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| Altitude Illness |
Altitude illness is a medical problem ranging from mild discomfort to fatal illness that may occur on ascent to higher altitude. It can affect anyone, including those who are experienced and fit, and who ascend to more than about 8,000 feet (2438 m). Several factors appear to be important in adaptation to altitude, including how long the ascent takes, how high, and length of stay. Much variation exists between people; in addition, an individual's response may vary from ascent to ascent.Sign and symptoms are Mild to moderately severe symptoms: (Headache, Lack of energy and appetite, Mild nausea, Dizziness, Weakness and Insomnia), Severe symptoms: (Increased headache, Irritability, Marked fatigue, Shortness of breath with exercise, Nausea and vomiting, Irregular or periodic breathing at night and Difficulty or cessation of breathing), High altitude pulmonary edema (NAPE) symptoms: ( Excessive shortness of breath on exertion, Severe respiratory distress, Shortness of breath at rest, Dry cough and/or wheezing, Increased heart rate and breathing rate, Marked irregular breathing present at night, Gurgling breathing, Frothy cough, Wet crackling sounds in the lungs, Confusion and Coma), High altitude cerebral edema (HACE) symptoms: ( Progressive headache that is unrelieved by mild pain relievers, Lack of coordination, Confusion and bizarre behavior followed by unconsciousness, Other symptoms of moderate altitude sickness, such as dizziness, vomiting, and irritability, are usually present)
CAUSES:
The physiology of altitude illness is still not completely understood. The fundamental problem is a decrease in air pressure, resulting in less oxygen delivery to the body.
MOST OFTEN AFFECTED:
Altitude sickness can affect any age individual, men and women in equal proportion. Young, well-conditioned climbers have a higher incidence of altitude illness, probably because they push themselves more.
RISK FACTORS:
•In general, the faster and higher the ascent, the more likely a person will experience symptoms of altitude illness.
•Chronic illness
•Lack of conditioning
WHAT THE DOCTOR LOOKS FOR:
The doctor will consider other respiratory problems, such as pneumonia, respiratory infection, or heart failure.
TESTS AND PROCEDURES:
•A variety of blood tests may be performed.
•Arterial blood may be obtained to measure blood gasses.
•A chest X-ray may be done to evaluate the respiratory system.
•An electrocardiogram (EKG) may be done to monitor heart function.
GENERAL MEASURES:
•Severe cases of altitude sickness may require hospitalization.
•Treatment is tailored to fit the severity of disease and may be limited by the environment.
•Definitive treatment is to descend to a lower altitude. Dramatic improvement accompanies even modest reductions in altitude (as little as 1,000 feet).
•Giving oxygen helps relieve symptoms.
•Descent is rarely needed for mild cases. Drink fluids, eat a light diet, and curtail activity.
•For severe symptoms, the victim should be immediately evacuated to a lower altitude and given continuous oxygen.
•A portable hyperbaric chamber is another effective and practical alternative for severe symptoms when descent is not possible.
ACTIVITY:
Rest until symptoms clear.
DIET:
Increased intake of fluids, a light diet, and avoidance of alcohol
COMMONLY PRESCRIBED DRUGS:
•Aspirin or codeine to relieve headache
•Antibiotics, if infection is present
•Dexamethasone or acetazolamide
•Corticosteroids
PREVENTION/AVOIDANCE:
•Staged ascent with appropriate acclimatization
•Sleeping elevation: "Climb high and sleep low" is a prudent practice for anyone going above 12,000 feet (3656 m).
•Adequate hydration: Dehydration makes altitude sickness worse.
•Good physical conditioning
•Consider carrying a supply of oxygen.
•Some drugs can prevent or lessen the symptoms of altitude sickness.
COMPLICATIONS:
•Aspirin or codeine to relieve headache
•Antibiotics, if infection is present
•Dexamethasone or acetazolamide
•Corticosteroids
WHAT TO EXPECT:
•Mild to moderate altitude sickness resolves over 1 to 3 days. Climbers may resume ascent once symptoms subside.
•People with severe symptoms can expect complete recovery if there is no underlying disease. They should not resume ascent.
•Problems are more likely among people who have had one or more attacks.Labels: higher altitude |
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