At 11000ft, the standard barometric pressure is 69 kPa (514 mmHg). This means that there is 68% of the oxygen available at sea level.
The Golden Rules
1. If you feel unwell, you have altitude sickness until proven otherwise
2. Do not ascend further if you have symptoms of altitude sickness
3. If you are getting worse then descend immediately
*created by Dr David Shlim
Altitude Travel Handbook
1. Kept our mind away from the thought of any kind of ‘sickness’
2. Stayed indoors for most of the day we landed at Leh.
3. Travelled only locally (Leh sightseeing) on day 2.
4. Travelled only just around Leh – some palaces / monasteries on day 3.
(The first 3 days of soft travel makes you more acclamatised)
5. Then ventured out to far flung areas like Lamayuru on day 4. Stayed at Lamayuru that night.
6. Then returned to Leh on day 5. Stayed at Leh.
7. Then on day 6 we ventured out for the more arduous Nubra valley via Khardungla Pass – stayed at Nubra for that night.
8. Back to Leh on day 7 – rest at Leh
9. Next day to Pangong – stay at Pangong.
10 Back to Leh and rest a day before flying back.
British Mountaineering Council (BMC) www.thebmc.co.uk/medicine
Epilepsy action website www.epilepsy.org.uk/info/sportsandleisure/index
Foreign & Commonwealth Office travel advice www.fco.gov.uk/travel
Gamow Bag www.chinookmed.com
General travel information www.fitfortravel.nhs.uk
International Porter Protection Group (IPPG) www.ippg.net/guidelines/index.html
International Society for Mountain Medicine (ISMM)
Kathmandu Environmental Education Project (KEEP) www.keepnepal.org
- has a full list of UK doctors holding the UIAA Diploma of Mountain Medicine
Mountains for Active Diabetics (MAD) www.mountain-mad.org
Oxygen (constant flow system) www.topout.co.uk and www.poisk-ltd.ru
Oxygen (demand flow system) www.summitoxygen.com
Portable Altitude Chamber (PAC) www.treksafe.com.au
Union Internationale des Associations d’Alpinisme (UIAA) www.uiaa.ch/index.aspx
What is altitude sickness?
Altitude sickness has three forms. Mild altitude sickness is called acute mountain sickness (AMS) and is quite similar to a hangover – it causes headache, nausea, and fatigue. This is very common: some people are only slightly affected, others feel awful. However, if you have AMS, you should take this as a warning sign that you are at risk of the serious forms of altitude sickness: HAPE and HACE*. Both HAPE and HACE can be fatal within hours.
HAPE is excess fluid on the lungs, and causes breathlessness. It is never normal to feel breathless when you are resting – even on the summit of Everest. This should be taken as a sign that you have HAPE and may die soon. HAPE can also cause a fever (a high temperature) and coughing up frothy spit. HAPE and HACE often occur together.
If you think you may have had HAPE, please register with the International HAPE database
HACE is fluid on the brain. It causes confusion, clumsiness, and stumbling. The first signs may be uncharacteristic behaviour such as laziness, excessive emotion or violence. Drowsiness and loss of consciousness occur shortly before death.
Treatment of HAPE and HACE
Immediate descent is absolutely essential
Dexamethasone and acetazolamide should both be given, if available
Pressure bags and oxygen gas can buy time
What causes altitude sickness?
Two things are certain to make altitude sickness very likely – ascending faster than 500m per day, and exercising vigourously. Physically fit individuals are not protected – even Olympic athletes get altitude sickness. Altitude sickness happens because there is less oxygen in the air that you breathe at high altitudes.
Altitude sickness prevention
Go up slowly, take it easy, and give your body time to get used to the altitude. The body has an amazing ability to acclimatise to altitude, but it needs time. For instance, it takes about a week to adapt to an altitude of 5000m.
Can I take drugs to prevent altitude sickness?
As with everything, many ‘quack’ treatments and untested herbal remedies are claimed to prevent mountain sickness. These treatments can make AMS worse or have other dangerous side effects – many herbs are poisonous. Only one drug is currently known to prevent AMS and to be safe for this purpose: acetazolamide (diamox). It causes some minor side effects, such as tingling fingers and a funny taste in the mouth.
*HAPE stands for high altitude pulmonary oedema, and HACE for high altitude cerebral oedema. These medical terms simply mean ‘fluid on the lungs/brain’.
Please help us to spread this information as widely as possible. Everyone who travels to high altitude should know this. Following these simple rules could prevent many deaths in the mountains each year.
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