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Trekking at High Altitude - What are the common medical problems? What precautions to take?

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Many high altitude places are remotely located and away from medical help. Persons travelling to such places should be prepared and made aware of common problems that occur in these conditions.

While the concentration of air remains the same at 21% oxygen, as we rise in altitude, the atmospheric pressure decreases, resulting in our every breath containing fewer and fewer molecules of oxygen. This in turn reduces the amount of oxygen available to the blood and tissues in the body.

High altitude is defined as :

High Altitude1500 - 3500 m5000 - 11,500 ft
Very High Altitude3500 - 5500 m11,500 - 18,000 ft
Extreme AltitudeAbove 550 mAbove 18,000 ft

Altitude sickness is caused by acute exposure to high altitudes and is generally divided into three conditions; acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE).These illnesses often occur following a rapid ascent and can effectively be prevented by ascending slowly. Usually, the symptoms are only temporary and subside with time as altitude acclimatisation occurs. However, in more extreme cases symptoms can be fatal.

The symptoms used to diagnose altitude sickness are headache, along with any of the following;

  • Lack of appetite, nausea, or vomiting
  • Fatigue or weakness
  • Dizziness or light-headedness
  • Insomnia

Additional early indications of altitude sickness may include shortness of breath upon exertion, persistent rapid pulse, drowsiness, general malaise, and peripheral edema (swelling of hands, feet, and face).

Symptoms of life-threatening conditions resulting from extreme altitude sickness include:

  • pulmonary edema (fluid in the lungs) - persistent dry cough, fever and shortness of breath even when resting
  • cerebral edema (swelling of the brain) - headache that does not respond to analgesics, unsteady walking, increasing vomiting and gradual loss of consciousness.

The usual prevention of altitude related illness is modest altitude gains of not more than 300m per day above 3000m and to spend 2 nights in the same place every 1000m. Most trekkers appear to acclimatise reasonably with this rate of ascent, although a minority do not acclimatise well. Medications are also available from your GP and may prevent or decrease likelihood of getting sick.

Eye problems at altitude are often overlooked. There is a greater amount of UVA and UVB radiation to the eye at altitude than at seal level. Eye damage such as snow blindness is compounded by rays bouncing off bright snow. This painful state comes from the rays burning your eye cornea. The best way to prevent eye damage is the use of proper high altitude sunglasses that filter out all UVA/UVB.

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