3 ACUTE MOUNTAIN SICKNESS You drive up to the Paradise Ranger by dfsdf224s


									                                                     likelihood, and those who had it previously
                                                     have a greater chance of getting it again
You drive up to the Paradise Ranger Station          Physical conditioning has absolutely no
on Mount Rainier and then hike up to Camp            influence on susceptibility. In fact, fit
Muir at just a little over 10,000 feet. You          individuals tend to go faster and therefore
begin to have a severe headache and feel             may have a higher incidence. Overexertion
nauseous and weak. If your condition                 and dehydration contribute to AMS and may
worsens, you may begin to have difficulty            be a predisposing factor. The key is to move
hiking. As we get into the official climbing         at a slow, steady, comfortable pace, stay
season here in Western Washington and                well hydrated and listen to your body. An
start to hike or climb to higher altitudes the       look for the symptoms of AMS
risks going to high altitude is important to
understand., so it’s essential that you              HEADACHE is by far the most common
understand the physiological effects of high         single symptom. It can vary from a minor
altitude.                                            nuisance to a severe throbbing. The severity
                                                     of the headache is a good guide to its
First high altitude is defined as being over         significance. A minor headache can be from
8,000 feet above sea level The concentration         a hard day of exertion, sun, cold or
of oxygen at sea level is about 21% and the          dehydration. This will usually disappear
barometric pressure averages 760 mmHg.               with some fluids and rest. The morning upon
As altitude increases, the concentration             waking, is a good time to judge symptoms.
remains the same but the number of oxygen            A headache upon awakening is probably due
molecules per breath is reduced. At 12,000           to altitude and should be taken more
feet (3,658 meters) the barometric pressure          seriously. A headache may be noticed on a
is only 483 mmHg, so there are roughly               descent from a pass or summit. This is a
40% fewer oxygen molecules per breath. In            delayed altitude effect and probably due to
order to properly oxygenate the body, your           the exertion on ascending. Aspirin can be
breathing rate (even while at rest) has to           taken to help relieve the pain.
increase. This extra ventilation increases the
oxygen content in the blood, but not to sea          Another symptom is Altitude insomnia this
level concentrations. Since the amount of            characterized by difficulty falling asleep and
oxygen required for activity is the same, the        frequent awakening during the course of the
body must adjust to having less oxygen. In           night. Over thirty percent of people going
addition, for reasons not entirely understood,       above 8,000 feet note difficulty sleeping.
high altitude and lower air pressure causes          Possibly secondary to periodic breathing
fluid to leak from the capillaries which can         (Cheyne-Stokes respiration). Some climbers
cause fluid build-up in both the lungs and           may awaken with the sensation of not
the brain.                                           breathing! The cold, dry air of the
                                                     mountains can cause a deep, hacking cough
 Anyone hiking or climbing to, and in, high          on exertion. Hard candies, throat lozenges
altitudes is at risk of developing AMS.              and proper hydration usually help relieve
Susceptibility varies from individuals and           this problem.. A lack of coordination and
with the same person from time to time.              balance that is very noticeable is called
Ascending quickly will increase its                  Ataxia. This is due to the lack of oxygen to

the brain.                                             indication that immediate descent is
                                                       required. It is important to get the person to
Rarely does a person with AMS have a good              descend before the ataxia reaches the point
appetite at high altitude. The better the              where they cannot walk on their own (which
appetite at higher altitudes, the better a             would necessitate a litter evacuation).
person is acclimatizing. Nausea is a
problem, but will eventually pass as a                 Severe AMS presents as an increase in the
person acclimatizes. Vomiting is a more                severity of the aforementioned symptoms,
serious problem. The big concern here is               including shortness of breath at rest,
dehydration, which can lead to rapid                   inability to walk, decreasing mental status,
weakness and the inability for that person to          and fluid buildup in the lungs. Severe AMS
continue.                                              requires immediate descent to lower
                                                       altitudes (2,000 - 4,000 feet [610-1,220
The basic Treatment of AMS and the only                meters]).
cure is either acclimatization or descent.             There are two other severe forms of altitude
Symptoms of Mild AMS can be treated with               illness, High Altitude Cerebral Edema
pain medications for headache that help to             (HACE) and High Altitude Pulmonary
reduce the severity of the symptoms, but               Edema (HAPE). Both of these happen less
remember, reducing the symptoms is not                 frequently, especially to those who are
curing the problem.                                    properly acclimatized. When they do occur,
                                                       it is usually with people going too high too
Moderate AMS includes severe headache                  fast or going very high and staying there.
that is not relieved by medication, nausea             The lack of oxygen results in leakage of
and vomiting, increasing weakness and                  fluid through the capillary walls into either
fatigue, shortness of breath, and decreased            the lungs or the brain.
coordination (ataxia). Normal activity is
difficult, although the person may still be            High Altitude Cerebral Edema (HACE) is
able to walk on their own. At this stage, only         the result of swelling of brain tissue from
advanced medications or descent can reverse            fluid leakage. Symptoms can include
the problem. Descending even a few                     headache, loss of coordination (ataxia),
hundred feet (70-100 meters) may help and              weakness, and decreasing levels of
definite improvement will be seen in                   consciousness including, disorientation, loss
descents of 1,000-2,000 feet (305-610                  of memory, hallucinations, psychotic
meters). Twenty-four hours at the lower                behavior, and coma. It generally occurs after
altitude will result in significant                    a week or more at high altitude. Severe
improvements. The person should remain at              instances can lead to death if not treated
lower altitude until symptoms have subsided            quickly. Immediate descent is a necessary
(up to 3 days). At this point, the person has          life-saving measure (2,000 - 4,000 feet [610-
become acclimatized to that altitude and can           1,220 meters]). There are some medications
begin ascending again. The best test for               that may be prescribed for treatment in the
moderate AMS is to have the person “walk a             field, but these require that you have proper
straight line” heel to toe. Just like a sobriety       training in their use. Anyone suffering from
test, a person with ataxia will be unable to           HACE must be evacuated to a medical
walk a straight line. This is a clear                  facility for proper follow-up treatment.

                                                      higher altitude. The recommendation of the
High Altitude Pulmonary Edema (HAPE)                  Himalayan Rescue Association Medical
HAPE results from fluid buildup in the                Clinic is 125 mg. twice a day (morning and
lungs. The fluid in the lungs prevents                night). (The standard dose was 250 mg., but
effective oxygen exchange. As the condition           their research showed no difference for most
becomes more severe, the level of oxygen in           people with the lower dose, although some
the bloodstream decreases, and this can lead          individuals may need 250 mg.) Possible side
to cyanosis, impaired cerebral function, and          effects include tingling of the lips and finger
death. Symptoms include shortness of breath           tips, blurring of vision, and alteration of
even at rest, “tightness in the chest,” marked        taste. These side effects may be reduced
fatigue, a feeling of impending suffocation           with the 125 mg. dose. Side effects subside
at night, weakness, and a persistent                  when the drug is stopped. Contact your
productive cough bringing up white, watery,           physician for a prescription. Since Diamox
or frothy fluid. Confusion, and irrational            is a sulfonamide drug, people who are
behavior are signs that insufficient oxygen is        allergic to sulfa drugs should not take
reaching the brain. One of the methods for            Diamox. Diamox has also been known to
testing yourself for HAPE is to check your            cause severe allergic reactions to people
recovery time after exertion. If your heart           with no previous history of Diamox or sulfa
and breathing rates normally slow down in             allergies.
X seconds after exercise, but at altitude your
recovery time is much greater, it may mean            Dexamethasone (a steroid) is a prescription
fluid is building up in the lungs. In cases of        drug that decreases brain and other swelling
HAPE, immediate descent is a necessary                reversing the effects of AMS. Dosage is
life-saving measure (2,000 - 4,000 feet [610-         typically 4 mg twice a day for a few days
1,220 meters]). Anyone suffering from                 starting with the ascent. This prevents most
HAPE must be evacuated to a medical                   symptoms of altitude illness. It should be
facility for proper follow-up treatment.              used with caution and only on the advice
                                                      of a physician because of possible serious
Some medications for altitude illnesses are:          side effects. It may be combined with
Ibuprofen is effective at relieving altitude          Diamox. No other medications have been
headache. Nifedipine rapidly decreases                proven valuable for preventing AMS.
pulmonary artery pressure and relieves
                                                       TACOMA MOUNTAIN RESCUE
HAPE. Breathing oxygen reduces the effects
                                                       BOARD MEETING MINUTES
of altitude illnesses.
                                                       March 27, 2002
Diamox (Acetazolamide) allows you to                  These minutes as published are unofficial
breathe faster so that you metabolize more            and subject to approval at the next regularly
oxygen, thereby minimizing the symptoms               scheduled board meeting. Convened 19:30.
caused by poor oxygenation. This is
especially helpful at night when respiratory          BOARD MEMBERS PRESENT: Ken
drive is decreased. Since it takes a while for        Capron, Tod lokey, Chris Berryman, Gus
Diamox to have an effect, it is advisable to          Bush, Stan Kartes, Bill Weber, Greg Lang,
start taking it 24 hours before you go to             Rick Wire.
altitude and continue for at least five days at

OTHER MEMBERS PRESENT: Casey                     EQUIPMENT REPORT: Ken Capron
Hill, Bubba Rush, Rod Scott, Alan                     C    Ken is looking for a
Givotovsky                                                 replacement as equipment
                                                           chair; Rod was appointed to
TREASURER’S REPORT: Victor Caro                            the position.
C      Currently in deficit – large number            C    Chris motioned to purchase
       of expenses.                                        rope - 2 spools 8mm; 2 x 50
Monthly report accepted as presented for                   m 11mm low
       02-28-02 through 03-27-02 (Full                C    Gus motioned to replenish
       report is attached to the official                  stores of patches and stickers.
       meeting minutes.)                              C    Tod purchased a projector
Victor was absent; Ken read the report.                    screen.
                                                      C    Tod will purchase a remote
KIT REPORT: Tracy Berryman                                 pointer for computer.
      Changing pencils was discussed; no
             motion made due to cost             COMMUNICATIONS: Stan Kartes
             increase.                               C    Greg Lang was appointed to
      Tin can order coming; new design                    the Communications Chair
             discussed.                                   during Stan’s absence
      Tracy was absent; Chris read the               C    Pager service was cancelled;
             report.                                      cell phones brought on line.
                                                     C    Board approved budget for
OPERATIONS REPORT: Gus Bush                               30 unit pagers at the March
     C    No missions.                                    13 unit meeting.
     C    Mt. Bachelor Mission
          Critique on March 13.                  SAFETY & EDUCATION: Rick Wire
     C    SAR coverage in April                       C    June 1 (10-2pm) Milton
          Rucksack                                         Safety Fair 2002;
                                                      C    BoeAlps Intermediate self-
TRAINING REPORT: Russ Brinton                              rescue course
     C    March training was rigging at               C    Girlscouts “Lost in the
          Ft. Stillicum.                                   Woods”
     C    Chris proposed extending                    C    Casey Hill will purchase 3
          training schedules to include                    helmets.
          weekday options for                         C    Practice riot at Sprinker on
          members not available for                        March 14 was extremely
          weekend trainings.                               successful
     C    Chris B. and Ken C. attended
          avalanche course at Mt.                MEMBERSHIPS REPORT: Chris
          Hood.                                  Berryman
     C    April is survival training.                  C  Austin Peters voted in at FS
     C    Russ was absent; Rick and
          Chris reported.                        SARVAC: Fran Martoglio
                                                     C      Not present

SAR COUNCIL: Wendy Stefaniak
     C    Not present

MAST: Bill Weber
     C      Not present

     C    Cache remodel equipment
          around cache.
     C    Website location has been
          purchased; transfer in
                                           The following members attended the Kit
     C    Truck has new floodlights.
                                           Party on 3 Apr 2002
                                           John Simac
                                           Chris and Tracy Berryman
     C    Testing of 7mm cordage by
                                           Greg Lang
          John, Rod, and Rick
                                           Ken Capron
     C    Cache/Kit Party tables
                                           Chris Muhs
          (3’x8’) need replacing.
                                           Gus Bush
                                           Bill Weber
Meeting Adjourned at 21:30
                                           Ken, Christine and Ian Davies
Respectfully yours,
                                           Tim Greminger
Tod Lokey, Secretary
                                           They made 218 Kits

                                           The Kit parties are held from 7:00 to 9:00
                                           P.M., the first Wednesday of the month and
                                           the Prep parties are held the third
                                           Wednesday, both at the Cache. If you need
                                           directions, call 531-2120. We need your

            KIT PARTY


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