Acute Mountain Sickness (AMS)

Many of our itineraries in Nepal go above 2,800 metres (9200 feet) where it is quite common for travellers to experience some adverse effects on their health due to the altitude. 

It has even been reported that it happened to Sir Edmund Hillary!

Whilst our leaders have basic first aid training and are aware of the closest medical facilities and are familiar with the symptoms of altitude sickness.

It is very important that you make yourself familiar with the effects and the causes of travelling at altitude, monitor your health and seek assistance accordingly.

Our experienced guides and leaders are equipped with first aid kits and safety items such as Portable Altitude Chambers (PAC’s) that can be used in the event of severe altitude sickness.

Please read this document carefully and utilise the table at the end on a daily basis to record the symptoms of your general health that you may be experiencing.

Please note this document is assembled from feedback and information provided from our group leaders and tour guides on the ground.

The following information is for general advice and guideline purposes only and is in no way intended to replace the advice of a trained medical professional. 

As such You-in is unable to accept responsibility for any inconvenience, injury and/or loss sustained by any person, caused by errors and omissions, or as a result of the advice and information given here. 

We recommend all travelling passengers to conduct their research before travelling.

For free and useful resource information please also visit – http://medex.org.uk/medex_book/about_book.php – Medex 2008

Before You Travel

Some pre-existing medical conditions can be difficult to adequately treat on the ground and are known to severely worsen at high altitude, leading to more serious consequences. It is imperative that you discuss your pre-existing medical condition/s with your doctor. 

We do understand that certain medications are reported to aid acclimating to high altitude. A common choice of medication is Diamox TM which can be obtained on prescription.

Please discuss these options with your doctor to see if they are right for you.

During Your Trip

Whilst our leaders have basic first aid training and are aware of the closest medical facilities and familiar with the symptoms of altitude sickness, it is very important that you make yourself familiar with the effects and the causes of travelling at altitude, monitor your health and seek assistance accordingly.

What Is AMS?

Acute Mountain Sickness or ore commonly known – Altitude sickness, is the reaction of the body adjusting to a lower amount of oxygen in the atmosphere. 

Normally, the higher the altitude, there is less oxygen available for the body to absorb and carry on normal functions.

AMS most commonly occurs from above 2,800 metres (9,200 ft) but this varies for everyone – to put simply, there is no way of knowing your susceptibility being exposed to altitude, thus it is vital you monitor your health.

Symptoms may be mild and may subside or even go away after a day’s rest on one of your scheduled rest days, or if it is ignored and not treated it could lead to death in severe cases.

AMS Symptoms

Some symptoms can appear within 1-2 hours, although most often appear around 6-10 hours after ascent and generally subside in 1-2 days as your body adjusts to altitude. 

They may reappear as you continue to go to a higher altitude.

Symptoms generally occur gradually and usually can be one or a combination of the following:

• Loss of appetite
• Headache
• Disturbed sleep or drowsiness
• Fatigue
• Irritability
• Nausea / vomiting
• Dizziness
• Swelling of feet, face and hands

If the body is unable to adjust to altitude these symptoms will persist and, if they are left untreated, altitude sickness may progress to High Altitude Cerebral Edema (HACE) or High Altitude Pulmonary Edema (HAPE). *** Both can be fatal if ignored ***

Symptoms of HAPE (fluid on the lungs):

• Breathlessness
• Severe fatigue, progressing to coma
• Low fever up to 38°C/100°F
• A dry cough, developing to a wet one with blood-tinged discharge or saliva.
• Tightness in the chest & blueness/darkness of face, lips & tongue

HAPE can occasionally develop without the usual symptoms of AMS – a telltale sign is when at rest, breathing does not return to normal, it remains shallow, rapid and panting even after an extended period of inactivity, and is often accompanied by a cough.

Symptoms of HACE (fluid on the brain):

• Severe headache symptoms not relieved by painkillers or lying down
• Blurred or double vision/retinal haemorrhage
• Confusion, disorientation & drowsiness
• Nausea/vomiting
• Loss of balance or coordination
• Blurred or double vision/retinal haemorrhage

How To Avoid Altitude Sickness?

Certain medications (such as sleeping pills) or medical conditions (such as respiratory disease) can increase the risk of altitude sickness – you must inform your leader of any medical conditions or medications before ascending to altitude.

You can reduce symptoms and help your body to acclimatise and avoid altitude sickness by:

• Drinking plenty of water – we recommend at least 4 litres per day on top of other forms of fluids such as tea or soups
• Avoiding alcohol, tobacco and substances that can interfere with sufficient delivery of oxygen to the body or cause dehydration.
• Taking it easy or have a regular break. Walk at a slower pace than you would at sea level and avoid overexertion.
• Eating small, frequent meals high in carbohydrates.

AMS Treatment

Our experienced guides and leaders are equipped with first aid kits and safety items such as Portable Altitude Chambers (PAC’s) that can be used in the event of severe altitude sickness.

By following the previously mentioned guidelines, most travellers can successfully acclimatise. However, there are some instances where medical treatment is required.

Ultimately, the best treatment for acute altitude sickness is to descend to a lower altitude.

In the best interests of your health and well-being, there may be times when your leader makes the decision that you or a member of your group is at risk of serious altitude sickness and for safety insists that you/they cannot ascend further – please respect that they are within their rights to do so and are making that decision in the best interests for you.

By completing the below chart from the first day you experience any altitude sickness symptoms, will help you to keep track and monitor any of the altitude-related symptoms you may experience.

We encourage you to discuss with your leader straight away if you are experiencing any altitude sickness symptoms, so you both can follow your acclimatisation progress. 

However, should you rate the severity of any symptoms at 7 or more, or the symptoms continue/worsen after the initial 1-2 days, please inform your leader without delay, so that we can seek the advice of a trained medical professional if necessary?

The key is to personally assess whether your symptoms are improving or worsening, as everyone will have a different perception of the severity of their symptoms.

A rough guide would be:

1 = Very minor symptoms that are causing no discomfort
5 = Moderate discomfort
10 = Extreme discomfort