Mountain Sickness – Causes, Symptoms, Preventions, Treatment

Mountain sickness is an illness that ranges from a mild headache and weariness to a life-threatening build-up of fluid in the lungs or brain at high altitudes. Acute mountain sickness (AMS) is the mildest and most common form. Because more people are traveling to areas of high elevation for skiing and mountain climbing, AMS has become a greater public health concern.

Acute mountain sickness is an illness that can affect mountain climbers, hikers, skiers, or travelers who climb too fast. It usually occurs when people rapidly reach a high altitude (typically above 8,000 feet or 2,400 meters).

Causes

The concentration of oxygen at sea level is about 21% and the barometric pressure averages 760 mmHg. As altitude increases, the concentration remains the same but the number of oxygen molecules per breath is reduced. At 12,000 feet (3,658 meters) the barometric pressure is only 483 mmHg, so there are roughly 40% fewer oxygen molecules per breath. In order to properly oxygenate the body, your breathing rate (even while at rest) has to increase. This extra ventilation increases the oxygen content in the blood, but not to sea level concentrations. Since the amount of oxygen required for activity is the same, the body must adjust to having less oxygen.

Symptoms

The most prominent symptom is usually headache, and most people also experience nausea and even vomiting, lethargy, dizziness and poor sleep. Symptoms are very similar to a really bad hangover. Acute mountain sickness can be diagnosed using a self-assessment score sheet. If you have recently ascended to over 2500m, have a headache and your total score is 3 points or more on the score sheet, then you have acute mountain sickness.

Prevention

Avoid ascents of greater than 300 metres per day if starting from above 3000 metres. If early signs of mountain sickness appear, rest for a day at the same altitude. If they persist or increase, descend at least 500 metres. Acetazolamide (Diamox) can be used to help prevent mountain sickness when a gradual ascent cannot be guaranteed. It should NOT be used as an alternative to a gradual ascent. It acts on acid-base balance and stimulates respiration. It should be combined with a good fluid intake. It should not normally be used in young children except under close medical supervision.

Treatment

* The higher the altitude at which a hyperbaric chamber is used, the greater the apparent descent can be simulated. (This is because portable hyperbaric chambers can increase atmospheric pressure by 2 pounds per square inch.)

* For example, a hyperbaric chamber at 9,800 feet (3,000 meters) can simulate a descent of 4,800 feet (1,500 meters), but the same hyperbaric chamber used at 24,600 feet (7,500 meters) can simulate a descent of 7,800 feet (2,400 meters).

* The main form of treatment for all forms of mountain sickness is to climb down (descend) to a lower altitude as rapidly and safely as possible. Supplemental oxygen should also be given, if available. People with severe mountain sickness may be admitted to a hospital.

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