Acute Mountain Sickness - Prevention, Detection & Treatment

Factors that Influence Acute Mountain Sickness

• Altitude: of course the main factor in getting AMS. The higher the altitude the more serious the conditions will be that cause AMS.
• Rate of Ascent: the speed in which you gain altitude. The faster you ascend the less change you give your body to acclimatize and adjust to the higher altitude conditions.
• Degree of Exertion: the more you physically exert your body the more likely you are to suffer from AMS.
• Hydration: the more dehydrated you are the more likely you are to suffer from AMS.

Preventing Acute Mountain Sickness

• Start low and walk slowly but steadily to higher altitudes. Likewise take slow, deep and deliberate breaths. See our High Altitude Hiking Techniques section for more details.
• The sleeping altitudes are most important and make sure that the difference in height between two consecutive sleeping places is not higher larger than 1500 feet (500 meters). You can reach higher altitude differences during the day time but make sure your second camp is not more than 1500 feet from your first camp.
• If you must drive or fly directly to altitudes higher than 10000 feet (3000 meter) than take at least a period of 24 hours of rest before you start your steady ascent.
• Keep yourself well hydrated (3-4 liters per day) and check your urine for clarity.
• Eat a diet high in carbohydrates.
• Do not over exert yourself and keep a steady Walking Rhythm without any large peaks in physical effort.
• Do not use medications as prophylactics. There could be unpredictable side effects and they could mask early warning signs and give a false sense of security.
• Constantly check yourself for symptoms of AMS which will be described below.

Primary Symptoms of Acute Mountain Sickness

• Lassitude: can be mistaken for physical exhaustion but exhaustion disappears after proper food and fluid intake and rest. Lassitude typically worsens in a period of 24-48 hours where you are no longer capable of finding the energy to eat, drink, talk or do anything.
• Ataxia / Coordination Loss: ataxia is the loss of co-ordination and can worsen rapidly to the point where you loose all sense of co-ordination and direction. There are two easy ways to test for ataxia and the testing should be performed by team mates:
  
  
  • Toe the Line: Draw a Line and have the person walk heel-to-toe straight over the line. Difficulty in keeping balance or even falling over are signs of ataxia.
  • Romberg Test: have the person stand straight up with arms at the sides and feet together. Place your arms around the body of the person and tell the person to close his/her eyes. The person is showing signs of ataxia if the person starts swaying in 15-20 seconds

Secondary Symptoms of Acute Mountain Sickness

• Headaches: are the most common symptom of AMS. If you feel a headache after a period of exertion take a rest, breath deeply and/or take an aspirin and wait for the headache to disappear. Stop ascending if the headache persists even after a nights rest and medication and is moderate to sever. If the headache is severe and persists after a second night's rest it is a clear sign that something is wrong and you will need to descend at least 1000 feet (350 meter).
• Cheyne-Stokes Syndrom / Periodic Breathing: you might find yourself repeatedly stopping breathing for periods of 10 to 15 seconds. This is called Cheyne-Stokes Syndrom and is not a serious condition as long at is not combined with the other symptoms of AMS. It can however cause insomnia which is another common high altitude ailment. In higher altitudes it is important to breath deeply and steadily.
• Gastrointestinal Disorders: loss of appetite, reduced urine output and especially nausea are all potential signs of AMS.

Edema

• High Altitude Cerebral Edema (HACE): is the accumulation of excessive fluid in the substance of the brain. The brain is especially susceptible to injury from edema, because it is located within a confined space and cannot expand. CE develops itself over the course of several days. Symptoms are those of AMC in combination with disorientation, hallucinations and ultimately unconsciousness.
• High Altitude Pulmonary Edema (HAPE): is the accumulation of excessive fluid in the lungs. The fluid in the lungs prevents effective oxygen exchange. As the condition becomes more severe, the level of oxygen in the bloodstream decreases, and this can lead to impaired cerebral function and even death. Symptoms include shortness of breath even at rest, tightness in the chest, extreme fatigue, a feeling of impending suffocation, weakness, and a persistent cough bringing up white, watery or frothy fluid. Confusion and irrational behavior are signs that insufficient oxygen is reaching the brain.

Treating Acute Mountain Sickness

• Rest, breath deeply and assure a good food/fluid intake. In case of light symptoms you should take a rest and perhaps use some aspirin to lighten possible headaches.
• Take high altitude medications like Diamox.
• Stop your ascent and rest at the same altitude. If the symptoms do not disappear after 24 hours or even worsen you should stop your ascent and rest at the same altitude.
• Descend 1000 feet (350 meters). If symptoms remain after 48 hours or worsen do not take any chances and descend at least 1000 feet or more.
• Seek medical assistance. If the symptoms are very severe descend even further down and seek medical assistance. Do not wait for the morning but rather descend in the night. Never have the patient descend alone! Do not hesitate to call in a helicopter for immediate evacuation if the severity reaches life threatening conditions.

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