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.
Relevance:
GS II: Health
Dimensions of the Article:
- What is high-altitude sickness?
- What about early intervention?
- What are the treatment strategies?
What is high-altitude sickness?
- High-altitude sickness, or Acute Mountain Sickness (AMS), occurs when the body cannot acclimatise to high elevations, typically over 8,000 feet (2,400 metres).
- As altitude increases, the air pressure and oxygen levels decrease, leading to hypoxia — a shortage of oxygen in the body’s tissues.
- Early symptoms of AMS include headache, nausea, fatigue, and shortness of breath. If left untreated, it can escalate into high-altitude pulmonary edema (HAPE), a life-threatening condition where fluid accumulates in the lungs, or high-altitude cerebral edema (HACE), where fluid collects in the brain.
- Both conditions require immediate medical intervention, and descent to lower altitudes is often the only way to prevent fatal outcomes.
- At higher altitudes, the body tries to adjust by increasing the breathing rate, which can cause hyperventilation, and produce more red blood cells to carry oxygen, which thickens the blood and strains the heart.
- In cases of HAPE, fluid accumulation in the lungs exacerbates breathing difficulties, while HACE causes symptoms like confusion, hallucinations, and even coma.
What about early intervention?
- The primary cause of high-altitude sickness is rapid ascent without allowing the body time to acclimatise.
- Gradual ascent, which allows the body to adapt to lower oxygen levels, is the best way to prevent high-altitude illnesses.
- According to the Wilderness Medical Society, travellers ascending above 3,000 meters should take a rest day every 3-4 days and avoid increasing their sleeping elevation by more than 500 metres per day.
- For travellers at moderate to high risk of AMS, doctors recommend medications like Acetazolamide, which aids acclimatisation by promoting better oxygenation, or Dexamethasone, a steroid that reduces inflammation in severe cases.
- Those with a history of HAPE may take Nifedipine as a preventive measure, starting a day before ascent. However, no prophylactic medication guarantees complete immunity, and anyone travelling to high altitudes with pre-existing health conditions should first consult with a doctor familiar with altitude-related risks.
What are the treatment strategies?
- 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.
-Source: The Hindu
