High Altitude Illness

ACUTE MOUNTAIN SICKNESS (AMS)

• AMS can afflict any visitor sleeping higher than 6000 feet
• Approximately 25% of visitors sleeping at 8000 ft or higher will develop AMS
• Cause is thought to be due to low oxygen (hypoxia) and high altitude (lower barometric pressure) 
• Symptoms include: headache, nausea/vomiting, dizziness/lightheadedness, fatigue or weakness
• Symptoms show within 24 hours
• Although rare in Colorado, if left untreated, AMS can progress to a serious, life-threatening form called HACE (high altitude cerebral edema). Symptoms include: severe headache, confusion, lethargy, lack of coordination, seizures, coma, and eventually death if untreated. The person may appear confused, disoriented, unable to walk a straight line, and slurring speech. THIS IS A 911 EMERGENCY!

HIGH ALTITUDE PULMONARY EDEMA (HAPE)

• HAPE is a serious form of altitude illness that causes fluid to fill the lungs
• Symptoms start within 2-4 days at altitude
• Symptoms include shortness of breath with activity and then at rest, persistent cough (sometimes with blood-pink foamy sputum), chest tightness and severe weakness
• Quick treatment is essential as HAPE is a life-threating condition
• If caught and treated early, HAPE can be successfully treated at your place of lodging with oxygen and medication
• Risk factors include: male gender, coming to altitude with a respiratory illness, history of heart or lung problems including pulmonary hypertension

PREVENTING ALTITUDE ILLNESS

• Slow ascent to altitude is key such as an over-night stay in Denver
• Avoid alcohol or medications such as narcotics or benzodiazepine sleep aids (Ambien, Lunesta, Benadryl and melatonin are safe to use)
• Do not overexert yourself the first 48 hours at altitude
• Hydrate just enough to keep your urine clear or pale yellow – overhydrating will not cure AMS
• Eat a diet that higher in carbohydrates and lower in protein and fats
• Medications such as Acetazolamide (Diamox®), if started 24 hours prior to coming to altitude can prevent AMS
• Sleeping on medical grade oxygen – provided by a licensed medical provider or with a prescription

RISK FACTORS FOR AMS

• history of previous AMS
• Residence at an altitude below 3000 ft
• Travel from low altitude to high altitude within 24 hours
• Obesity
• Current respiratory infection
• Over-exertion the first day or two at altitude
• Alcohol the first night at altitude

TREATMENT FOR AMS and HAPE

• Descent to lower altitude (most effective, but not always necessary)
• Oxygen – provided by a licensed medical provider or with a prescription ONLY after a diagnosis is made by a licensed medical provider
• Dexamethasone – a medication used in the treatment of AMS administered by a medical provider
• Ibuprofen or Tylenol for headache
• Rest

COMMON MYTHS ABOUT AMS

• All oxygen administration is the same
  • Oxygen bars are a novelty in Colorado and are not intended to treat any medical condition
  • Rental of an oxygen concentrator from a non-medical company, not requiring a prescription or not able to provide a medical assessment from a licensed medical provider is a dangerous practice. There is no regulation for what they are providing you. Rental of these machines can lead to worsening AMS or other life-threatening conditions that can mimic AMS
  • Pulse Oximeters and Oxygen Concentrators: What to Know About At-Home Oxygen Therapy | FDA
• Boost “oxygen in cans” can treat AMS
  • these are sold in many CO stores and are a novelty. They will not help AMS.
• IV hydration or over hydration will cure AMS
  • If your urine is clear to pale yellow, you are well hydrated
  • Drinking too much water or getting IV hydration when you are already well hydrated can lead to dangerous electrolyte imbalances and or worsening of some chronic medical conditions
• Being athletic or in “great shape” protects you from developing AMS
  • Being athletic can actually be a risk factor for HAPE and does not protect you from AMS
• Older people are more at risk for AMS
  • Actually, healthy people over 50 are at lower risk for AMS
  • Anyone, from babies to the elderly can develop AMS

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