Altitude Sickness Treatments

Altitude Sickness Treatments

Box 2-3. Tips for acclimatization

The following are helpful tips for people traveling to high altitude destinations.

	Ascend gradually, if possible. Try not to go directly from low altitude to >9,000 ft (2,750 m) sleeping altitude in one day.
	Consider using acetazolamide (Diamox) to speed acclimatization if abrupt ascent is unavoidable.
	Avoid alcohol for the first 48 hours.
	Participate in only mild exercise for the first 48 hours.
	Having a high-altitude exposure at >9,000 ft (2,750 m), for 2 nights or more within 30 days prior to the trip is useful.
	Treat an altitude headache with simple analgesics.

Preventive Measures for Travelers

The main point of instructing travelers about altitude illness is not to prevent any possibility of altitude illness, but to prevent death from altitude illness. The onset of symptoms and clinical course is sufficiently slow and predictable that there is no reason for someone to die from altitude illness unless trapped by weather or geography in a situation in which descent is impossible. The three rules that travelers should be made aware of to prevent death from altitude illness are—

	Know the early symptoms of altitude illness and be willing to acknowledge when they are present.
	Never ascend to sleep at a higher altitude when experiencing symptoms of altitude illness, no matter how minor they seem.
	Descend if the symptoms become worse while resting at the same altitude.

For trekking groups and expeditions going into remote high-altitude areas, where descent to a lower altitude could be problematic, a pressurization bag (such as the Gamow bag) can prove extremely beneficial. A foot pump produces an increased pressure of 2 lbs. per in², mimicking a descent of 5,000–6,000 ft (1,500–1,800 m), depending on the starting altitude. The total packed weight of bag and pump is 6.5 kg.

For most travelers, the best way to avoid altitude illness is by gradual ascent, with extra rest days at intermediate altitudes every 3,000 ft (900 m) or less. If ascent must be rapid, acetazolamide may be used prophylactically, and dexamethasone and pulmonary artery pressure-lowering drugs, such as nifedipine or sildenafil, may be carried for emergencies.