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 self-

administer 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?