Lesson 15: Altitude Sickness Emergency Reference Guide p. 30-33

ObjectivesDefine altitude illnesses, include Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE) & High Altitude Pulmonary Edema (HAPE)List signs & symptoms of AMS, HACE, HAPEDescribe emergency care for AMS, HACE, HAPEDescribe situations that require evacuationDescribe prevention techniques

Altitude Illness OverviewAltitude 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 inhaledMost common altitude illness is Acute Mountain Sickness (AMS)AMS commonly occurs when person recently has reached heights of 6500 8000 feet

Altitude Illness Overview (contd.)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 deathHigh 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:HeadacheLoss of normal appetiteNausea, with/without vomitingInsomniaUnusual weariness & exhaustion, called lassitude

Caring for AMSDescend or stop ascent & wait for improvement. If illness progresses, descent is mandatoryAdminister oxygen, if available & trained to do so. Especially helpful during sleepGive aspirin or acetaminophen for headaches, if patient is able to swallow & has no known contraindicationIf prescribed & recommended by patients health care provider, help patient self-administer medication for altitude illness

Signs & Symptoms for High Altitude Cerebral EdemaLoss of coordination or ataxia (e.g. cant walk in a strain line or stand straight with feet together)Severe headache not relieved by rest/medicationBizarre changes in personalitySeizures or coma

Care for HACESeverely ill patients must descend as soon as possibleProvide oxygen, if available & trained to do soKeep patient from becoming chilled or overheatedIf prescribed & recommended, help patient self-administer medications for altitude illnessUse portable hyperbaric chamber (caution: do not use in lieu of descending)

Signs & Symptoms of High Altitude Pulmonary EdemaDry cough, shortness of breath (at rest)Shortness of breath becomes more pronouncedPossible chest painCough that becomes productive, first frothy sputum, later reddish sputum

Care for HAPESeverely ill patients must descend ASAPIn addition to descent, provide oxygen, if available & trained to do soKeep patient from becoming chilled or overheated. Especially important for HAPE, since cold weather increases pulmonary artery pressures & makes HAPE worseUse portable hyperbaric chamber if available, not a substitute for descending

Guidelines for EvacuationPatient with AMS should stop ascending until symptoms resolve themselvesPatient with AMS does not require evac unless condition worsens, then descent is mandatoryGO 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 IllnessesMost High Altitude Illnesses are preventableMake a stage ascent, Allow body to adjustIncrease altitude of overnight camps graduallyIf possible camp no higher than 8000 ft first night, no more than 1000 - 1500 increase per nightIf trip starts > 9000, spend 2 nights acclimatingProceed higher during the day, but return to lower altitude during day during acclimation period

Preventing Altitude Illnesses (contd.)Eat high carb diet:>70% diet of carbs reduces symptoms of AMSStart high carb diet 1-2 days before starting tripMaintain appropriate exercise level until acclimated. Avoid excessive shortness of breathStay 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?