High Altitude Sickness

What is high-altitude or mountain sickness?

Sometimes, people get sick at high altitudes, especially, when they go up in the high altitude, which is called mountain sickness or high-altitude sickness.

What causes this problem?

Lack of oxygen causes high-altitude sickness. As altitude increases, the air becomes thinner, which means less oxygen exists in the atmosphere. You get less oxygen in your lungs while you take each breath, so the amount of oxygen in your blood declines. (This is called hypoxia) (hi-POKS'e-ah). Every person can experience mountain sickness, but it may be more severe among them who have heart or lung problems.

Type of Altitude Sickness

AMS: - Acute Mountain Sickness
HAPE: - High Altitude Pulmonary Edema
HACE: - High Altitude Cerebral Edema

What are the symptoms?

Symptoms usually begin within 48 hours of arriving at high altitude, you may have it the higher you go up, the greater the effects. People can notice effects when they go to an altitude of 7,000 to 8,000 feet. If you have heart diseases such as heart failure or lung disease such as emphysema, you may have symptoms at lower altitudes. Symptoms include both heart rate and breathing rate increase as the body tries to send more oxygen to its tissues. At very high altitudes, body fluid can leak into the brain called brain or cerebral edema or into the lungs, pulmonary edema. Both of these conditions can be serious or even life-threatening.

A. Acute Mountain Sickness - AMS

Mild symptoms feel like hangover / not feeling well
A headache
Shortness of breath
Loss of appetite
Sleep Disturbance

B. High Altitude Pulmonary Edema (water in the Lung) - HAPE

Increasing shortness of breath at rest
A severe cough- Dry /Productive
Very tired – Unusual fatigue while walking
High pulse rate i.e. 110
The blueness of face, lip, fingernails – that means inability to transport Oxygen into the blood
It can happen after 2 nights of arrival in the altitude.

C. High Altitude Cerebral Edema (water in the Head) - HACE

Severe symptoms of Altitude Sickness
A severe Headache
Walking like a drunk (Ataxia)
Mental confusion/Altered mental status
Irritable – Does not want to be bothered by other people.
Unconsciousness or Coma
Test: Tandem walking test, Hell to toe step. Fall off from the line.


Acclimatization – after 1000m, ascend down to the lower altitude; stay one more night for acclimatization and then only go up in the high altitude.


Do not make RAPID ASCENT; don’t go too fast too high.
No alcohol, sleeping pills, and smoking.
Drink more fluid 3-4 liter a day clean water-boiled or treated/tea/coffee/soup/juice etc.
Do not carry heavy packs; 10-12 k.g is ok.
Climb higher sleep lower.
Over 3000m, 300m, ascend a day.
Do not travel alone.

DESCENT is the best medicine; do not wait for the Helicopter
Diamox – for AMS- 125 Mg, before dinner – for the sleeping problem if feeling Suffocated
Nifedipine for HAPE
Steroids/Dexamethasone for HACE
Hyperbaric Bag – Gamow Bag
Golden Rules
Awareness of altitude sickness

If you have mild symptoms, do not go higher, Take Aspirin.
If you have worsening symptoms, GO DOWN.
Do not leave your team member behind unattended either trekker or porter.
First Aid Medical Kit
First Aid Medical Kit


  • Sphygmomanometer (Blood pressure Instrument)
  • Syringes (20 ml, 10 ml)
  • Hot water bottle
  • Pen and writing pad
  • Stethoscope
  • Thermometer
  • Matchbox
  • Splints
  • Scissors
  • Tongue blades
  • Penlight
  • Cervical collar

Bandage and Dressings

  • Sterile gauze pads (large and small)
  • Band-aids
  • Triangular Bandages
  • Elastic Bandages (3, 4 and 6 inches)
  • Adhesive Tapes
  • Eye pads
  • Cotton roll (large and small)
  • Q-tips
  • Safety pins


For pain
Paracetamol (500mgs tablet and 125 mg in 5 ml syrup)
Aspirin (300mgs tablet)

For Allergy
Avil (25 mg tablet)
Benadryl Syrup
Trexel – (60mgs tablet, 30 mg in 5 ml syrup)

Eye: Neosporin Ophthalmic Cream
Throat and Lung: Amoxicillin (125mg per 5 ml syrup, 250 mg and 500 mg tablets)

For Abdomen
Metronidazole(200mgs, 400mgs tablets)
Tinidazole (500 mg tablets)
Oral Rehydration powder
Loperamide (2 mg tablets)

For open wounds
Cloxacillin and Cephalexin(125 mg in 5 ml 250 mg and 500 mg tablets)
For urinary infections
Norfloxacin (200 mg, 400 mg tablets)
Betadine (Solution and cream)
Miconazole Cream (for fungal infection)
Silver sulphadiazine(for burn injury)