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Mountain Sickness (cont.)

What is the medical treatment for altitude sickness treatment?

Descending to lower altitudes (about 1640-3280 feet or 500-1000 meters lower altitude than the altitude the person was at when symptoms developed) or delaying further ascent are treatments for altitude mountain sickness until symptoms are gone.

  • A Gamow bag may be used if descent is not feasible (see previous sections for details).
  • Oxygen (2-4 liters per minute) will improve oxygen saturation of blood.
  • Aspirin, acetaminophen (Tylenol), or ibuprofen (Advil, Motrin) may be taken for headache (do not give aspirin to children).
  • For nausea, the doctor may prescribe prochlorperazine (Compazine), an antinausea medication that also enhances the body's ability to increase the breathing rate in response to low-oxygen environments. Other antimetics have been used (for example, ondansetron (Zofran).
  • Sleeping pills for insomnia should not be taken. They are potentially dangerous because they can slow breathing. However, some doctors still may prescribe them under certain circumstances.
  • Acetazolamide (Diamox) may be prescribed to hasten acclimatization.
    • Acetazolamide is a diuretic (a drug that increases urine output) that increases kidney excretion of bicarbonate. This decreases the blood pH, thereby stimulating extra breathing, which results in higher oxygen levels in the blood.
    • In addition, acetazolamide corrects nighttime pauses in breathing known as periodic breathing. Acetazolamide also improves symptoms of insomnia.
    • This medication may also be utilized in a preventative manner in people with a prior history of altitude sickness.

High-altitude pulmonary edema responds best when the person descends from their current altitude.

  • Oxygen, if available, should be provided.
  • Nifedipine (Procardia), a medication for high blood pressure, has been shown to be beneficial for high-altitude pulmonary edema.
  • Antibiotics may be given if a fever is present and pneumonia is possible.
  • For more severe cases of high-altitude pulmonary edema, continuous positive airway pressure (CPAP) mask ventilation can be used. Although uncomfortable to wear, the CPAP mask helps by increasing the pressure of the inhaled air.
  • If this intervention fails, a tube may be placed through the mouth and into the airway (intubation). This, along with assisted ventilation, is required to treat respiratory failure.

The only definitive treatment for high-altitude cerebral edema is descent from the person's current altitude.

  • Dexamethasone (Decadron), a steroid, may be beneficial.
    • Generally, if xamethasone is considered, then a plan for descent should be in place unless descent is impossible.
    • Some people, after receiving dexamethasone, may feel so much better that they want to continue ascending. Under no circumstance should this be allowed.
  • Oxygen may be helpful.
  • A Gamow bag may buy time until descent is possible.

Anyone with high-altitude cerebral edema or high-altitude pulmonary edema should be kept as comfortable as possible.

  • Exertion of any type should be minimized, even during descent
  • This means that it may be necessary to arrange descent for the ill person by whatever means available (helicopter, snowmobile, or mule, for example).
Medically Reviewed by a Doctor on 12/15/2015

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