Acute Mountain Sickness (AMS) in Nepal

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

We should prepare thoroughly beforehand, and travelers themselves must be careful. Most trekkers/climbers feel some effects of altitude, such as shortness of breath and possibly a light headache, which is common.

AMS is very different, and if a person suffers from this sickness, he will get a brutal headache and will be unconscious, too. However, there are various symptoms beforehand, and we also have sufficient time to take precautions.

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. 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 rest more, then take 125-250mg of Diamox. It generally takes one to four hours to cool down. Take 125-250mg of Diamox in the evening and drink plenty of fluids.
• If you feel a bit better, don't leave taking precautions at that point. Take another 250mg of Diamox 6-8 hours later. If the symptoms worsen, please descend, acclimatize, and 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 terrible sign)
• Marked blueness of face and lips
• High resting heartbeat (over 130 beats per minute)

What to do when getting mild symptoms

• Descend down as soon as possible

High Altitude Cerebral Edema (HACE)

It is a dangerous case of AMS; if the above symptoms get worse and you cannot 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 to take treatment with medication, oxygen, and descent down.

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

High Altitude Pulmonary Edema (HAPE)

It is a serious case of AMS; if you get the above symptoms worse and accumulate 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 a Portable Altitude Chamber (PAC). If there is no PAC bag or oxygen, one should be taken down to a low altitude, which is only a life-saving method. 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, or smoke.
• Drink more fluid, 3-4 liters daily, 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 a 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, climbing Island Peak or Mera Peak, or 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 be rescued/evacuated to a hospital in Kathmandu for further treatment.

Helicopter rescue is costly in Nepal. We suggest you buy a travel insurance policy that covers the expenses of these emergencies.

What happens if someone or I get AMS during the trek?

We wish you wouldn't have AMS or any other sickness while on the trek. However, there is always a risk of AMS (Altitude sickness) while going on a high-mountain trek, so we must be careful about it. Our guide will provide you with information on how to avoid AMS. However, if you or any member of the group gets AMS, we will do everything to bring you back safely.

It depends on the situation and the place where people get sick. As such, if someone gets AMS and can still walk, we take a day's rest (while others continue the trek) with one of the porters/guides. We then see how the situation is and continue trekking the next day if it gets better.

Or,

If there is no improvement or even worse, we do not have other options. Rather than returning to the same trail as descending, which is the only way to avoid AMS, or if the situation worsens and you cannot walk, we rescue/evacuate you and bring you back to Kathmandu to visit a doctor.