Leisure Travel

Medical awareness for high-altitude trekking – Part I

(This article will be published in two parts; Introduction to afflictions associated with high-altitude trekking (part – I) and better understanding of each of these conditions (part – II). If you have any doubts or need clarification please leave us a comment and we will address it in the next article or reply asap.)

Trekking these days has gained popularity. While this is a sign forward, popularity can lead to blind enthusiasm. To most people a high-altitude trek or a Himalayan trek is a daring activity that challenges their physical limits. What with trek organizers providing food, shelter & porters the activity has now become more accessible.

The purpose of this article is to encourage readers to equip themselves with adequate knowledge as regards mountain sickness & wilderness first-aid. Awareness will make you realize whether a particular organization is following the acclimatization protocol in their itinerary or not.  Please remember that high-altitude sickness is a reality that can strike anyone irrespective of their physical fitness, and has resulted in deaths that could have been prevented if there was awareness & preparedness. An affected individual would not be able to make the right decision so the “buddy system” is important & all the buddies should be knowledgeable.

The earliest documentation of the deleterious effects of high altitude on the body include Chinese official, Too-Kin’s description of the “Great and Little Headache” mountains on the Silk Road (between 37 and 32 BC) and Plutarch’s account of Alexander’s route to India (326 BC).

The initial knowledge of the physiological effects of altitude came from the sometimes fatal experiments performed by enthusiasts on themselves.

A vast pool of information gathered from travelers, mountain-climbing expeditions, hot-air balloon experiments, pressurized chamber studies, high-altitude warfare, high-altitude civilizations etc. culminated in the development of acclimatization protocols, diagnostic scoring systems, and preventive & remedial measures, all of which are continually evolving as studies continue.

When we were still not aware of the preventive & remedial measures, many people lost their lives. Some recovered as they were brought down to a lower altitude. But today, despite the ease of procuring information and the availability of easier and more rapid evacuation, we still hear of high altitude incidents wherein an individual succumbed to these survivable maladies. Hypothermia, a manageable condition if treated on time, was the responsible factor in many of these cases.

Had the “Golden Rules of Altitude Sickness” originally formulated by Dr. David Shlim in Kathmandu, been followed a number of lives could have been saved;

  • It is OK to get altitude illness. It is not OK to die from it.
  • If you feel unwell at altitude it is altitude illness until proven otherwise.
  • Never ascend with symptoms of altitude sickness.
  • If you are getting worse (or have High Altitude Pulmonary Edema or Cerebral Edema), descend immediately.
  • Never leave anyone with altitude illness alone.

To follow these rules one needs to understand;

  • Acclimatization to altitude;
  • Symptoms & signs of altitude illness (AMS i.e. Acute Mountain Sickness, HACE i.e. High Altitude Cerebral Edema & HAPE i.e. High Altitude Pulmonary Edema) & the Lake Louise Scoring System (LLSS);
  • The treatment protocols & take timely decisions for evacuation.

Besides this, when visiting remote areas, whether as a leisurely activity or otherwise, it is also imperative to know “Wilderness First-aid.”

There are various authentic sites giving frequently updated information on acclimatization, altitude illness, the Lake Louise Scoring System & the management protocol. Many pocket altitude & wilderness first aid books are also available that provide good guidance.

(To be continued in part-II soon. Please subscribe to our email updates and follow us on social media platforms to be in the loop)

NOTE: We are extremely sorry if you have received two updates – one via Tongue Ticklers and one via Harini and Harsha. We had not thought of that while transferring the feed, and it has hopefully been taken care of properly now, and won’t happen again.

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Kumkum is a Plastic Surgeon who has been climbing and trekking in the Himalaya since 1976, encouraging people to be more knowledgeable about high-altitude and wilderness first-aid. Her other interests include rock climbing, cycling & martial arts.

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August 23, 2018

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