Acute Mountain Sickness - A Common Condition When Climbing
AMS, or acute mountain sickness is common at high altitudes. At elevations over 3,000m three quarters of people can expect to suffer mild symptoms. The occurrence of altitude sickness is dependent upon several factors, such as elevation, rate of ascent, and the individualβs susceptibility. Many people experience mild altitude sickness during the normal acclimatization process. The mild discomfort that accompanies this adaptation should be considered normal and acceptable.
Symptoms usually start 12-24 hours after arrival at altitude and begin to decrease in severity about the third day. The symptoms of mild AMS are headache, dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed sleep, and a general feeling of malaise. Symptoms tend to be especially bad at night when respiratory drive is decreased.
Mild altitude sickness does not interfere with normal activity and symptoms generally subside within 2-4 days as the body acclimatizes. As long as symptoms are mild, and only a nuisance, ascent can continue at a moderate rate. When hiking, it is essential that you communicate any symptoms of altitude sickness immediately to the expedition leader or lead guide.
Altitude sickness is considered to be a neurological problem caused by changes in the central nervous system. It is basically a very mild form of High Altitude Cerebral Edema. The only cure is acclimatization or else descent. Symptoms of mild AMS can be alleviated with Ibuprofen but keep in mind that reducing the symptoms is not curing the problem or treating the cause.If symptoms of mild AMS worsen, the climber may be exhibiting early signs of:
Moderate AMS
Moderate AMS includes severe headache that is not relieved by medication, nausea and vomiting, increasing weakness and fatigue, shortness of breath, and decreased coordination (ataxia). Normal activity is difficult, although the person may still be able to walk on their own. At this stage only descent can reverse the problem. Descending even a hundred meters may help and definite improvement will be seen with a descent of 300-500 meters.
Twenty-four hours at the lower altitude will result in significant improvements. The person should remain at lower altitude until symptoms have subsided. At this point, the person has become acclimatized to that altitude and can begin ascending again.
The best test for moderate AMS is to walk in a straight line, heel to toe. Just like a sobriety test, a person with ataxia will be unable to walk in a straight line. This is a clear indication that immediate descent is required. It is important that the person descends before the ataxia reaches the point where they can no longer walk on their own. If, despite all careful preparations, such a condition should develop in a team member our staff are trained in rapid evacuation techniques. The team member will be carried to a location of complete safety within hours, from any point on the mountain.
Severe AMS
This condition presents itself as an increase in the severity of the aforementioned symptoms, including:
- shortness of breath at rest
- inability to walk
- decreasing mental status
- fluid build-up in the lungs
Severe AMS requires immediate descent to lower altitudes of around 1,000 meters.
There are two other severe forms of altitude illness, High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE). Both of these happen less frequently, especially to those who are properly acclimatized. When they do occur, it is often because inexperienced people may go too high too fast, or else may go very high and stay there. The lack of oxygen results in leakage of fluid through the capillary walls into either the lungs or the brain.
High Altitude Pulmonary Edema (HAPE)
HAPE results from fluid build-up in the lungs. The fluid in the lungs prevents effective oxygen exchange. As the condition becomes more severe, the level of oxygen in the bloodstream decreases, and this can lead to cyanosis, impaired cerebral function, and death.
Symptoms of HAPE
- shortness of breath even at rest & tightness in the chest
- marked fatigue & weakness
- feeling of impending suffocation at night
- persistent cough bringing up white, watery, or frothy fluid.
Confusion, and irrational behavior are signs that insufficient oxygen is reaching the brain. In cases of HAPE, immediate descent to below 2,000m altitude is a necessary life-saving measure. Anyone suffering from HAPE must be evacuated to a medical facility for proper follow-up treatment.
High Altitude Cerebral Edema (HACE)
HACE is the result of swelling of brain tissue from fluid leakage. Symptoms can include:
- headache
- loss of coordination (ataxia)
- weakness
- decreasing levels of consciousness
- disorientation
- loss of memory
- hallucinations
- psychotic behaviour
- coma
It generally occurs after a week or more at high altitude. Severe instances can lead to death if not treated quickly. Immediate descent to 1,000m altitude is a necessary life-saving measure. Anyone suffering from HACE must be evacuated to a medical facility for proper follow-up treatment.
Many people spend a lot of time and money training and equipping themselves for a Kilimanjaro climb, only to fail in their objective of reaching the summit. Failure is avoidable and we really want trekkers to understand how to prevent it.
There are three usual methods for climbers to reach Arusha:
A growing number of Team Kilimanjaroβs climbers are nowadays climbing Mount Kilimanjaro for charity. While of course many of our climbers will climb Kilimanjaro with us without our necessarily knowing that they are raising money for charity while they climb, we suggest that it may nonetheless be in the interests of their cause to let us know, if they are happy to do so. Indeed, for some climbers the knowledge that climbing Kilimanjaro for charity may allow them to offset some of their own fundraising costs may be instrumental in their decision to climb, if they are in any doubt at the outset as to whether they are in a suitable position to finance their proposed fundraising trip.
Climbers would usually expect to be collected from their hotel by their guide and support team at 0730 on the morning of their climb. Where there are climbers staying at different hotels this pick-up time may be deferred slightly. Climbers joining climbs on which there are other climbers staying at different hotels who wish to have an accurate estimate of their amended pick-up time are asked to either call or SMS our Arusha office.
Having had lunch at Moshi (assuming time permits following your descent) and been transferred back to your hotel after the climb, if you are booked into the same hotel that you stayed in before your climb the reception staff ought to have retrieved your bags from their lock room and would normally have this waiting for you at reception. Occasionally however, particularly when your hotel is busy, this may not be possible and you may have to wait while a member of staff goes to the lock room and retrieves your bag for you.
Technically an ascent of Kilimanjaro is classified as entry into the Extremely High altitude zone. Altitude is defined on the following scale: High Altitude Classification of Zones
Our attitude to safety is unique in that our founder is from time to time contracted by Kilimanjaro National Park Authority to conduct safety work on the mountain and to advise on route selection and accident prevention.
AMS, or acute mountain sickness is common at high altitudes. At elevations over 3,000m three quarters of people can expect to suffer mild symptoms. The occurrence of altitude sickness is dependent upon several factors, such as elevation, rate of ascent, and the individualβs susceptibility. Many people experience mild altitude sickness during the normal acclimatization process. The mild discomfort that accompanies this adaptation should be considered normal and acceptable.