable to walk.
Cause of altitude sickness
The main cause of altitude sickness is due to the low oxygen level and reduction of air pressure. The risk of getting altitude sickness are if the traveler ascend quickly, having heart, nervous system and lungs problem or any other illness previously, if not acclimatized to the altitude, drinks liquor, caffeine added drinks and smoking and if the traveler lives near sea level and travels higher altitude.
Prevention of altitude sickness
There are some ways to be followed out for the prevention of altitude sickness which are gradual ascent to the higher altitude, take an acclimatization day while traveling, try to stay overnight at lower level altitude, drink enough soups and water, avoid alcohol and smoking at higher altitude, eat a calorie diet meal, recognize symptoms of altitude sickness, if the symptoms are matched go to the lower level altitude and use Acetazolamide (Diamox) if needed and carry oxygen if possible.
Treatment of altitude sickness
Early treatment of altitude sickness is important  and easier to treat, if the symptom seen is more than mild then the patient should needs medical attention and should go to hospital immediately.
The very first treatment to be given to the patient of altitude sickness will be descend to the lower altitude safely as soon as possible and give an extra oxygen if possible.
People with severe mountain sickness may need to be admitted to a hospital.
A medicine called acetazolamide (Diamox) may be given to help you breathe better. It can help reduce symptoms. This medicine can make you urinate more often. Make sure you drink plenty of fluids and avoid alcohol when taking this drug. This medicine works best when taken before reaching a high altitude.
If you have fluid in your lungs (pulmonary edema), treatment may include:
  • Oxygen
  • A high blood pressure medicine called nifedipine
  • Beta agonist inhalers to open the airways
  • Breathing machine in severe cases
  • Medicine to increase blood flow to the lungs called phosphodiesterase inhibitor (such as sildenafil)
Dexamethasone (Decadron) may help reduce acute mountain sickness symptoms and swelling in the brain (cerebral edema).
Portable hyperbaric chambers allow hikers to simulate conditions at lower altitudes without actually moving from their location on the mountain. These devices are very helpful if bad weather or other factors make climbing down the mountain impossible.
Outlook (Prognosis)
Most cases are mild. Symptoms improve quickly when you climb down the mountain to a lower altitude.
Severe cases may result in death due to lung problems or brain swelling, called cerebral edema.
In remote locations, emergency evacuation may not be possible, or treatment may be delayed. This can have a negative effect on the outcome.
The outlook depends on the rate of descent once symptoms begin. Some people are more prone to developing altitude-related sickness and may not respond as well.
Possible Complications
Complications may include:
  • Coma (unresponsiveness)
  • Fluid in the lungs (pulmonary edema)
  • Swelling of the brain (cerebral edema), which can lead to seizures, mental changes, or permanent damage to the nervous system
  • Death
When to Contact a Medical Professional
Call your provider if you have or had symptoms of acute mountain sickness, even if you felt better when you returned to a lower altitude.
Call your local emergency number if you or another climber have any of the following symptoms:
  • Severe breathing problems
  • Altered level of alertness
  • Coughing up blood
Climb down the mountain right away and as safely as possible.
 
Reference
Medlineplus.gov. (2020). Acute mountain sickness: MedlinePlus Medical Encyclopedia. [online] Available at: https://medlineplus.gov/ency/article/000133.htm [Accessed 3 Jan. 2020].
WebMD. (2020). What Is Altitude Sickness?. [online] Available at: https://www.webmd.com/a-to-z-guides/altitude-sickness#3 [Accessed 4 Jan. 2020].
nhs.uk. (2020). Altitude sickness. [online] Available at: https://www.nhs.uk/conditions/altitude-sickness/ [Accessed 4 Jan. 2020].
 


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