31/05/2024
How to avoid altitude sickness while climbing Mount Kilimanjaro!
Here are few things to be aware of before you do it!
Altitude illnesses are a mix of disorders caused by body's inability to adapt to elevations at or above approximately 2,500 meters (8000)feet.above Sea level. Yet physiological changes may be seen as low as 1,500 meters (5000). The data are unuclear to whether these disorders are separate conditions or one disorder that presents as spectrum of worsening signs and symptoms. Altitude illnesses may present as mildly irritating symptoms to life threatening problems that will certainly lead to death if left unmanaged.
Increasing elevation reduces atmospheric pressure which in turn reduces the number of oxygen molecules available for each breath. Atmospheric pressure is primarily a function of altitude,yet is also dependent on latitude (decreasing farther from the equator) seasons (lower in winter) and barometric pressure (a low pressure trough can equal a 600 foot gain in elevation in terms of oxygen availability.
These reductions in pressure and oxygen impair the body's ability to function on all levels. All people are susceptible to altitude illnesses but to varying and largely unpredictable degrees.The best predictor of performance and susceptibility to altitude illnesses is one's past performance at altitude.
Over the course of minutes at a given altitude above 1,500 meters (5000 ft) the body compensate through increasing the heart rate and respiratory rate and depths.This process is the start of acclimatization,or adaptations to higher altitudes. In addition, the body increases blood pH requiring increased urination to buffer the change. While necessary, this process also dehydrates a body that is already challenged to maintain hydration. Over the course of numerous days, the body begin to acclimatizatize in other ways include an increase in blood cells productions and an increasing ability to efficient carry and use oxygen. Aclimatization does not preclude altitude illnesses and is not necessarily related to person's fitness level,sex,or race.
Prevention:
*Maintain hydration despite luck of thirsty
*Maintain nutrition despite luck of appetite. Carbohydrates are easier to digest at altitude and may improve oxygen uptake.
*Climb high sleep low (This add time to acclimatization actions.
*Ascend gradually, recent recommendations suggest a maximum gain of 600 meter's 2000ft/day above 2500 meters (8000).
*Communicate with your companions, pay particular attention to those individuals with past history of altitude illnesses. Assess for any changes in behavior or ability to work when at altitude Altitude illnesses can mimic and sometimes exaberate dehydration, hypoglycemia,head injuries, respiratory infections, exhaustion and even overdoses.
*Consider prophylactic use of 125mg acetazolamide (diamox) up twice a daily.
Acute mountain sickness (AMS)
*Is the most common altitude disorders experienced at elevation. It symptoms most likely result from swelling in and around the base of brain and results from reduced oxygen availability due to atmospheric pressure decreases.severity of ams varies tremendously,but when severe,it will lead to death if Left unmanaged.the oneset is gradual, and it is easy to confuse with other conditions.
Sygn and symptoms
Mild ams
1*headache _-often worse in early morning, related to slowed breathing or abnormal nocturnal breathing while sleeping..
2*dizziness
3*fatigue/lethargy
4*loss of appetite,nosea and or vomiting.
5*poorly sleep.
Severe AMS the above s/s of mild ams in addition to one or more s/s below.
1*altered lor
2*poor coordination and or ataxia.
3*poor overall impressions (lassitude _unresponsiveness to death..
Severe ams is life threatening and can quickly progress to other forms of altitude illness.
High altitude cerebral edema (HACE)
HACE is a life threatening altitude illness that may be precipitated by sign and symptoms of AMS.in particular, HACE is associated with neurological dysfunction.
Newer evidence suggests that minor brain swelling occurs in the majority of new comers to altitude, even as low as 1500 meters (5000ft).
Susceptible individuals have increased cerebral blood flow and increased intracranial pressure (icp) that may lead to leakage of blood vessels of the brain.
*Signs and symptoms*
1*any signs and symptoms associated with AMS and/or HAPE.
*2 Altered ( LOR) confusion, abnormal behavior..
*3 vision distabances (eg.. hallucinations tunnels vision, blindness ete.)
*4 Unresponsiveness to death..
*High altitude pulmonary edema*HAPE.
HAPE is a life threatening altitude illness that may be precipitated by sign and symptoms of AMS in particular, HAPE is associated with fluid accumulation in the lungs and respiratory distress.fluid accumulates in the alveoli and membrane of the lungs due to increased blood flow and pressure throughout the lungs..
As a result, pulmonary function decrease as fluids accumulates.
Respirations are inhibited by either a decreased area for gas exchange or by increased distance that oxygen must travel.
HAPE is sometime misdiagnosed as pneumonia,or a lung infection..
*Signs and symptoms*
*1 any signs and symptoms associated with AMS and/or HACE.
*2 respiratory distress/shortness of breath (first with activity,then at rest.)
*3 Rales (sounds of fluid in the lungs)
*4 coughing fits, progressively more severe.cough is progressively More productive (wet) and frothy.
*5 bloody or Pink frothy sputum.
*6 weakness
*7 Syanosis
*8 Unresponsiveness to deaths..
*Treatment for altitude illnesses*
1*The only true treatment for altitude illnesses is descent.descend 500_1000 meters (1500_3000ft) or more for severe AMS, HACE, and or HAPE.
*2 hydration,rest and nutrition for mild ams.monitor these individuals closely for worsening signs and symptoms.
3*pressure - breathing (pursed lips during exhalation.) this May also be good technique for prevention..
4*supplemental oxygen if available.
*5 Gamow bag for hyperbaric oxygenation, If available.
*6 Consider medications:
*Severe AMS*:250 mg acetazolamide every 6-8
hours as needed.
*HACE*:250 mg acetazolamide every 6-8 hours as needed, 8 mg dexamethasone initially,then 6 every 6 hours (up to 24hours)
*HAPE*:250 mg acetazolamide every 6-8 hours as needed.2 puffs Albuterol every 1_2 hours as needed..
*Evacuation criteria for altitude illness*
Evacuate/descend for sign and symptoms of severe AMS, HAPE or HACE*
