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modern medical
facilities and as the rescue and evacuation are measured
in days, it is imperative to make a comprehensive first
aid box consisting of basic drugs and accessories as part
of the paraphernalia for trekking. Modern dentistry is
unknown in the hill of Nepal so it is advised to have a
checkup before departure from home. Tooth fillings,
sometimes loosen in cold temperatures and high altitudes,
so it is recommended to have them checked. Travelers are
requested to bring medicine prescribed by their doctor at
home. Common medicine for stomach problems, headache, and
malaria is available in Kathmandu. Medicine is usually not
available in remote areas. So necessary medicine is
advisable to carry with you. Before going to Nepal, it is
advised to get injections against typhoid, meningitis and
hepatitis.
OVERCOMING ALTITUDE PROBLEM
This is often known as Acute Mountain Sickness (AMS),
which is particularly a matter of important medical
consideration while trekking in the Himalayas. Altitude
Sickness means the effect of altitude on those who ascend
too rapidly to elevations above 3000 meters. Early
mountain sickness will manifest itself in headache,
nausea, shortness of breath, fatigue; etc can be
encountered as initials of the sickness. The major
information source on prevention and treatment of the
sickness is Himalayan Rescue Association (HRA) and
Adventure Treks Nepal (P). Ltd. is the confide life member
of it. We assure every trekker that all our guides have
followed the training conducted by HRA with the
understated information.
CAUSE/FACTOR OF ALTITUDE SICKNESS
1. Less Oxygen
2. Low Pressure i.e. Barometric Pressure
3. Rapid Ascent
4. Possible Dehydration
5. Hypothermia TYPE OF ALTITUDE SICKNESS
TYPES ALTITUDE SICKNESS
1. AMS - Acute Mountain Sickness
2. HAPE - High Altitude Pulmonary Edema
3. Hace - High Altitude Cerebral Edema
SYMPTOMS
1. (AMS) ACUTE MOUNTAIN SICKNESS
Mild symptom feels like hangover/not feeling good
a. Headache
b. Fatigue/Tiredness
c. Nausea
d. Shortness of breath
e. Loss of appetite
f. Sleep disturbance
g. Dizziness
2. (HAPE) HIGH ALTITUDE PULMONARY EDEMA (Water in
lungs)
a. Increasing shortness of breath even at rest
b. Severe cough-dry/Productive
c. Very tired-Unusual fatigue while walking
d. High Pulse rate i.e. 110
e. Blueness of face, lips, finger nails that means
inability to transport Oxygen into the blood
3. (HACE) HIGH ALTITUDE CEREBRAL EDEMA (Water in the
head)
Severe symptoms of altitude sickness
a. Severe Headache
b. Vomiting
c. Walking like a drunk (Ataxia)
d. Mental confusion/Altered mental status
e. Irritable-Does not want to be bothered by other people
f. Unconsciousness or Coma
TEST - Tandem walking test, Heel to toe step fall off from
the line.
DECISION MAKING
1. Find out the main problem i.e. at altitude. Assume all
problems are Altitude Sickness unless proven otherwise.
2. If it is an altitude problem with mild symptoms, stay
at the same altitude until the symptoms are completely
gone. Take an Aspirin tablet, try to go up but listen to
your body. If symptoms are worsening, go down.
PREVENTION
1. Acclimatization: - After a 1000m. ascent, stay one more
night for acclimatization.
2. Do not make RAPID ASCENT; don't go too fast too high.
3. No alcohol, sleeping pills and smoking.
4. Drink more fluid 3-4ltrs a day… clean, boiled or
treated water/tea/coffee/soup/juice etc.
5. Do not carry heavy packs, 10 - 12 Kilograms is ok.
6. Climb higher sleep lower.
7. Over 3000m, 300m. Ascent a day.
8. Do not travel alone.
TREATMENT
1. DESCENT is the best medicine; do not wait for the
Helicopter.
2. Medicine:
a. Oxygen.
b. Diamox…for AMS 125mg. Before dinner, for sleeping
problem if feeling suffocated.
c. Nafedipine for HAPE
d. Steroids/Dexamethasone for HACE
3. Hyperbolic Bag - Gammow Bag
4. Golden Rules
a. Awareness of ALTITUDE SICKNESS
b. If you have mild symptoms, do not go higher. Take
Aspirin.
c. If you have worsening symptoms, go down.
d. Do not leave your team member behind unattended, either
trekker or porter.
5. IMPORTANT
a. Go up slowly.
b. Drink plenty of fluids (at least 3 liters per day)
c. Get all information about Altitude Sickness before your
trekking tour that will make you confident to make your
tour successful.
Our advice: Drink 4ltr of water minimum a day,
don't exhaust yourself so much and breathe deep and take
rest more than usual.
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