As winter begins to loosen her grip and spring is just around the corner, many are making plans on heading into the high country. Some things to consider along with mosquito spray and SPF 50,000 lol.
I used to work for the Ambulance service in EP and am stil active in EMS in Northeast Colorado. More of a meeting hack now though. With that said, There is nothing more disconcerting to a visitor to be told "Go " when they have a high altitude emergency. I mean how would you feel if after 6 months of planning and preparation your vacation is suddenly cut short by something as silly as elevation.
So, why all the acronyms? well.. good question, AMS.. "Acute Mountain Sickness, HAPE; High Alittude Pulmonary Edema, HACE; High Altitude Cerebral Edema are all the severe reactions to what in it's milder forms is simply called Altitude Sickness. something almost all of us get when we go from low altitude to high altitude. So what is "high altitude" again that is dependent on which article you read.. to some it's as low at 6,500 feet. However common literature uses the level of 8,000 as a defining point between the milder effects and the more acute serious forms of the malady.
In its milder forms, its hard to diagnose as it mimics other diseases.. I can describe it simply as "flu like" Headache, tiredness, general malaise, Some times easily masked with Tylenol or Ibuprofen.
So what is the mechanism of AMS.. at sea level and at altitude there is around 21% oxygen right? Yep.. the issue is not the percentage, its the pressure of the atmosphere its just there are less oxygen molecules available. I could get all scientific and lose you here, but i do better with analogies.. Let's paint a common theme first... You live at or below 1,000 in altitude, you hop a plane and fly to Denver (Mile High City remember?) then you rent a car, head up past Ed's place in Lyons and motor up Hwy 36 to Estes Park. WOW... what a view! You have reservations somewhere so you have time right? Park pass in hand you head up to RMNP, Oh BTW.. Estes is around 7500 feet. You show the pass and your ID to the ranger at the kiosk, grab your map and head up to AVC.. (Alpine Visitors Center).. Somewhere along the way you complain of a headache, take an ibuprofen or Tylenol, but its no big deal "YOU'RE ON VACATION" YAY.. you're here. Darn headache anyway.. and wow, you're now nauseous, SOB, (Which doesn't mean you have magically turned into a jerk) SOB means Short of Breath, Lips look a little SMURFY.. (Blue) , you're sick as a dog.. now what? well to some it's not that clear, Sometimes people read the signs and symptoms and head down, some well wait.. the symptoms get so bad that they end up using Emergency Medical Services. Which means a HUGE BILL! horrible inconvenience and possibly and end to the vacation.. Wow no wonder people wait to call 911 ?
We used to call it the 7500 feet cardiac stress test, Shortness of breath, chest pain, in anyone over the age of 40 means coronary artery disease until proven otherwise. So is it Altitude Sickness or Heart Disease, for the sake of this discussion, we'll focus on altitude sickness.
So... what just happened? well simply you went from 1,000 feet to around 12,200 feet in less than a day. OMG... Other contributing factors can include, alcohol consumption even in small quantities, lack of sleep, dehydration, (Remember there are less water molecules in the air too, even though it's cool outside, the air at altitude is very dry..) physical fitness etc.. and maybe you're just susceptible.
So lets do it differently, Land in Denver, get a room.. (might be nice anyway ?) NO ALCOHOL>>> get a good nights rest, drink lots of fluid, eat a healthy breakfast and then.. head on up.. take some time in town, buy a T shirt (lots of selection there ?). Head on up to Bear Lake, get a short walk in around the lake.. Get another good nights sleep,
THEN>>> go on up to AVC.. If at any time you feel short of breath, nauseous, head achy, go down and spend more time in EP..
A good rule of thumb is always.. Climb High, Sleep Low... that's even for the experts, there are many stories of young healthy climbers being overcome with the acute forms..
I Look forward to not hearing from you in the Emergency Department.. see you on the trails
(original forums topic
**(Photo by Roger Wollstadt Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)