Acute Mountain Sickness in worse (HACE and HAPE):
AMS signs:
Headache, often with loss of appetite, nausea, vomiting, tiredness, dizziness, disturbed sleep etc.
What to do?? Stay at height for 1-3 days or descend, Diamox (250mg every 8/12 hrs). drink at least 3 litters water in a day.
HACE Signs:
Severe headache, loss of balance/coordination, staggering, irrational behavior, confusion, drowsiness, coma, death (sometimes in a few hours).
What to do in this condition?? Check with straight-line heel-to-toe walking. HACE victims cannot do it. Descend immediately! even in a night, at least 200m. Take someone else your staff. Oxygen, Gamow bag, keeps patient warm, Diamox.
HAPE Sign:
Breathless (even at rest), dry cough/pink or rusty spit, blue lips/nails, very tired, low fever, gurgling breath, drowsy, coma, death.
What to do? See HACE + nifedipine
PREVENTION! PREVENTION IS BETTER THAN CURE:……..
Ascend slow (300-500m/day), don’t extent yourself, eat high carbohydrate callory foods, drink lots water minimum 3 liters per day. Locals recommend garlic soups, avoid alcohol and caffeine.
Other problems:
- Sick: Doctors at VDC health posts. Trained doctors in Manang, Annapurna circuit trekking trail HRA health aid office, in Pheriche Everest region trekking trail, and Namche Bazar in the Everest’s region, HRA in Langtang region and other famous areas in Nepal. Foreign doctors in Manang and Pheriche (March-April, late Sept.-early December).
- Private Helicopter evacuation: call. Contact by your agency incase in the emergency. Have credit card (U$D 2500-3000 per resque) and travel insurance number.
- Horse/Donkeys/mules/yaks stay on the uphill side of these beasts.