Altitude sickness: answers to the most important questions

Symptoms:

• Headaches

• Loss of appetite/nausea

• Dizziness

• Slight tiredness/sluggishness

• Sleep disorders

Spontaneous complete recovery within two to three days is common. Very severe headaches, vomiting, severe tiredness and drowsiness are warning symptoms. AMS can turn into to HACE or HAPE.

AMS therapy:

• Stay at the current altitude, do not climb any higher.

• Only continue the ascent when the symptoms have completely disappeared

• Drink plenty of fluids: unsweetened tea or water

• Avoid physical exertion

• Treat the symptoms, e.g. take paracetamol/ibuprofen for headaches

• If there is no improvement within 24 hours: descend

• Sleep with your upper body elevated

In case of severe symptoms: stop physical exertion immediately and descend at least 300 to 500 metres as soon as possible. Treat the symptoms, e.g. paracetamol for headaches. This condition needs to be treated by a specialist! Depending on the situation, further treatment such as cortisone therapy may be advisable.

Symptoms:

• Severe headaches that do not respond to medication

• Vomiting

• Dizziness

• Ataxia (not possible to walk without support, coordination severely restricted)

• Confusion, hallucinations, altered consciousness

Usually rapid deterioration, which can lead to coma and death without treatment.

HACE therapy:

• Never continue the ascent

• Avoid physical exertion

• Administer oxygen if possible

• Cortisone therapy (specialist)

• Descend, the person who is ill should be transported (great risk of injury due to dizziness and difficulty walking)

Symptoms:

• Significant loss of performance

• Shortness of breath, increased breathing rate

• Coughing

• Increased pulse rate

• Crackling or rattling sounds in the lungs, foamy, bloody sputum

• Mild fever

Without treatment, this advanced altitude sickness can lead to death. If they descend immediately (ideally by means of transport), those affected usually recover fully and quickly.

HAPE therapy:

• Never continue the ascent

• Avoid physical exertion

• The upper body should be in an elevated position

• Administer oxygen if possible

• Treatment with Nifedipine Retard by a specialist (cardiac medication). Caution: this medication lowers blood pressure and can therefore also cause dizziness.

• Descend, the person who is ill should be transported

What exactly happens in the body is complex and not completely understood. One thing is certain: the higher you ascend, the lower the oxygen saturation of the air. The body can therefore take in less oxygen than usual. The respiratory rate and pulse increase because the body still tries to transport as much oxygen as possible to the organs. However, it raises blood pressure, which leads to the symptoms of altitude sickness.

Altitude sickness usually occurs above 2,500 meters. Everyone can be affected; women and men, young and old, even people who have trained and locals.

It varies. At best, mild symptoms disappear completely after a day’s rest. If the signs of altitude sickness are ignored, the condition persists, worsens and, in the worst case, is fatal.

Mild symptoms usually improve with a day off. It is important to conserve your body and drink plenty of water or unsweetened tea. If symptoms are severe or persistent: immediately descend by at least 1,000 metres of altitude – this is the most important step for treating altitude sickness. If this is not possible, it is important to improve the body’s oxygen supply. This is possible with bottled oxygen

For mild symptoms, non-steroidal anti-inflammatory medications such as ibuprofen, paracetamol or aspirin can also help. Steroids help with severe symptoms of altitude sickness or a high-altitude cerebral oedema. For high-altitude pulmonary oedema, blood pressure reducers can help.

In certain situations, the use of medicinal prophylaxis can be useful, for example, if a slow ascent cannot be guaranteed and the ascent exceeds 500 metres per day.

The active ingredient acetazolamide (Diamox) works by adjusting the body’s acid-base balance and increases respiratory activity. This improves the oxygen saturation of the blood and thus facilitates acclimatisation. Do not take Diamox without consulting a doctor, allergies and interactions with other medications must be checked, among other things. In addition, it is only used to prevent altitude sickness, not to treat it.

Once you have crossed the ‘threshold’ of 2,500 metres, there are a few rules you need to follow (altitude tactics):

• Slow ascent: 300 to a maximum of 500 metres per day. This gives the body time to get used to the lower oxygen content in the air.

• Plan a rest day or a few rest days every 1,000 metres.

• Sleep at a lower altitude than the highest point of the day (climb high, sleep low).

• Take a rest day as soon as the first symptoms occur

• Descend if symptoms do not improve

• For direct flights to above 2,500 metres above sea level, (e.g. Leh, Cusco, La Paz) acclimatisation for two to three days is recommended; do not make the ascent the same day!

• Drink plenty of fluids

• Avoid nicotine, alcohol, sleeping pills

• Before travelling, one or more stays at an altitude of over 2,500 meters will help the body to get used to the altitude.

Altitude sickness can affect everyone; backpackers on Machu Picchu in Peru, professional and amateur climbers, tourists on the Jungfraujoch or cycling enthusiasts cycling through a pass. Most of the time, altitude sickness develops from 2,500 metres above sea level, but it can also occur at lower altitudes.

There are risks that contribute to altitude sickness. These are:

• If you’ve had altitude sickness in the past

• Fast ascent; going from moderate altitudes to more than 3,000 metres and from 4,000 metres above sea level at more than 300 metres of altitude per day

• Continuing the ascent despite initial symptoms, overexertion

• Dehydration

• Infections

In addition, people who suffer from migraines, women and young adults are more vulnerable.