What is Altitude Sickness?

A mixture (syndrome) of problems like headache, nausea, shortness of breath, tiredness encountered at high altitude i.e. above 3000 meter.

Cause / Factor of Altitude Sickness

  1. less oxygen
  2. low pressure i.e. barometric pressure
  3. rapid ascent
  4. possibly dehydration
  5. hypothermia etc..

Type of Altitude Sickness

  1. AMS: – Acute Mountain Sickness
  2. HAPE: – High Altitude Pulmonary Edema
  3. HACE: – High Altitude Cerebral Edema

Symptoms of Altitude Sickness

  1. Acute mountain sickness – ams mild symptoms feel like hangover / not feeling well
  2. Headache
  3. Fatigue/tiredness
  4. Nausea
  5. Shortness of breath
  6. Loss of appetite
  7. Sleep disturbance
  8. Dizziness
  9. High altitude pulmonary edema (water in the lung) – hape
  10. Increasing shortness of breath at rest
  11. Severe cough- dry /productive
  12. Very tired – unusual fatigue while walking
  13. High pulse rate i.e. 110
  14. Blueness of face, lip, finger nails – that means inability to transport oxygen into the blood
  15. It can happen after 2 nights of arrival in the altitude.
  16. High altitude cerebral edema (water in the head) – hace

Severe Symptoms of Altitude Sickness

  1. Severe headache
  2. Vomiting
  3. Walking like a drunk (ataxia)
  4. Mental confusion/altered mental status
  5. Irritable – does not want to be bothered by other people.
  6. Unconsciousness or coma.
  7. Test: tandem walking test, hell to toe step. fall off from the line

Decision Making

Find out the problem i.e. at altitude assumes all problems are altitude sickness unless proven otherwise. if it is altitude problem with mild symptoms, stay at the same altitude until the symptoms gone. e.g. take an aspirin, try to go up but listen to your body. if symptoms are worsening, go down.


  1. Acclimatization – after 1000m.
  2. Ascent, stay one more night for acclimatization.
  3. Do not make rapid ascent; don’t go to fast too high.
  4. No alcohol, sleeping pills and smoking.
  5. Drink more fluid 3-4 liter day clean water – boiled or treated/tea/coffee/soup/juice etc.
  6. Do not carry heavy packs; 10-12 kegs is ok.
  7. Climb higher sleep lower.
  8. Over 3000m, only 400m. ascent a day.
  9. Do not travel alone.

Golden Rules

  1. Awareness of altitude illness.
  2. If you have mild symptoms, do not go higher, take aspirin
  3. If you have worsening symptoms, go down.
  4. Never leave your team member behind unattended either trekker or porter.


  1. Descent is the best medicine; do not wait for the helicopter.
  2. Medicine
  3. Oxygen
  4. Diamox – for ams- 125 mg. before dinner – for sleeping problem if feeling suffocated.
  5. Nafedipine for hape
  6. Steroids/dexamethasone for hace.
  7. Hyperbaric bag – gamow bag

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