 |
 |
 |
|
|
|
[Kilimanjaro Overview] [Routes] [Nutrition] [Fitness & Training] [Altitude] [Tips for Success] [Departure Dates] [Equipment Rental] |
|
|
|
Specific High Altitude diseases - AMS, HAPE, HACE
From Iain Allan's " Guide to Mt. Kenya and Kilimanjaro" by Brent A Blue MD and Alastair RL Stevenson, BDS Specific high altitude diseases are divided into three categories: acute mountain sickness (AMS), high altitude pulmonary oedema (HAPE) and high altitude cerebral oedema (HACE). Current medical thought is that high altitude disease is related to decreased breathing while sleeping at altitude. Thus, the adage, "climb high, sleep low". It is known that at high altitude many climbers hear their tentmates breathing periodically, with long pauses between breaths (Cheyne-Stokes breathing). This is considered normal, within limits, but thought to be related to mountain diseases. Acute mountain sickness is the most frequent high altitude disease, and is a failure to acclimatise. Symptoms include headache (common), nausea, vomiting, anorexia, fatigue, insomnia, swelling of hands, feet or face (peripheral oedema), and decreased urine output. Nearly all climbers will have some of these symptoms. Persons with severe symptoms should stop ascending or consider descent for a few days. Examples of severe symptoms would be a headache unresponsive to aspirin and a night's sleep, decreased urine output, and persistent nausea or vomiting. They can be reduced or prevented by slow ascent and acclimatisation. Diamox (acetazolamide), a mild diuretic, has a side effect of preventing decreased rate of breathing during sleep and can be helpful in preventing acute mountain sickness. It is not a substitute for slow ascent or acclimatisation. Why a small percentage of climbers get the potentially deadly high altitude pulmonary oedema or high altitude cerebral oedema is unknown. The most common single denominator is rapid ascent without acclimatisation. HAPE and HACE have not been shown to be associated with sex, race, physical conditioning or previous, symptom-free high altitude work. Pulmonary oedema is heralded by increased shortness of breath even at rest, gurgling breath sounds (rales), which can be heard with an ear directly placed on the chest, and sometimes the production of a frothy white sputum. The patient usually has a cough and may produce this sputum, blood tinged. Always assume with these symptoms high altitude pulmonary oedema until proven otherwise and do not make the mistake of treating just for pneumonia. High altitude cerebral oedema is heralded by severe headache and uncoordination. Hallucinations frequently occur, but are usually denied. There are several medical diagnostic signs but only a couple which do not require equipment for testing : In researcher Peter Hackett's words, these are three treatments for HAPE & HACE ....."descent, descent, descent". Sometimes as little as 500 meters can make a tremendous difference. Treatment must be immediate. It is all-right to allow the patient to walk if he can, but if he cannot, he must be carried down. Severe cases (all cases of HACE) should be carried to medical help. All other treatments are only holding measures. Oxygen can be used if available, but is no substitute for descent. A rate of about two litres a minute is necessary over an extended period (12-24 hours) to be of any value. A "blast" for five or ten minutes is useless. Many drugs, heart stimulants, diuretics, steroids, analgesics, have been used, but none has consistently shown any obvious benefits. Concentrate on descent and evacuation. After a couple of days of acclimatisation at low altitudes, a slow re-ascent may be tried. For further reading on Mountain Medicine for Mt. Kenya and Kilimanjaro, read Guide to Mount Kenya and Kilimanjaro by Iain Allan, Mountain Club of Kenya, published by The Mountain Club of Kenya, PO Box 45741, Nairobi, Kenya. |
|
|
|
[Kilimanjaro Overview] [Routes] [Nutrition] [Fitness & Training] [Altitude] [Tips for Success] [Departure Dates] [Equipment Rental] |
 |
|
||
|
© 1994 - 2005. Tribe Safari. All rights reserved.
Destinations:
|