Shei-Pa National Park Headquarters, National Park Service, Ministry of the InteriorShei-Pa National Park Headquarters, National Park Service, Ministry of the Interior

Mountain sickness is the syndrome caused by low pressure and oxygen depletion in the mountain environment. When our body ascends to a certain height in a short time, it cannot timely get used to the high-altitude environment, thus suffering from mountain sickness. Generally, gradual adaptation to the highland is better. But the drop height of landforms and the habit of mountain climbing in Taiwan lead to that most people, when being over 2,500 meters, start to have symptoms of mountain sickness, for there is scarcely any modulation itinerary.

What causes mountain sickness lies in 3 elements: altitude, ascending speed, and personal adaptability. In general, people will have initial symptoms of mountain sickness when adapting themselves to the mountain area, usually in 4 to 8 years after reaching the 2,500-meter-high area. The symptoms on people with better adaptability will be alleviated rapidly in the second or third day. Since all serious mountain sickness is preventable, to correctly understand mountain sickness is the best way to keep the safety of mountain climbing. The following is the symptom, prevention, and treatment of mountain sickness as your reference in mountain climbing.

Symptoms

Acute Moutain Sickness（AMS）

• Minor symptoms: headache, vertigo, anorexia, insomnia, nausea, periphery edema, tiredness.
• Intermediate symptoms: vomit, headache that cannot be alleviated with normal anodyne, urine decrease.
• Major symptoms: consciousness change, unsteady step, dyspnea in rest, pulmonary rale, cyanosis (lips or fingernails turn purple, meaning anoxemia)

High Altitude Pulmonary Edema（HAPE）

• Initial symptoms: motor ability dropping(usually the earliest symptom), dry cough,tiredness, chest tightness, rapid heartbeat, rapid breath.
• Terminal symptoms: hard to breathe in rest, suffocation feeling at night, unceasing cough, cough up white phlegm or blood, hard to breathe even lying down, pulmonary rale.

High Altitude Cerebral Edema（HACE）

• Acute headache (often worsens when walking, exerting strength, or lying down), nausea, vomit, unsteady step, abnormal judgment, abnormal behavior, hallucination, chaotic consciousness, and even coma. Another way to judge if a person suffers from HACE is to ask him to walk in a straight line by placing a foot's tiptoe to the other's heel. If unable to do so, he must go downhill immediately.

Prevention

• Altitude prevent: Prevention is always better than treatment. Walking up gradually can give the body enough time to get used to the change of altitude and is also the most important principle of preventing mountain sickness.
• General prevention :Carry oxygen cylinders or portable hyperbaric bad, avoid intense activity, keep warm, and do not smoke, have alcoholic drinks, take tranquilizer, or eat carbohydrates. Avoid consuming the food that easily generate gas, like beans or carbonated beverages and eat those of high glucose and low fat. All the above can alleviate or prevent mountain sickness.
• Medication prevention :On medicine, those proven effective in mountain sickness include diamox (acetazolamide), dexamethasone, and nifedipine. The patient allergic of sulfonamide or suffering from favism is forbidden taking diamox.
• Others: 1. Attempting to get on a mountain over 3,000 meters, climbers should first adapt themselvesin the 2,500-meter-high area for one night and then continue climbing.2. If having to ascend from level ground to 3,000 meters in 24 hours, climbers should considertaking medicine for prevention.

Treatment

The key of successful treatment is the early discovery, early diagnosis, and early treatment. The principles of treatment are as follows:

• Get away from the high-altitude environment (going downhill).
• Improve the environment that causes symptoms (giving oxygen, increasing pressure).
• Take a rest (reducing the consumption of oxygen)
• Take medicine.

Golden principle of dealing with mountain sickness

The key of successful treatment is the early discovery, early diagnosis, and early treatment. The principles of treatment are as follows:

• When over 2,500 meters above sea level, the symptoms of headache, nausea, rapid breath, and vomit should be considered related to mountain sickness, unless other reasons can be proved to cause them.
• The patient having minor mountain sickness symptoms should not go up further, unless symptoms disappear. Please note that never leave the patient with mountain sickness alone under whatever circumstances.
• If his symptoms worsen, or turn from minor to major, the patient should descend at least 1,000 meters to a lower place.
• The best and safest principle to deal with mountain sickness is descending to a lower place. When the patient is still conscious andable to walk, it is the right time to walk downhill. Do not call for help till he is in a coma or paralysis, because it is more difficult to go downhill or have first aid this moment.