Before looking at altitude sickness in terms of treatment and prevention, let's first take a look at what altitude sickness is, and it's signs and symptoms. As with any serious condition like this, it is good to know what to look for in case of a developing emergency while out on your hiking adventures.
What is Altitude Sickness?
Altitude Sickness occurs when the human body is exposed to high altitudes with low partial pressure of oxygen. Typically it starts to occur above 2400 meters (8000 feet).
One of the key problems with altitude sickness is that there is, as yet, no way to tell if someone will succumb to it. That is, you can take two people of equal fitness levels, health, etc. and expose them to high altitude. One will succumb to altitude sickness while the other will not with no identifiable reason as to why it hits one and not the other.
What to Look For?
Broadly speaking the initial symptoms of altitude sickness can feel like a bad hangover or the flu. However symptoms can become severe and life threatening if not dealt with appropriately. Symptoms are categorized as primary and severe with primary symptoms being present in the initial onset of altitude sickness, and severe symptoms setting in with prolonged exposure and where no remedial action has been taken.
First on the list to look out for is a headache developing above 2400 meters. If any of the symptoms listed below also appear in conjunction with the headache it may be a sign of altitude sickness . Of course, if multiple symptoms from the list below appear concurrently, the likelihood that it is altitude sickness increases. The symptoms are:
- Feeling Dizzy
- Feeling Drowsy
- Pins and Needles
- General feeling of being unwell
- Shortness of breath
- Swelling of hands, feet or face
If someone is entering the early stages of altitude sickness it is important to take remedial action as soon as possible. This is looked at in more detail below.
When altitude sickness enters the severe stages it can be life threatening and the symptoms listed below may manifest. These symptoms fall under two main condition headings HAPE and HACE:
HAPE – High Altitude Pulmonary Edema (aka fluid in the lungs)
- Persistent dry cough
- Shortness of breath even when resting
- Symptoms akin to bronchitis
HACE – High Altitude Cerebral Edema (aka swelling of the brain)
- Headache that does not go away with treatment
- Walking unsteadily / stumbling
- Worsening nausea
- Retinal hemorrhage
- Gradual loss of consciousness
Treatment is reviewed in more detail below but as both HAPE and HACE are life threatening, the act of moving to lower altitudes may help to save anyone afflicted with either condition.
Note: On a previous post related to hypothermia I mentioned the mumbles, fumbles, stumbles and grumbles. They are signs to watch out for, for many conditions and they apply here too as an indication that something may be up!
As mentioned above, there is no way to tell if someone will succumb to altitude sickness or not. However there are certain things you can do to try and best prepare yourself for higher altitudes. As with any of these things, prevention, where possible, is better than ever getting into the situation in the first place.
While it is possible to take some specific medications which may help prevent you from getting altitude sickness, these are generally only ever advised when someone has no other choice but to ascend high altitudes at a fast rate. Generally speaking, acclimatization is the preferred method of altitude sickness prevention.
To prevent altitude sickness from occurring, in the first instance, you should always ascend to higher altitudes (above the danger level of 2400 meters / 8000 feet) slowly and avoid any activities that will stress the body in the first 24 hours at the new altitude.
It is best to avoid alcohol or anything that will dehydrate the body as that will only serve to exacerbate any potential problem. Logically following on from that, you should try and stay as hydrated as possible while you acclimatize.
When moving to very high altitudes on an ongoing basis, hikers and climbers may use the ‘climb-high, sleep-low' approach. This refers to ascending a certain distance during the day and then coming back down a percentage of that to sleep at night. The recommended altitude increase in one day is 300 meters. Therefore, as an example, if starting on a given morning from 4500 meters and ascending to 5500 meters, you would then come back down to 4800 meters to sleep. You would then continue on in this vein as you ascend further and further up.
Most people will have heard of ‘base camps' the most famous probably being the North and South base camps at Everest. The North base camp is located in Tibet at 5150 meters and the South base camp in Nepal at 5364 meters. A key function of base camps is to help assist with the acclimatization process.
What to do?
If you’re unfortunate enough to find yourself in a position where someone in your party is getting altitude sickness, the first thing to do is to descend to a lower altitude. This is the only real way of dealing adequately with the problem.
If however you can't descend, below 3700 meters you can try to administer oxygen for mild to moderate symptoms.
In short, there is no good way of dealing with the problem while staying at the same altitude that is causing the problem. The affected person needs to be taken down to lower altitudes ASAP. This is of course not always possible e.g. if the weather does not permit.
In extreme situations or if you’re ever unsure what to do, call the emergency services if you can to ask for advice and guidance.
To date, the only hiking trip I have been on was where altitude was potentially a problem was when I climbed Gran Paradiso and Mont Blanc in the Alps. Mont Blanc rises to 4810 meters so the risk of altitude sickness was very real for me but luckily I got on fine. I of course spent time acclimatizing before I ascended and I whad expert guidance and training so all the necessary precautions were taken. Even with all that though, Altitude sickness could still have happened.
Even though I didn't succumb to it, I do recall feeling a bit funny when we reached the top of Mont Blanc. While I loved standing at the summit enjoying the view, I was happy enough to start to descend after 20 minutes or so as I did feel a little odd and my hunch was that it was altitude related.
It's worth noting as well, that one of the experienced Alpine Guides we had, told me that he had summited Mont Blanc dozens of times and never had an issue with Altitude sickness. Then one day, as he did his normal hike to the top with a group, he suddenly felt terrible, doubled over and started to throw up! Even for an experienced guide like him who had been at that altitude many times before, it can still just happen. As mentioned repeatedly above though, you just never know who or when someone may or may not be impacted so you need to keep a close eye on it to be sure.
Finally, this is not an exhaustive explanation of Altitude Sickness or the varying problems it can cause. Rather, I hope that this has provided a useful introduction to help generate awareness. Educate yourself as much as possible on this subject especially if you plan to take your hiking adventures above 2400 meters / 8000 feet.
Note: If you're planning to ascend to dangerous levels, always ensure you get expert training, I highly recommend professional guidance and assistance as best required.
Keep you and your hiking friends safe while hiking high! Stay safe!
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