Medical Aspects
of high altitude mountaineering

You should carry your own first aid kit and be familiar with its use. Problems peculiar to the tropics and high altitudes need special attention.

Altitude Sickness: Problems result from the inability of the human body to adjust to a rapid gain in altitude and range from mild cases of Acute Mountain Sickness (AMS), experienced to some extent by most climbers, to the often fatal Pulmonary and Cerebral Oedemas, the latter being far less common. A slow pace and copious fluid intake (unless oedema is suspected) reduce the severity of Altitude Sickness. Dehydration, even mild, leads to thickening of the blood with increased possibility of pulmonary embolism or a thrombosis. Urine colour should be pale and the output copious. (Oedemas are the accumulation of liquid in a part of the body).

Improvised rescue of oedema victim at Lake Kitandara in the Rwenzori

Symptoms of AMS include loss of appetite, headache, nausea, vomiting, exhaustion, lassitude, weakness, a rapid pulse even at rest, insomnia, swelling of hands and/or face and reduced urine output. Climbers with severe symptoms must stop ascending and seriously consider descending to a lower altitude, since often a drop of as little as 500m. and a stay of a couple of days at that level will allow recovery. The drug DIAMOX can sometimes help or prevent or reduce the severity of AMS. With Pulmonary Oedema, additional symptoms may be noticed - shortness of breath, even at rest, gurgling, bubbly sounds in the chest and sometimes watery blood-tinged sputum. Skin may be cold and clammy, lips and finger nails bluish. With Cerebral Oedema, severe headache, hallucination and lack of co-ordination are additional symptoms. Treatment: IMMEDIATE DESCENT.

Pneumonia: This can kill, in some cases very rapidly. Symptoms include rise in temperature, pain in chest, shivering, rapid breath and dry cough sometimes with red mucus. Cure involves keeping the patient warm, getting him to lower altitudes, providing warm drinks and antibiotics, and by beating chest to encourage coughing.

Sun: At an altitude of 4,000m, only about 60% of the harmful UV sunlight is filtered out by the atmosphere. This can result in very rapid burning of exposed skin; lips are particularly badly affected. Good suncreams are recommended. Dark glasses with side panels should be worn when crossing snow to prevent snow blindness, even in misty conditions. Snow blindness is painful and feels like sand in the eyes; rest and eye drops help; great care is required to avoid rubbing eyes (bandaging?).

Hygiene: Do not pollute streams by washing yourself or catering-utensils in them. These are water supplies for you and other people. If there is no latrine dig a private hole for your excrement as far as possible from camps or paths, using an ice axe or stick, then refill it neatly. Do not leave rubbish lying around. Some, such as food and paper can be buried in well-vegetated zones, but tins, bottles, metal foil and plastics must be carried out.

Basic First Aid Kit: Aspirin or Paracetamol for headaches and fevers. Throat lozenges for dry throats. Lip salve. Crepe bandages, tape and gauze. Eye drops, e.g. Optrex. Soap for washing wounds. Mild disinfectant wash. Anti-Diarrhoea medicine, e.g. Imodium. A laxative. Diamox for mountain sickness; a side effect of this drug is a tingling sensation in the extremities. Stronger pain killer, e.g. Fortral or Sosogen. Antibiotics for pneumonia or other major infections. Water purifiers.

Information and recommendations contained in this section should be regarded as a guide only. More detailed information can be obtained from specialised publications such as ‘Medicine for Mountaineering’ (The Mountaineers, Seattle, USA).

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© Andrew Wielochowski 13/04/02. From the "Kilimanjaro Map and Guide"