Sunday, March 25, 2012

Altitude Sickness or Illness


Dijukno when you go higher in altitude, the amount of oxygen available in each breath grows lower lf you go too high too fast, problems may occur?   For simplicity, these problems can be divided into two categories:
 mild and severe.


MILD ALTITUDE ILLNESS

Anyone coming from lower altitudes to 10,000 feet (3,048 meters), and often even at lower altitudes, may complain of acute mountain sickness (AMS):  headache, unusual fatigue, nausea, loss of appetite, difficulty sleeping, unusual shortness of breath when exercising, and lassitude.  The best treatment is:  Do not go up until the symptoms go down.  Stop ascending until the signs and symptoms go away.  Light exercise is recommended.  Also, stay hydrated and well fed. Acetazolamide may be used for treatment after symptoms appear, and this drug actually aids in acclimatization for many people.  Consult your physician, and do not use acetazolamide if you are allergic to sulfa drugs.  If the symptoms do not go down within two days, the patient should descend further.  A descent of 2,000 feet (610 meters) usually brings relief of symptoms.


SEVERE ATTITUDE ILLNESS

Untreated mild illness may progress to severe. The most important early sign of this progression is often ataxia (loss of coordination). An ataxic patient cannot walk a straight line or stand straight with feet together and eyes closed.  Ataxia typically indicates the patient is progressing into a severe form of altitude illness known as high-altitude cerebral edema (HACE):  severe headache unrelieved by rest and medication, bizarre changes in personality, perhaps seizures and or coma.  Or severe altitude illness may show up as high-altitude pulmonary edema (HAPE):  constant shortness of breath, chest pain, productive cough, and very fast heart rate.  Severely ill patients need to go down as soon as possible.  In addition to descent, the best treatment is supplemental oxygen.  Treatment may also include the drug nifedipine (sold often as Procardia) for HAPE and the drug dexamethasone (sold often as Decadron) for HACE.  Consult your physician.  If descent is delayed, use of the Gamow Bag, a portable hyperbaric chamber that simulates descent, may save the patient's life. Do not use a Gamow Bag instead of descent.


PREVENTION OF ATTITUDE ITLNESS

  1. Above 10,000 feet ascend no faster than your ability to acclimatize an average of 1,000 to 1,500 feet (305 to 610 meters)/twenty-four hours of sleeping gain (in other words, sleep no more than 1,000 to 1,500 feet higher than the night before).  You can climb high, but sleep low.
  2. Drink plenty of water.  It does not prevent sickness but is important for general health.
  3. Exercise lightly every day
  4. Eat plenty of carbohydrate rich low fat foods.  Above 16,000 feet (4,880 meters), a diet of at least 70 percent carbohydrates is recommended.
  5. Avoid alcohol and sedatives
  6. Consult your physician about the uses of acetazolamide to prevent AMS, nifedipine to prevent HAPE, and dexamethasone to prevent AMS and HACE.



EVACUATION GUIDELINES

Evacuate (descend) with any sick patient who does not improve within 48 hours.  Rapid descent and or evacuation is recommended for all patients with signs and symptoms of severe altitude illness.



Foresthill Bridge

The Wilderness First Responder Kit

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