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

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

ObjectivesObjectives

• Define altitude illnesses, include Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE) & High Altitude Pulmonary Edema (HAPE)

• List signs & symptoms of AMS, HACE, HAPE• Describe emergency care for AMS, HACE,

HAPE• Describe situations that require evacuation• Describe prevention techniques

Altitude Illness OverviewAltitude Illness Overview• Altitude 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 inhaled• Most common altitude illness is Acute

Mountain Sickness (AMS)• AMS commonly occurs when person

recently has reached heights of 6500 – 8000 feet

Altitude Illness OverviewAltitude Illness Overview (cont’d.)(cont’d.)

• 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 death

• High Altitude pulmonary edema (HAPE) is caused when fluid collects in air spaces in the lungs. HAPE can be life threatening.

Checking for Acute Mountain Checking for Acute Mountain Sickness Sickness (AMS)(AMS)

• Acute Mountain Sickness Signs & Symptoms:– Headache– Loss of normal appetite– Nausea, with/without vomiting– Insomnia– Unusual weariness & exhaustion, called

“lassitude”

Caring for AMSCaring for AMS• Descend or stop ascent & wait for improvement.

If illness progresses, descent is mandatory• Administer oxygen, if available & trained to do

so. Especially helpful during sleep• Give aspirin or acetaminophen for headaches, if

patient is able to swallow & has no known contraindication

• If prescribed & recommended by patient’s health care provider, help patient self-administer medication for altitude illness

Signs & Symptoms for High Signs & Symptoms for High Altitude Cerebral EdemaAltitude Cerebral Edema

• Loss of coordination or “ataxia” (e.g. can’t walk in a strain line or stand straight with feet together)

• Severe headache not relieved by rest/medication

• Bizarre changes in personality• Seizures or coma

Care for HACECare for HACE• Severely ill patients must descend as soon as

possible• Provide oxygen, if available & trained to do so• Keep patient from becoming chilled or

overheated• If prescribed & recommended, help patient self-

administer medications for altitude illness• Use portable hyperbaric chamber (caution: do

not use in lieu of descending)

Signs & Symptoms of High Signs & Symptoms of High Altitude Pulmonary EdemaAltitude Pulmonary Edema

• Dry cough, shortness of breath (at rest)• Shortness of breath becomes more

pronounced• Possible chest pain• Cough that becomes productive, first

frothy sputum, later reddish sputum

Care for HAPECare for HAPE• Severely ill patients must descend ASAP• In addition to descent, provide oxygen, if

available & trained to do so• Keep patient from becoming chilled or

overheated. Especially important for HAPE, since cold weather increases pulmonary artery pressures & makes HAPE worse

• Use portable hyperbaric chamber if available, not a substitute for descending

Guidelines for EvacuationGuidelines for Evacuation

• Patient with AMS should stop ascending until symptoms resolve themselves

• Patient with AMS does not require evac unless condition worsens, then descent is mandatory

• GO 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 IllnessesPreventing Altitude Illnesses• Most High Altitude Illnesses are preventable• Make a stage ascent, Allow body to adjust• Increase altitude of overnight camps gradually• If possible camp no higher than 8000 ft first

night, no more than 1000’ - 1500’ increase per night

• If trip starts > 9000’, spend 2 nights acclimating• Proceed higher during the day, but return to

lower altitude during day during acclimation period

Preventing Altitude Illnesses Preventing Altitude Illnesses (cont’d.)(cont’d.)

• Eat high carb diet:– >70% diet of carbs reduces symptoms of AMS– Start high carb diet 1-2 days before starting trip– Maintain appropriate exercise level until acclimated.

Avoid excessive shortness of breath– Stay well hydrated (higher loss of fluids at high

elevations)– Talk to your health care provider about possible

prescription medication

Questions???Questions???

What else could you add to your What else could you add to your First Aid Kit?First Aid Kit?