Altitude sickness can strike anyone ascending above 8,000 feet, regardless of fitness level. Understanding its forms, symptoms, and treatment can mean the difference between a successful adventure and a medical emergency.
Types of Altitude Sickness
Acute Mountain Sickness (AMS)
The mildest and most common form, affecting 25% of people above 8,000 feet.
Symptoms appear 6-24 hours after ascent:
- Headache (throbbing, worsens at night)
- Nausea and loss of appetite
- Fatigue and weakness
- Dizziness
- Difficulty sleeping
High Altitude Pulmonary Edema (HAPE)
Life-threatening fluid buildup in lungs. Can occur without AMS symptoms.
Warning signs:
- Extreme shortness of breath at rest
- Persistent cough, possibly with pink frothy sputum
- Chest tightness or congestion
- Blue lips or fingernails (cyanosis)
- Gurgling sounds when breathing
- Extreme fatigue
High Altitude Cerebral Edema (HACE)
Brain swelling that can be fatal within hours if untreated.
Critical symptoms:
- Confusion and disorientation
- Loss of coordination (ataxia)
- Severe headache unrelieved by medication
- Hallucinations
- Paralysis
- Loss of consciousness
Immediate Treatment Actions
For Mild AMS:
- Stop ascending immediately
- Rest at current elevation
- Hydrate aggressively (avoid alcohol)
- Take ibuprofen for headache
- Consider acetazolamide (Diamox) if available
For HAPE or HACE – MEDICAL EMERGENCY:
- DESCEND IMMEDIATELY – even 1,000 feet can help
- Administer oxygen if available
- Use portable hyperbaric chamber if available
- Give dexamethasone (for HACE) if available
- Evacuate to medical facility urgently
Prevention Strategies
Gradual Acclimatization
- Ascend no more than 2,000 feet per day above 8,000 feet
- "Climb high, sleep low" principle
- Rest day every 3,000 feet of elevation gain
- Spend 2-3 nights at moderate elevation before going higher
Hydration and Nutrition
- Drink 4-6 liters of water daily
- Avoid alcohol and sleeping pills
- Eat high-carbohydrate meals
- Maintain regular eating schedule
Medication Prevention
- Acetazolamide: 125-250mg twice daily, starting 24 hours before ascent
- Dexamethasone: For those with previous HACE
- Nifedipine: For previous HAPE sufferers
Risk Factors
Increased risk for:
- Rapid ascent rate
- Previous altitude sickness
- Living at low elevation
- Physical exertion before acclimatization
- Dehydration
- Respiratory infections
The Golden Rules
- Any illness at altitude is altitude sickness until proven otherwise
- Never ascend with symptoms of AMS
- If symptoms worsen, descend immediately
- Never leave someone with altitude sickness alone
Emergency Descent Protocol
When descent is necessary:
- Descend at least 1,000-2,000 feet
- Continue until symptoms improve
- Do not re-ascend same day
- Seek medical evaluation
- Consider evacuation if symptoms persist
Equipment for High-Altitude Travel
Essential items:
- Pulse oximeter
- Emergency medications
- Communication device
- GPS with elevation
- Emergency shelter
- Oxygen canister (for extreme altitude)
Remember: Altitude sickness is preventable with proper acclimatization. Don’t let summit fever override safety. The mountain will always be there for another attempt.