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ACCLIMATIZATION Major Dr Inam Danish Khan Medical Officer Nehru Institute of Mountaineering
PROLOGUE Altitude acclimatization High Altitude Diseases Cold Acclimatisation Cold Injuries Heat Acclimatisation Heat Illness
HIGH ALTITUDE O2 - 21 %  8850 m/ 29000 ft  pA = 0.3  5500 m/ 18000 ft 0 m  pA = 0.5  pA = 0.75  2700 m/ 9000 ft   pA = 1 atm
GUIDING PRINCIPLES     Ascend gradually	    < 2000 ft in a day Work high, sleep low Take proper meals and plenty of fluids Take adequate sleep, do some exercise Abstain from tobacco and alcohol etc. Avoid physical exertion and cold exposure Avoid sleeping pills, tranquilizers etc. Don’t get overconfident, follow schedule Immediately report health problems If you feel unwell, it is high altitude illness unless proven otherwise
ACCLIMATISATION SCHEDULE STAGE 1 (9000 ft – 12000 ft ) 6 DAYS      Day 1&2  -  rest, short walk, no climb     Day 3&4  -  1.5-3 km walk without load                          No steep climb     Day 5&6  -  5 km walk with load/                          300 m climb with load
ACCLIMATISATION SCHEDULE STAGE 2 (12000 ft – 15000ft ) 4 DAYS STAGE 3 (15000 ft – 18000ft ) 4 DAYS    Day 1&2  -   1.5 km walk without load                          no steep climb.    Day 3        -   3 km walk without load                           300 m climb without load    Day 4        -   3 km walk with load/                           300 m climb with load
RE ENTRY  < 10 Days    -   no re acclimatization  10-28 days  -   4-4-4  > 28 Days    -   complete acclimatization
WHAT HAPPENS BEYOND 5500M/18000FT? No acclimatization is possible DETERIORATING ZONE      6000-8000 M DEATH/LETHAL ZONE        >8000 M
HIGH ALTITUDE ILLNESSES  1. ACUTE MOUNTAIN SICKNESS (AMS)  2. HIGH ALTITUDE PULMONARY OEDEMA (HAPO)  3. HIGH ALTITUDE CEREBRAL OEDEMA (HACO)
ACUTE MOUNTAIN SICKNESS SYMPTOMS ,[object Object]
6-24 hrs of ascent
Headache
Nausea / Vomiting
Loss of sleep
Loss of appetite
Fever
Weakness
Dizziness
Memory problemCAUSES ,[object Object]
Undue exertion
Alcohol/Smoking on mtnTREATMENT ,[object Object]
Plenty of fluids
Paracetamol 500 mg X 3
Diamox 250 mg X 3
Avomine SOS
Descent if severe,[object Object]
2nd night of ascent
Symptoms of AMS
Breathlessness
Cough
Blood in sputum
Abnormal pulse, resp
Cyanosis (Tongue?)
UnconsciousnessCAUSES ,[object Object]
Undue exertionTREATMENT ,[object Object]
Dexamethasone 4 mg

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