Altitude sickness in Mountain – to know about the safety measures to avoid AMS and to understand the basic medical treatments once AMS hits you are most important things for you before trekking in Nepal. The Acute Mountain Sickness is an illness caused due to gain in elevation. Compared to sea level the amount of oxygen in higher altitude is less and the oxygen level goes thinner as trekkers continue to gain higher altitude. Here we have listed the details of AMS please have a look.
The symptoms of AMS are can be several. They vary from person to person. However, general symptoms of AMS are as follows. If you are seen with, any of these symptoms do not delay to identify the illness and go for the quick treatment ASAP.
Severe cases of AMS may lead you to HAPE (High Altitude Pulmonary Edema) or HACE (High Altitude Cerebral Edema). HAPE hits your respiratory system where as HACE hits your Nervous System.
Symptoms that may occur with more severe acute mountain sickness include:
Related Oxygen Rate at Different Altitude
Altitude Oxygen Rate
In Meters In Feet
8.850 29.035 33%
8.000 26.247 36%
7.000 22.966 41%
6.000 19.865 47%
5.500 18.045 50%
5.200 17.061 52%
5.000 16.404 53%
4.500 14.764 57%
4.000 13.123 60%
3.500 11.483 64%
3.000 9.843 68%
Sea Level 100%
HACE is caused by an accumulation of fluid in or around the brain. Typically, symptoms and signs of AMS become worse and HACE develops. Someone with HAPE may also develop HACE.
Heel-to-toe walking test: The victim is asked to take 10 very small steps, placing the heel of one foot to the toes of the other foot as they go. Reasonably flat ground is necessary and the victim should not be helped
Standing test: The victim stands with eyes closed, feet together and arms by their sides
Finger-nose test: With eyes closed, the victim repeatedly and rapidly alternates between touching the tip of their nose with an index finger then extending this arm to point into the distance (a useful test if the victim is in a sleeping bag)
Mental arithmetic test: Give the victim a mental arithmetic test, eg. subtract 7 from 100, 7 from 93, and so on (but remember some people may be poor at arithmetic even at sea level)
If the victim cannot do any of the above tests easily (or refuses to cooperate), or show excess wobbling or falling over in the two first tests (be prepared to catch the victim if they fall over!), assume they are suffering from HACE. If in doubt about the victim performance, compare with a healthy individual. Be prepared to keep repeating these tests.
Descend immediately (prompt descent will begin to reverse the symptoms). Descend as low as possible, at least 1000m /3280 ft. Descend at night or in bad weather if necessary. Carry the victim if possible, as the exertion of walking can make the illness worse
If descent is not immediately possible (eg. dangerous terrain or weather, not enough helpers or while waiting for a helicopter), oxygen or the use of a PAC and appropriate medications will keep the person alive until descent can be undertaken
NB: If both oxygen and a pressure bag are available, give the oxygen while the bag is being prepared and after the victim comes out of the bag. Do not give oxygen inside the bag unless it is designed for this purpose and you have been trained to do so.
Prop the victim up in a semi reclining position as lying down flat may make their condition worse
Avoid even the slightest exertion if this is possible. Even walking a few steps may make their symptoms worse or reappear. Do not leave the victim alone.
If a person is turning blue or is falling into unconsciousness, give them rescue breathing before they stop breathing
Symptoms of HAPE are due to the accumulation of fluid in or around the lungs. It may appear on its own without any preceding symptoms of AMS (this happens in about 50% of cases), or it may develop at the same time as AMS. HAPE can easily be mistaken for a chest infection or asthma: if in doubt treat for both.
A reduction in physical performance (tiredness, severe fatigue) and a dry cough are often the earliest signs that HAPE is developing breathlessness.
In the early stages of HAPE, this may mean just taking a bit longer to get one breath back on resting after mild exercise. Later on, there is marked breathlessness with mild exercise. Finally, breathlessness occurs at rest. Record the respiratory rate (NB: At 6000m/19700ft, acclimatized respiration rate is up to 20 breaths per minute)
The dry cough may later become wet with frothy sputum, which may be bloodstained (pink or rust colored). This is a serious sign
Wet sounds in the lungs when breathing in deeply (place your ear on the bare skin of the victim back below the shoulder blades; compare with a healthy person).
Note: There may be NO wet sounds in even quite severe HAPE: this is called dry HAPE.
There may be: mild fever up to 38.5ºC, a sense of inner cold, pains in the chest
Blueness or darkness of face, lips, tongue or nails due to lack of oxygen in the blood (cyanosis)
Drowsiness, difficulty waking up, coma, death
Same general treatment as for HACE, EXCEPT: Use oxygen or the PAC and appropriate medications will keep the person alive until descent can be undertaken