First Aid for Altitude Sickness

What is Altitude Sickness

At sea level, the air we breathe is roughly 21% oxygen. This precious gas is vital for our cells to function properly, generate energy, and keep our organs running smoothly. As we climb, the air pressure decreases, reducing the total amount of oxygen in each breath we take.

So, what happens when you’re suddenly faced with this oxygen deprivation? Your body tries to compensate in various ways. Here’s how:

Increased heart rate and breathing: Your body tries to take in more air with each breath and circulate it faster to deliver oxygen to your cells.

Thickening of blood: This helps carry more oxygen molecules per red blood cell.

Production of more red blood cells: This is a long-term adaptation that takes days to weeks.

This process of adjusting to the lower oxygen levels is called acclimatization. However, if you ascend too rapidly, your body might not have enough time to adapt effectively. This is when altitude sickness arrives.

Altitude sickness occurs when your body doesn’t have time to adjust to decreased oxygen levels at high altitudes. When symptoms arise, quick action and supportive measures can prevent progression and help the person recover. Here’s a comprehensive first aid guide:

• Mild Symptoms (Acute Mountain Sickness- AMS): This is the most common form and usually occurs within 6-24 hours of reaching high altitude. Symptoms include headache, nausea, fatigue, dizziness, loss of appetite, trouble sleeping, and shortness of breath during exertion.
• Moderate Symptoms (High-Altitude Pulmonary Edema—HAPE): This is a more serious condition in which fluid accumulates in the lungs, causing shortness of breath at rest, a dry cough, and pink or bloody sputum.
• Severe Symptoms (High-Altitude Cerebral Edema – HACE): This is a life-threatening condition where fluid builds up in the brain, leading to confusion, disorientation, loss of coordination, hallucinations, and eventually coma.

Risk factors for Altitude sickness

The risk factors for altitude sickness often relate to the altitude itself or how you get there.

• Higher altitudes: The higher you go, the greater your risk for altitude sickness.
• Speed of ascent: Getting to a higher altitude quickly increases your risk of developing altitude sickness. People who fly to high altitudes rather than walk, hike or drive are much more likely to develop it. Above 8,000 feet, you should ascend no more than 1,640 feet (500 meters) per day.
• Alcohol and drug (medical and nonmedical) use. Drinking alcohol or using certain medications, especially sedatives (either medical or nonmedical), can greatly increase the chances of developing altitude sickness.
• History of altitude sickness. Having any form of altitude sickness, especially the more severe forms like HAPE or HACE, increases your risk of having it in the future.

Recognize the Symptoms

• Mild Symptoms (Acute Mountain Sickness):
  • Headache
  • Nausea and vomiting
  • Fatigue and weakness
  • Dizziness or lightheadedness
  • Loss of appetite and difficulty sleeping
• Moderate to Severe Symptoms:
  • Severe headache unresponsive to usual measures
  • Shortness of breath at rest
  • Confusion, irritability, or decreased alertness
  • Ataxia (loss of coordination)
  • Cyanosis (bluish skin, indicating poor oxygenation)
  • In cases of High-Altitude Pulmonary Edema (HAPE), a dry cough or pink, frothy sputum; for High-Altitude Cerebral Edema (HACE), altered mental status and difficulty walking

Being vigilant about these signs is critical to halting further damage.

How is altitude sickness treated

1. Stop Ascent Immediately

• Halt Further Climbing: If any symptoms occur, it’s crucial to stop ascending. Continuing upward can quickly worsen the condition.
• Initiate Descent: For moderate or severe symptoms, begin a gradual descent to a lower altitude as soon as safety permits. Descending even a few hundred meters can make a significant difference.

2. Provide Supportive Care On-Site

• Rest and Fresh Air: Help the affected person sit or lie down in a calm, shady, and well-ventilated area. Reducing exertion can ease the strain on the body and allow recovery.
• Hydration: Encourage drinking water or electrolyte-replenishing fluids. Proper hydration supports the body’s acclimatization process and counteracts dehydration, which can worsen altitude sickness.
• Cooling Measures: In hot conditions, a cool damp cloth on the forehead or a slight cooling mist can help regulate body temperature. Avoid overcooling, which may cause shivering and further stress the body.

3. Monitor and Observe

• Keep a Close Watch: Monitor the person’s breathing, mental status, and overall condition. Note any worsening of symptoms, such as increased confusion, shortness of breath, or difficulty walking.
• Prepare for Emergencies: If symptoms progress to signs of severe conditions like HAPE or HACE (e.g., confusion, inability to walk, severe shortness of breath), treat this as a medical emergency.

4. Seek Professional Medical Help

• Call for Assistance: If the symptoms are moderate to severe or if there is no improvement after initial measures, call for emergency medical assistance immediately.
• Inform Medical Personnel: When possible, provide clear information about the altitude reached, the time and progression of symptoms, and any first aid measures you’ve already undertaken.

5. Follow-Up and Prevention

Know Your Limits: Recognizing early signs of altitude sickness and being prepared to halt progress can prevent complications and help you enjoy your high-altitude adventure safely.

Special Consideration

1. Rest & Hydration – Encourage the affected person to rest and drink plenty of fluids to prevent dehydration.
2. Pain Relief – Over-the-counter pain relievers like ibuprofen can help alleviate headaches and discomfort.
3. Supplemental Oxygen – If available, providing oxygen can help ease symptoms while descending.
4. Avoid Alcohol & Sleeping Pills – These can depress the respiratory system and worsen altitude sickness.
5. Monitor Symptoms – Watch for signs of High-Altitude Pulmonary Edema (HAPE) or High-Altitude Cerebral Edema (HACE), which require urgent medical attention.
6. Gradual Acclimatization – When traveling to high altitudes, ascend slowly to allow the body time to adjust.

REFERENCES

1. Sanju Saira, First Aid Manual for Nurses, 3rd Edition, CBS Publishers & Distributors Pvt Ltd, ISBN 978 9394525252.
2. Burtscher J, Swenson ER, Hackett P, et al. Flying to high-altitude destinations: is the risk of acute mountain sickness greater? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289512/) J Travel Med. 2023;taad011.
3. Center for Wilderness Safety. Oxygen levels at altitude. https://wildsafe.org/resources/ask-the-experts/altitude-safety-101/oxygen-levels/). Updated 2022 Oct 7.
4. Jensen JD, Vincent AL. High Altitude Cerebral Edema. https://www.ncbi.nlm.nih.gov/books/NBK430916/). 2022 Jul 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

Stories are the threads that bind us; through them, we understand each other, grow, and heal.

JOHN NOORD

Connect with “Nurses Lab Editorial Team”

I hope you found this information helpful. Do you have any questions or comments? Kindly write in comments section. Subscribe the Blog with your email so you can stay updated on upcoming events and the latest articles.