Altitude Sickness Information


Altitude sickness often known as acute mountain sickness (A.M.S.) in general may occur when people quickly ascend normally in altitudes of over 3000 m. We ensure minimal risk by building in rest days into our trekking itineraries. Most people will feel some effects of altitude, shortness of breathe and possibly light headedness, which are fairly common. Acute mountain sickness is very different and normally involves a severe headache, sickness and loss of awareness. In almost every potential case there are enough warning signs to take appropriate action.

Our expert and trained guides will advise you about any health requirements and also altitude sickness while you are trekking, so you should not worry about it. We do however recommend you get advice from you travel doctor or health advisor before you leave. The following information gives you an idea about high altitude sickness and how to minimize the effects.

The safety of our clients is taken very seriously at Ace the Himalaya. We ask all our clients to submit a copy of their insurance prior to the departure, so that we can proceed with evacuation when necessary.

All our guides, porters and staffs are facilitated with GSM and CDMA cellphones during the trips covering most parts of the country. In case of a very remote area, they are provided with a satellite phone for communication during an emergency.

There are three stages of altitude sickness and symptoms.

1. Normal AMS Symptoms – Should expect but not worry
Following are the normal altitude symptoms that you should expect but should not be worried about. Every trekker will experience some or all of these, no matter how slowly they ascend.

  • Periods of sleeplessness
  • Abnormal need of more sleep (often 10 hours or more)
  • Occasional loss of appetite
  • Vivid, wild dreams especially at around 2500-3800 meters in altitude
  • Periodic breathing
  • The need to rest/catch your breath frequently while trekking, especially above 3500 meters
  • Runny nose
  • Increasing urination while moving to/at higher altitudes (a good sign)
  • Dizziness

2. Mild AMS Symptoms – NEVER GO HIGHER
Many trekkers in the high valleys of the Himalaya get mild AMS. Admit or acknowledge that you are having symptoms. The following symptons characterize mild AMS:

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

What to do if a mild symptom doesn’t go way?

  • If you find mild symptoms developing while walking, stop and relax (with your head out of sun) and drink some fluids. Drink frequently.
  • If mild symptoms develop while walking, stop, have rest, drink some fluids and take 125-250 mg of Diamox. Diamox generally takes one to four hours to begin alleviating symptoms. Drink more water and consider staying close by.
  • If symptoms develop in the evening, take 125-250 mg of Diamox and drink plenty of fluids again.
  • If symptoms partially go away but are still annoying, it is safe to take another 250 mg of Diamox 6-8 hours later.
  • If mild symptoms continue getting worse, try descending for a few hours which may be more beneficial than staying at the same altitude. Going higher will definitely make it worse. You’re here to enjoy trekking, not to feel sick.

3. Serious AMS Symptoms – IMMEDIATE DESCENT

  • Persistent, severe headache
  • Persistent vomiting
  • Ataxia (loss of co-ordination, an inability to walk in a straight line, making the sufferer look drunk)
  • Losing consciousness (inability to stay awake or understand instructions)
  • Mental confusion or hallucinations
  • Liquid sounds in the lungs
  • Very persistent, sometimes watery, cough
  • Difficulty breathing
  • Rapid breathing or feeling breathless at rest
  • Coughing clear fluid, pink phlegm or blood (a very bad sign)
  • Severe lethargy/fatigue
  • Marked blueness of face and lips
  • High resting heartbeat (over 130 beats per minute)
  • Mild symptoms rapidly getting worse

Dangerous Cases of AMS

High Altitude Cerebral Edema (HACE)
This is a build-up of fluid around the brain. HACE can lead to unconsciousness and to death within 12 hours from the onset of symptoms, but normally takes 1-2 days to develop. At the first sign of ataxia, begin treatment with medication, oxygen and descent. Usually 4 to 8 mg of dexamethasone is given as a first dose, then 4 mg every six hours, Diamox every 12 hours and 2-4 litres/minute oxygen. Descent is necessary but a PAC (portable altitude chamber) bag will often be used first if available.

High Altitude Pulmonary Edema (HAPE)
This is an accumulation of fluid in the lungs and is very serious. It is responsible for all the other mild and serious symptoms and it is often accompanied by a mild fever. By far the treatment is oxygen at 4 liters a minute but using PAC (portable altitude chamber) bag treatment is a good substitute. If there is no PAC bag or oxygen, then descent will be life saving. HAPE can lead to unconsciousnes and death very quickly.

Prevention of Acute Mountain Sickness (AMS)

  • Allow sufficient time for acclimatization (After 3000 meters)
  • Don’t make rapid Ascent. Don’t go too far too fast.
  • No Alcohol, sleeping pills and smoking
  • Drink more fluid 3-4 litres a day, clean water, boiled or treated, tea, coffee, soup and juice
  • Climb high and sleep low
  • Do not trek/travel alone; take guide/porter
  • Follow the advice from your guide, hotel, local, guide book
  • Descent if mild symptoms are rapidly getting worse
  • Never leave or descent sick person along
  • Avoid getting cold
  • Take an easy and comfortable trekking route even if it’s longer

First-Aid Kit
This is the basic list to cover the more common ailments that affect trekkers. Climbing groups, expeditions and trekkers going to isolated areas will need a more comprehensive kit.

  • Bandage for sprains
  • Plasters/Band-aids
  • Iodine or water filter (optional)
  • Moleskin/Second skin – for blisters
  • Antiseptic ointment for cuts
  • Anti-bacterial throat lozenges (with antiseptic)
  • Aspirin/Paracetamol – general painkiller
  • Oral rehydration salts
  • Broad-spectrum antibiotic (norfloxacin or ciprofloxin)
  • Anti-diarrhoea medication (antibiotic)
  • Diarrhoea stopper (Imodium – optional)
  • Antibiotic for Guardia or similar microbe or bacteria
  • Diamox 250/500mg (for altitude sickness)
  • Sterile Syringe set (anti-AIDS precaution)
  • Gel hand cleaner.

Please Note: Our guide will also carry the first-aid kit bag during the trek. However, we still recommend you to bring your personal first-aid kit as well.