How to Assess Altitude Illness

There are three gradations of altitude illness: acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE).

Instructions

Difficulty: Easy

Assess for Mild Altitude Illness (AMS)

1. Look for the following signs and symptoms: headache, nausea, vomiting, malaise, loss of appetite, sleep disturbances, shortness of breath on exertion, dry cough escalating to a productive cough, bluish tint around the mouth and in the fingernail beds, swelling of the hands or face.
2. Treat for mild altitude sickness if the person exhibits any of the above symptoms (see "How to Treat Mild Altitude Illness").
3. Evaluate for signs of severe altitude illness by using the following steps.

Assess for Severe Altitude Illness (HAPE or HACE)

4. Look for signs of mild altitude illness, plus the following signs and symptoms: shortness of breath at rest, fatigue, dizziness, vision disturbances, hallucinations, paralysis or loss of sensation in any part of the body.
5. Have the person walk in a straight line and stand with his feet together and eyes closed: Does he stumble or waver?
6. Take the person's heart and respiratory rate (see "How to Measure and Record Vital Signs During First Aid" and "How to Measure and Record Respiratory Rate"). Is either one elevated?
7. Use a stethoscope or put your ear to the person's chest and listen as he takes a deep breath. Do you hear any fluid in the lungs, or is he coughing up any blood?
8. Monitor the person's level of consciousness (see "How to Assess Level of Consciousness During First Aid"). Is it less than A and O times 4?
9. Treat immediately for severe altitude illness if you answered yes to any of the above questions (see "How to Treat Severe Altitude Illness").

Tips & Warnings

• The signs and symptoms of even the mildest stages of altitude illness often resemble those for colds, flu and dehydration. Assume that any illness at altitude is either caused by the ascent or will improve with acclimatization or descent.
• Altitude illness can kill. Treat cases of mild altitude illness immediately to prevent their developing into severe altitude illness.
• Descend immediately and rapidly if any of the signs and symptoms of severe altitude illness are present. Don't wait to see if they'll get better - they won't without a descent.
• People with altitude illness suffer from impaired judgment and will need others to assess their condition and make decisions for them. Be especially careful if the afflicted person is a physician, guide or has more training or experience than you do - trust your own judgment, not his.
• This information is not intended as a substitute for professional medical advice or treatment.