• Last Updated on Oct 1, 2022

Acute Mountain Sickness (AMS) in Nepal

High altitude sickness is also known as acute mountain sickness (AMS), and generally, it occurs when people ascend to the high-altitude mountains too quickly (after above 3000M). But we want to make sure that none of our guests will get such sickness during trekking.

We should have all the preparation beforehand, and travellers themselves have to be careful about it. Most trekkers/climbers feel some effect of altitude, such as shortness of breath and possibly light headache, which is common.

AMS is very different, and if a person suffers from this sickness, he gets a brutal headache and will be unconscious either. But there are various symptoms beforehand, and we have sufficient time to take precautions as well.

While you are trekking and climbing with a guide, the guides will brief you on what sort of precautions you have to take to be prevented such sickness. Therefore, you don't have to worry about the matter, and we also recommend you get some advice from your travel doctor or health advisor before you travel to Nepal.

Table of Contents

Steps of High-Altitude Acute Mountain Sickness (AMS)

Normal AMS Symptoms

  • Running nose
  • Dizziness, Sleeplessness
  • Occasional loss of appetite
  • Periodic breathing

It may occur to everyone, so do not worry as this is common to everyone.

What to do when getting Normal AMS

  • Consult with the guide.

Mild AMS Symptoms

  • Mild headache
  • Nausea
  • Dizziness
  • Weakness
  • Sleeplessness
  • Dry Raspy cough
  • Tiredness
  • Loss of appetite
  • Running nose
  • Hard to breathe

What to do when getting mild symptoms

  • If you get mild symptoms, stop and relax (with your head out of the sun) and drink some fluids frequently.
  • Stop and have a rest more and take 125-250mg Diamox, and it generally takes one to four hours to be cool down. Take 125-250mg Diamox in the evening and drink plenty of fluids.
  • If you feel a bit better, don't leave-taking precautions at the point. Take another 250mg Diamox 6-8 hours later. If the symptoms continue to get worse, please descend, acclimatize, and again ascend, when you feel better.

Serious AMS Symptoms

  • Persistent and severe headache
  • Persistent vomiting
  • An inability to walk in a straight line and making the sufferer look drunk
  • Losing consciousness
  • Mental confusion
  • Liquid sounds in the lungs
  • Difficulty breathing
  • Rapid breathing or feeling breathless at rest
  • Coughing clear fluid
  • Pink phlegm or blood (a very bad sign)
  • Marked blueness of face and lips
  • High resting heartbeat (over 130 beats per minute)

What to do when getting mild symptoms

  • Descend as soon as possible.

High Altitude Cerebral Edema (HACE)

It is a dangerous case of AMS, If the above symptoms get worse and you could not take any precautions, one can die within 12 hours, but if one takes precautions immediately, it takes one or two days to get well. Therefore, if one gets such symptoms, it is better one take treatment with medication, oxygen, and descent down.

Usually, 4 to 8mg of dexamethasone is given as a first dose to those who suffer from such sickness, and then 4mg Diamox is given every six hours gap and similarly, 2-4 liters/minute oxygen is given, and one is taken to down.

High Altitude Pulmonary Edema (HAPE)

It is a serious case of AMS, if you get the above symptoms worse and accumulates fluid in the lungs and mild fever, there is a chance of High-Altitude Pulmonary Edema (HAPE).
In the treatment, one should be given oxygen at the rate of 4 liters a minute, using Portable Altitude Chamber (PAC). If there is no PAC bag or oxygen, then one should be taken down to the low altitude, and it is only the way of life-saving. The HAPE can also lead to unconsciousness and death in a short time.

Prevention of Acute Mountain Sickness (AMS)

  • Make sufficient time for acclimatization (After 3000 meters).
  • Don't ascend rapidly.
  • Don't' use alcohol, sleeping pills, and smoking.
  • Drink more fluid 3-4 liters a day, clean boiled water/tea/coffee/soup/juice, etc.
  • Climb high and sleep low.
  • Don't go trekking alone, take a guide/porter.
  • Follow the advice from your guide.
  • Descent if mild symptoms are rapidly getting worse.
  • Never leave to descent sick person alone.
  • Avoid getting cold.


There is always a risk of high-altitude sickness, while you go on High Mountain trekking such as Everest Base Camp Trek, Everest High Pass Trek, Langtang Circuit Trek, Annapurna Circuit Trek, Manaslu Circuit Trek, or climbing on Island Peak or Mera Peak and any other trekking and mountain expeditions in Nepal.

We at Outfitter Himalaya always suggest you trek or climb with an experienced guide to be safe as you are on your adventure holidays, and we want you to enjoy your adventure to the fullest. Cause of a Serious AMS, you may also have to rescue/evacuate to a hospital in Kathmandu for further treatment. The helicopter rescue cost in Nepal is very expensive. So, we suggest you buy a travel insurance policy that covers the expenses of these emergencies.

What happens if I or Someone Gets AMS During the Trek?

  • We wish that you won’t have AMS or any other sickness while on trek. However, there is always a risk of AMS (Altitude Mountain sickness) while going on a high mountain trek. So, we have to be careful about it.
  • Our guide will provide you with information to avoid AMS. However, if in case if you or any member of the group get AMS, then we do everything to bring you back safely.
  • And, it depends on the situation and the place people get sick. As such, if someone gets AMS and is still able to walk, then we take a day's rest (while others continue the trek) with one of the porter/guides. And, we see how the situation and to continue trekking the next day if the situation gets better.
  • Or, if there is not any improvement or even worse. We do not have other options rather than return to the same trail as descending is the only way to avoid AMS, or if the situation gets worse and cannot walk, we then rescue/evacuate to bring you back to Kathmandu to visit a doctor.
  • The cost of evacuation by helicopter is expensive in Nepal, and it is almost impossible to pay the people. So, we strongly suggest you buy an insurance policy that covers the evacuation in the worst situation.
Arjun Rijal

Arjun Rijal

Hello, Hi & Namaste from the Himalayas !!!

I am Arjun Rijal, Founder Director of the Outfitter Himalaya Holidays P. Ltd & working as a travel planner/consultant for Nepal, Bhutan, and Tibet Travel. I love hiking, trekking, and traveling.

I have been in most of the trekking regions in Nepal, that include Everest Base Camp, Annapurna Base camp, Annapurna Circuit, Manaslu, and Langtang. I also have travelled to Bhutan, India & planning further travel to many other countries in the world.

Find my writing on traveling, trekking, tours, travel news, and updates about the tourism activities of Nepal, Tibet & Bhutan.

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