Post #3 of 6:
The most recent issue of the Wilderness Medicine Newsletter, Nov/Dec 2006, is dedicated to the recognition and management of high altitude illnesses. To follow is a series of postings regarding high altitude illnesses, recognition and management.
ACUTE MOUNTAIN SICKNESS (AMS)
Greatest danger is that untreated AMS may progress to life-threatening HAPE or HACE.
Don’t go up until the symptoms go down!
Signs & Symptoms: diagnosis is made when they have a headache and one or more of the following symptoms:
nausea with or without vomiting
fatigue or weakness
loss of appetite
dizziness or light-headedness
insomnia – difficulty sleeping
Treatment: Don’t go up until the symptoms go down!
Do not go any higher until all symptoms have cleared, which indicates acclimatization to that altitude.
Descend to the last sleeping altitude where they were symptom free or descend as far as necessary for improvement; 500 to 1000 meters is usually sufficient.
Continuing on with symptoms of AMS increases the risk of HAPE, HACE, and DEATH.
Rest, Rest, Rest, and Drink, Drink, Drink.
Hydration status is based on the color of urine they are producing.
If they decide to stay at altitude to acclimatize, if symptoms do not improve within 12 to 24 hours, DESCEND.
Mild analgesics: acetaminophen, paracetamol, aspirin, or ibuprofen.
Acetazolamide (Diamox), 250mg po (by mouth) every 12 hours until symptoms improve.
Children may take 2.5mg/kg body weight po every 12 hours.
For severe AMS:
Dexamethasone (Decadron), 4mg po every 6 hours.
Children may be given 1mg/kg body weight po up to 4mg and a second dose in 6 hours.
Oxygen, 2 – 4 liters per minute by nasal cannula, titrate up as needed.
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