Acute Mountain Sickness In Monday’s Medical Moments

20170216_115353When I started in the hiking community, I had no idea what Acute Mountain Sickness was, other than I knew that going to higher elevations could make you feel sick!  I grew up in KC and Tulsa, where there is no “real” elevation.

So, let’s go over a basic explanation of Acute Mountain Sickness (AMS).  The first thing I would like to do is clarify a few points:

  1.  AMS comes into play at approximately 2500m, or 8,000 feet, and higher.
  2.  Advanced physical fitness does not keep a person from being inflicted with AMS.
  3.  Many cases advance to more severe cases because the person ignores the first signs, and just “pushes thru”.

BONE: DON’T LET YOUR FEAR OF APPEARING LESS FIT THAN OTHERS STOP YOU FROM DEALING WITH YOUR SYMPTOMS. Anyone can get AMS.

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Acute Mountain Sickness can present as a mild case.  Symptoms will most likely be a headache, nausea, loss of appetite, and difficulty sleeping.  With this mild case, a person may just feel “yuck”, or they may feel horrible.  If you, or someone in your group, presents with these  above symptoms, drink a Liter of water and rest for 1 hour.  If, after a Liter of water and an hour of rest, you do not feel better, your best plan of action is to work your way back down to 7,000 feet.

HAPE – High Altitude Pulmonary Edema – Excess fluid in the lungs is a more serious case of AMS. Symptoms of HAPE are the same as AMS, and may also include difficulty breathing, possible high fever, and coughing up white or pink frothy substance.  Symptoms of AMS can sometimes be confused with having a chest infection of some sort.  HAPE can become very serious, if not already, and really the only acceptable plan of action is to be taken down to 7,000 feet.  A follow up with a medical professional is recommended.

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14917183_1783976385209877_4362953165875358881_oHACE – High Altitude Cerebral Edema – Excess fluid on the brain is the most severe and dangerous case of AMS.  Symptoms of HACE can include a severe headache, irrational/bizarre behavior, nausea and vomiting, drowsy, confusion.  HACE can lead to a coma, and even death in a few hours.  This situation requires the fastest evacuation to medical treatment as possible.

So, what causes AMS?  While an in depth understanding is not completely available, nor the goal of this post, but here is how WebMD explains AMS:  Air is “thinner” at high altitudes. When you go too high too fast, your body cannot get as much oxygen as it needs.

Prevention of AMS, or at least decreasing the odds, includes slower ascents and taking lots of rest periods, allowing for acclimation; adjustment to the new elevation.  Diamox is a medication that you could also visit with your doctor about, furthermore,  Diamox can be prescribed before and during  a high elevation adventure, to aid in acclimation.  There are also a few medication that can aid in the treatment of HAPE and HACE, however, they also require a prescription, and in depth consultation with your physician.  These medications include Nifedipine, Viagra, and/or Dexamethasone.   If you are lucky enough to have a trained medical person with you, they may have these medications with them.

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*For those of you that do not know, I am an RN.  I have practiced in an ICU/Emergency Room setting for the majority of my almost 12 years of being a nurse.  I have completed my Wilderness Upgrade For Medical Professionals in 2016, with the National Outdoor Leadership School (NOLS).  In an attempt to make wilderness medical situations/emergencies just a little less scary and/or confusing for those who don’t have medical training, I am going to periodically put out “Monday’s Medical Moment” posts. Posts will be for basic information only.  Care and treatment by a medical professional is not to be replaced by this post. 

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