Beware, AMS – Acute Mountain Sickness: symptoms, stages, prevention

25/04/2024

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BEWARE OF ACUTE MOUNTAIN SICKNESS!!!

What you need to know and how to avoid getting sick? Symptoms, stages, prevention of acute mountain sickness.
Symptoms of acute mountain sickness can occur at altitudes above 2500 m.

“AMS” or altitude adaptation is physiological changes in the body associated with oxygen starvation of the body. There are three stages of acute mountain sickness/altitude adaptation.
The process of hypoxia occurs due to the fact that the partial pressure of air is lower, which affects the efficiency of breathing. Accordingly, the amount of oxygen that enters the blood is less.

Stages of acute mountain sickness

Stage 1 of AMS” occurs in almost everyone. At this stage, there may be slight dizziness, drowsiness, lack of appetite, slight tingling in the head and limbs, shortness of breath while moving up and under load.
If these symptoms appear, we recommend drinking more water (at least 3 liters of liquid per day), reducing the load, pace of movement, rest, and not overeating. To relieve a headache at night, you can take ibuprofen, spasmalgon, paracetamol.

Stage 2, acute stage of AMS. Symptoms: acute headache, nausea, diarrhea, vomiting, against the background of overwork, the temperature can either drop to 36° or rise to 37-38° C, severe dizziness, shortness of breath even at rest, due to high overexcitation, there is no sleep. Risk of developing pulmonary or cerebral edema after 12-24 hours.

If these symptoms appear, it is strictly contraindicated to gain altitude; if possible, descend to 500-1000 m until rest and recovery, drink plenty of warm fluids (4 liters or more), tablets: diacarb, aminophylline.

Stage 3 is dangerous and fatal. At this stage, the pulse at rest is 130-150 or higher, coordination of movements is impaired, unrelated speech, high temperature 38 ° C – 39 ° C (cerebral edema is possible without an increase in temperature), you cannot lie down, you cannot sit (the ideal position is reclining ), in case of pulmonary edema, wheezing and compression in the lower chest, difficulty breathing.

The patient urgently needs to be taken down, as low as 1000-2000 m as possible, hospitalization is necessary. If the patient can walk and there is no possibility of emergency hospitalization, then he needs to go overnight or during the day.
Medicine: intramuscular/dexamethasone tablets, antibiotics in case of pulmonary edema, diuretics (to remove fluid from the body), warm drinks.

Prevention, how to avoid exacerbations, the acute phase of acute mountain sickness?

Walking day no more than 8-9 hours

Gain (master a new altitude) per day 700-1000 meters for altitudes up to 4500 m, 500-700 meters for altitudes 4500-6000 m, 300-500 for altitudes above 6000 m. If there is already acclimatization, then the altitude gain per day can be more.

For altitude, every 1500-2000 m of elevation gain, take rest days, if possible with a descent down at night (the rule is from 4000 m and above).

For altitudes of 4500 m and above, the rule “walk high, sleep low” works well; before going out to spend the night at a new height, you can go radially to it (climbing in one direction and returning to the starting point).

After intense walking days, more than 12 hours should be a day of rest and recovery, preferably at low altitudes. If the walking day is 9-12, it is recommended to reduce the load, the duration of the walking day.

Monitor your heart rate during hikes/ascents (most modern smartwatches allow you to do this). It is optimal for its value to be at the level of 110-130, no more. For a short time, at the end of the day or climb, the heart rate will of course increase, this is inevitable, by controlling this parameter you will be able to maintain strength and recover faster at high altitudes.

Avoid hypothermia and overheating. Since this is an extra burden for the body. In case of a cold or exacerbation of chronic diseases, stop climbing, if possible, go down 1000-2000 m. You need to understand that in case of inflammation, for example, when the temperature rises from 37.5° C to 38° C, the amount of oxygen for the body is required twice as much , which leads to a risk of pulmonary edema.

Start the pulse oximeter. Take daily measurements of pulse and oxygen in the blood (pulse oxygen meter) in the morning and evening. The critical oxygen index for altitudes of 5000-6000 m is 65-70%. With such oxygen levels in the blood at such altitudes, further climb is prohibited.
The critical pulse at rest is 100-120 beats/minute and above. For reference, when the pulse is 85-90 beats/min, a person can no longer fall asleep; he needs to take medications to lower the pulse.

Watch also a detailed video about acute mountain sickness