What to do in case of acute altitude sickness?

We now assume that you are among those climbers who are either very sensitive to altitude sickness or who have not bothered with the advice, because You have got altitude sickness. It is also possible that you have it even more seriously and that your symptoms suit too much fluid in the lungs or fluid in the brain. What to do now? That of course depends on the severity of your symptoms.


For everyone with symptoms of altitude sickness, also in light form, the following applies:


1. Do not rise further. If it is only the lightest form of altitude sickness - headache that still responds well to a normal painkiller such as acetaminophen or ibuprofen, with a mild form of appetite reduction, mild nausea, slight sleeping problems, a little light in the head - you can still if necessary try to reach a maximum of 300 meters higher, unless a return of that new height is not possible for whatever reason. If you continue to rise with these minor complaints, you must keep a close eye on the progress of your complaints. If they get worse with the rise, and that chance is rather high, there is nothing else: you have to go back to the height at which you were still free of complaints and stay there for at least a day. In this situation, at least 300 to 500 meters lower. If the symptoms then subside, you can go up again after one or two rest days, but your next sleeping height may not be more than 300 higher than your starting point. If the symptoms do not decrease within 24 hours but also do not get worse, then wait another day. If your symptoms even increase, despite the peace and quiet, then you have to go down at least 500 meters and if possible, see a doctor.

 2. You must always down if there are signs that indicate pulmonary edema (fluid in the lungs) or brain edema (fluid retention in the brain). No discussion with the tour guide or traveling companions about this is possible: you run very high risks by waiting. A descent of 500 meters is usually sufficient to reduce the symptoms or disappear completely. If descending is not possible due to weather conditions, the time of day or the severity of your condition, then treatment in a hypobaric pressure bag is the best option, pending descent.

3. Drink as much as possible, that is at least 5 liters per day at 4000 meters. The almost always disturbed moisture balance must be restored as quickly as possible.

4. Administer oxygen will always reduce the symptoms, but do not decide too quickly. With minor complaints it is completely unnecessary, with serious complaints it is useful or necessary, but only in combination with other measures. For the average tourist, lugging relatively heavy bottles is not useful and they are also quite expensive. Moreover, there are always people who believe that with oxygen in the backpack they no longer have to take normal precautions, which means that they do indeed need oxygen later on. If you do want to take oxygen with you, you have to take into account that the administration per oxygen mask must last at least fifteen minutes if it is to be useful. Suffering the mask every now and then for a few minutes is useless waste of oxygen that you may really need. If oxygen is really needed, it is descending! In that case, adjust the oxygen supply to at least 4 liters per minute. In severe cases you can start higher (never hurts, if you have enough oxygen with you), for example 10-20 liters per minute until the condition improves, and then back to 4-8 liters. Only if you only want to use oxygen to sleep better, you can set the unit lower, for example at 0.5 to 1 liter per minute. However, this is not necessary from a medical point of view, and you should also be more economical here. Realize that the frequent use of oxygen extends your acclimatization time.

5. A much more practical means of obtaining extra oxygen if necessary the hypobaric air bag. Some travel organizations nowadays take such a portable inflatable air bag on trips to / at higher altitudes. This is recommended for (group) trips above 3000 meters, especially if rapid evacuation to 'safer places' is not possible in the event of problems. The advantage over oxygen in bottles is that the ambient air is the saving medium, and it never runs out. In such an inflation chamber, the air pressure is artificially increased, equivalent to a descent of about 2000 meters if you are at 4000 meters. Obviously this helps, but the same applies here as for oxygen: it is useful for serious problems and must be accompanied by other measures. Experience shows that two to four hours of 'treatment' in an inflation room often improves the condition very much, so that the necessary descent is also physically possible again.

6.Medicines can be helpful, sometimes necessary.


The following applies to all complaints:

if you feel worse despite rest at the same height: descend immediately and only climb again when you are fully recovered.

Author: Han Willems - More info about altitude sickness

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