Everything you need to know about Altitude sickness
Before venturing into higher altitudes, it is essential to educate yourself about altitude sickness, as it is the most common complication in alpine terrain and can affect anyone, even experienced climbers. This acute condition is often underestimated and ignored.
Learn about why AMS (acute mountain sickness), if left untreated, can lead to severe physical damage such as pulmonary or cerebral edema, and discover how to prevent it in this blog post.
HOW DOES ALTITUDE SICKNESS OCCUR?
The causes of altitude sickness are diverse. It’s important to mention that not everyone suffers from AMS, but there are risk factors and possible causes that increase the possibility of such condition. One main reason is the rapid ascent from lower altitudes to Alpine regions. At higher altitudes, the oxygen level decreases due to lower air pressure, which means less oxygen is taken in with each breath. Dehydration is another factor, as the body loses more fluids at higher altitudes.
- Rapid ascent above 2500 meters above sea level
- ascending more than 300 meters per day above 3000 meters
- dehydration, unresolved infections/flu
- previous experience of altitude sickness increases the risk of recurrence
- individuals suffering from migraines have an increased risk of experiencing AMS.
Your Oxygen Levels at higher altitude
Are you in risk?
As already mentioned, there are certain factors that can predispose someone to altitude sickness. Even with the risk factors, it is not guaranteed that one will suffer from altitude sickness. If you belong to the at-risk group, you should inform those around you so that they can react appropriately in case of emergency.
Possible risk groups include:
- Previous altitude sickness
- Individuals with lung diseases (COPD, chronic bronchitis)
- Smokers (due to reduced lung capacity)
- Rapid ascent above 2,500 meters
- Dehydration
- Current/not fully healed infections
The symptoms of altitude sickness should be taken seriously. The earlier you notice them, the sooner you can address them and prevent deterioration. The most common signs include headaches, fatigue, nausea, dizziness, difficulty sleeping, shortness of breath, and swelling of hands, feet, and face. Ignoring these symptoms can lead to serious complications such as pulmonary or cerebral edema. These complications can be fatal if not promptly addressed and require immediate medical attention. Depending on the location, immediate medical help may not be available, making it even more crucial to prevent such a situation.
signs of altitude sickness
immediate and untreatable headaches
nausea, vomiting and dizziness
swelling in hands, feet and face
rapid heartbeat and shortness of breath even at rest
insomnia
loss of appetite and decreased performance
mild and early symptoms
The mild and early symptoms of altitude sickness manifest as:
Immediate, untreatable headaches
Nausea, vomiting and dizziness
swelling in hands, feet and face
sleep problems
rapid heartbeat and shortness of breath, even at rest
loss of appetite and decreased performance
complications
Ascending further beyond 4,000 meters despite clear signs of altitude sickness will lead to serious complications and requires immediate medical assistance.
High altitude cerebral edema (Hace)
Due to persistent lack of oxygen in the brain, intracranial pressure increases, leading to fluid accumulation in the brain.
Symptoms include:
- Impaired movement and coordination
- Uncertainty in walking, standing, and sitting
- Impaired consciousness and significant decline in performance
Failure to treat the cerebral edema can lead to a coma and ultimately death.
High altitude cerebral edema (Hace)
Due to increased blood flow in the lung vessels and their constriction, pressure in the lungs rises, eventually leading to reduced oxygen uptake.
This manifests as:
- Severe shortness of breath during both activity and rest. Bluish discoloration of the lips indicates a lack of oxygen in the body.
- Rattling sounds while breathing
- Significant decline in performance
- Dry cough, which over time can produce bloody sputum
- Rapid heartbeat
Prevention and therapy
Prevention is more important than therapy
The simplest solution to avoid altitude sickness is a gradual ascent. Once mild symptoms are noticeable, take a break until the symptoms disappear. It’s advisable to choose a lower sleeping location and attempt the ascent again the next day or when the symptoms have subsided. The body needs time to acclimatize to higher altitudes, and this process is called acclimatization.
Descending doesn’t necessarily mean the end of the adventure; on the contrary, it allows your body to recover and acclimatize, making it capable of ascending further in a matter of hours to days.
Additionally, it’s crucial to ensure adequate fluid intake, at least 3 liters of water or tea per day, while avoiding alcohol.
If a slow ascent or rapid descent is not possible, medication can be considered. Please discuss this with your trusted doctor!
- Steroids (Dexamethasone): Acts as an anti-inflammatory and can be taken in case of acetazolamide intolerance.
- Acetazolamide (Diamox): Can improve oxygen supply to the brain and delay altitude sickness by a few hundred meters.
- Nifedipine: Reduces blood pressure in the lungs and serves prophylactically for pulmonary edema.
- Paracetamol, Ibuprofen, and Aspirin: Help with headaches.
Your body is signaling what it can handle and what is too much, and listening to these signs is not a sign of weakness. It becomes a weakness only when these signs are ignored.
individual evaluation
The Lake Louise Scoring sheet provides information if you’re suffering from the acute mountain sickness and is therefore part of the diagnostic process. However, we belive that this scale is very helpful whenever there is doubt about whether one is affected or not.
Headache:
0 – No
1 – Mild
2 – Moderate
3 – Severe
Gastrointestinal Symptoms:
0 – No
1 – Loss of appetite or nausea
2 – Moderate nausea or vomiting
3 – Severe nausea or vomiting
Fatigue and Weakness:
0 – No
1 – Mild
2 – Moderate
3 – Severe
Dizziness:
0 – No
1 – Mild
2 – Moderate
3 – Severe
Insomnia:
0 – No
1 – Mild
2 – Poorly slept
3 – Did not sleep at all
A total score of 3 to 5 indicates mild AMS. A score of 6 or more signfies severe AMS and needs medical attention