HIGH ALTITUDE SICKNESS
1. Context
In September, a trekker from Idukki, Kerala, died in Uttarakhand while attempting to scale Garur Peak due to respiratory failure. Every year, numerous tourists like this succumb to the effects of high-altitude sickness in the pristine but challenging inner Himalayas. These regions present hidden dangers due to their extreme altitudes, where thinner air and reduced oxygen can lead to potentially fatal conditions.
2. What is High Altitude Sickness?
- High-altitude sickness, also known as Acute Mountain Sickness (AMS), occurs when the body struggles to adapt to elevations typically above 8,000 feet (2,400 meters). At higher altitudes, reduced air pressure and lower oxygen levels result in hypoxia, a condition where body tissues receive insufficient oxygen.
- Early signs of AMS include headache, nausea, fatigue, and difficulty breathing. If not addressed promptly, it can progress to severe conditions like high-altitude pulmonary edema (HAPE), where fluid builds up in the lungs, or high-altitude cerebral edema (HACE), where fluid accumulates in the brain. Both conditions are life-threatening and require urgent medical attention, often necessitating a rapid descent to lower altitudes to prevent fatal outcomes.
- At high elevations, the body attempts to adapt by increasing the breathing rate, which can lead to hyperventilation, and producing more red blood cells to transport oxygen. However, this thickens the blood, placing additional strain on the heart. In HAPE, fluid in the lungs worsens breathing difficulties, while HACE can cause confusion, hallucinations, and even lead to coma
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Registration System
To better manage high-altitude tourism, it is essential to implement a mandatory registration system for tourists entering remote mountain areas. Registrations, stored in a State government database, would allow authorities to monitor tourist movement and respond swiftly in case of emergencies. Such records would also support research on high-altitude illnesses by tracking demographic patterns and risk factors, helping scientists better understand how altitude impacts various populations
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3. Reasons for High Altitude Sickness
- The main cause of high-altitude sickness is ascending too quickly without giving the body enough time to adjust. A gradual ascent, allowing the body to adapt to lower oxygen levels, is the most effective way to prevent altitude-related illnesses.
- The Wilderness Medical Society advises that travelers going above 3,000 meters should take a rest day every 3-4 days and limit the increase in sleeping elevation to no more than 500 meters per day.
- For those at moderate to high risk of AMS, doctors may prescribe medications like Acetazolamide to aid acclimatization by improving oxygenation, or Dexamethasone, a steroid used to reduce inflammation in severe cases.
- People with a history of HAPE may be advised to take Nifedipine as a preventive measure, starting a day before ascending. However, no medication can guarantee complete protection, so it is essential for anyone with pre-existing health conditions to consult a doctor experienced in managing altitude-related health risks before traveling to high altitudes
4. Treatment for Accute Mountain Sickness (AMS)
The treatment for high-altitude sickness (AMS) primarily involves managing symptoms and preventing the condition from progressing to more severe forms like High-Altitude Pulmonary Edema (HAPE) or High-Altitude Cerebral Edema (HACE).
Here are the main treatment options:
- The most effective treatment for AMS is to descend to a lower altitude, ideally at least 1,000 to 2,000 feet (300 to 600 meters). This helps alleviate symptoms and allows the body to recover
- When high-altitude sickness does develop, the most effective treatment is immediate descent to lower altitudes. Symptoms usually improve significantly with a descent of 300-1,000 metres.
- Supplemental oxygen or a portable hyperbaric chamber, if available, can also help alleviate symptoms of AMS and HACE in emergencies. Pharmacological treatments, such as acetazolamide and dexamethasone, may provide short-term relief, but descent remains the cornerstone of treatment.
5. Way Forward
The following steps are recommended — establish state-of-the-art medical facilities in high-altitude regions of the Himalayas; create research centres dedicated to studying high-altitude illnesses; equip Himalayan States with air-ambulance services for rapid medical evacuation in emergencies; and provide health and safety information on government websites and at check-in points.
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For Prelims: Acute Mountain Sickness (AMS), Acclimatization
For Mains: Science & Technology (GS-III) - Physiological impact of high altitude, oxygen therapy
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Source: The Hindu
