Three Ways of Treating Altitude Sickness in Preppers


Acute Mountain Illness – What Preppers Need to Know & Stock in their Medical Kit

Unexpectedly, and sometimes against your wishes, you’ll find yourself being pushed back into mountainous areas.  And while these high peaks may not be part of your bug-out-plans, it’s important to know how to deal with acute mountain or altitude sickness in case you find yourself in this situation.

Preppers & Natives Retreating

A recent example of this occurred in the summer of 2014.  A terrorist group calling themselves ISIS, cloaked in ninja costumes and running around like idiots with pirate flags, pushed the Kurdish people of Northern Iraq to hill tops within a mountainous region.  It’s more accurate to say they fled to elevation in effort to avoid the heavy armor of the invading force.  You may remember the NATO helicopter airlifts tasked with removing the wounded and sick.  Many individuals had been injured during combat, while others, largely women and children, were evacuated because they were suffering from altitude sickness.

Acute Mountain Illness

These peaks were not excessive in elevation.  As such they illustrate two important elements to this disease.  First, it’s random; one cannot predict who will be affected.  Second, the speed of ascent seems to be related to disease severity – as well as the overall number of people effected.  In other words, if you’re forced to run uphill because you’re being chased by tanks, expect higher rates of acute mountain sickness than if you strolled up steadily.

Altitude Sickness in America?

In the United States, acute mountain or altitude sickness is experienced by 15% of people visiting a Colorado ski resort.  Even higher rates are found in mountain climbers.  This probably reflects the degree of exertion inherent to the sport (see table 1).

Altitude Sickness in Skiers

What is Altitude Sickness?

Described best as a spectrum of disease, Altitude illness reflects an incomplete response of the body in its attempt to adjust to elevation.  This spectrum can range from simple acute mountain sickness – producing symptoms similar to a hangover – to those of fluid retention in the lungs and sometimes even the brain.  These more severe forms confer a higher mortality rate.

It’s commonly believed as elevation increases, the air’s oxygen concentration decreases.  In reality, the oxygen concentration stays the same.  It’s the barometric pressure that decreases.  Known as the “partial pressure of oxygen” in medical circles, barometric pressure is best thought of as the driving force of oxygen.  The energy pushing it from your lungs into your blood stream.

Mountain Sickness

At 14,000 feet, this driving pressure is about half that at sea level.  As a very rough estimate, this means only half the oxygen will be pushed into the blood stream.  The body must compensate.

How Does Altitude Make You Sick?

The persons breathing rate, or respiratory rate (RR), increases in the first few days.  At the same time there is a water diuresis – a dehydration resulting from excessive urination – that serves to functionally increase the concentration of red blood cells (RBC’s) per unit of blood.  Excreted with the water is a base called bicarbonate, which helps keep the blood pH neutral.

Acute mountain illness is a benign disorder that generally resolves in a day or two, due to the compensatory mechanisms of the body described above.  Symptoms include one or all of the following: headache, insomnia, lethargy, loss of appetite, nausea and vomiting, and mild shortness of breath.  It’s best to think of the disorder as if it were a hangover.  Sometimes you’ll just have a sort of “mental fogginess”.  Often the 15% or so of skiers affected never realize they have AMS.  Instead, they attribute their symptoms to the alcohol typically consumed during the first few days of a of ski vacation.

Symptoms of Altitude Sickness

How “High” do You Have to be Before You Feel the Symptoms?

Symptoms can begin at elevations as low as 8,000 feet, and sometimes even lower, as in the case of the Kurds.  But symptoms increase substantially from this point with every additional 1,000 feet ascended.  For instance, at 8,000 feet, the base elevation of a typical ski resort, 15% of people suffer from AMS.  But at 10,000 feet, 50% of people are affected.

To avoid this, once you’ve hit 8,000 feet, try to limit your ascension to 1000 feet a day.  And remember the higher you go, the less altitude you should gain each day.

Symptoms of Mountain Illness

Your Brain Swells? – High Altitude Cerebral Edema

As one travels even higher, you can expect some mild cerebral edema (brain swelling) leading to mild lethargy and confusion.  Elevations 10,000 feet and above may produce profound water retention in the lungs, a disease called high-altitude pulmonary edema.  It may even produce cerebral edema severe enough to induce coma (high-altitude cerebral edema). See table 2.

acute mountain sickness tableAMS


Treatments for Altitude Sickness?

#1 Descent

The best treatment for all forms of Altitude illness is descent.  This isn’t always possible.  For instance when there are tanks waiting for you at the bottom of the hill.  If you can move down a bit, try sleeping at a lower elevation than you’ve ascended to that day.  This is thought to help speed the acclimation process.  And that leads us to the first and probably only practical medication a prepper would want to have in their kit for this.

#2 Diamox

Acetazolamide, also known by its trade name Diamox, produces effects that mimic and accelerate the compensatory mechanisms we discussed earlier.  It is a diuretic that causes water loss, effectively increasing the number of oxygen carrying red cells per unit of blood.

One of the most useful aspects of this medication, is its utility as a prophylactic treatment.  If you know you’ll be at elevation, start taking it one to two days prior to ascent.  You can even start the medication at the beginning of your climb, as might be the case if you have to flee upward unexpectedly.


Diamox tablets are scored and breakable, making them easier to customize in terms of dosage.  They are available in 125 and 250 mg tablets, and can be given to children as well as adults.

Okay, They Are Important to Have, But How Do You Use Them?

When using for prevention, the dosage is 5-10mg/kg/day in two divided doses.  This is continued for 48 hours.  If you are using it on someone already having symptoms, the dosage frequency doubles to 5-10 mg/kg/day in 3-4 times daily.

#3 Dexamethasone Injection

The last medication to discuss is the steroid dexamethasone, which is typically given in its I.V. form.  It’s mentioned here because it seems to be the preferred treatment in the movies.  We would suggest not giving steroids for altitude illness unless you’re forced to by severe shortness of breath or more severe neurological symptoms.  Even then, it might be better to treat the person with prednisone.  As you probably already have it in your kit, and because it’s easier to administer in its tablet form.

injectable dexamethasone

What Can You Really Expect?

Ear Pain!

One last tip about altitude.  By far the most common complaint of those at elevation is sore throat and ear ache, sometimes with a cough that resembles the signs and symptoms of bronchitis.  But this is not from an infection.  It’s caused by a combination of the dry air intrinsic to elevation, and the ongoing dehydration from diuresis and water loss inherent to the acclimation process.  The ear pain is from Eustachian tube dysfunction, the same sort of thing you experience on an airplane.  Treatments then are humidification of the air, perhaps by inhaling steam from water you boil, and chewing gum to open the Eustachian tube.

The Above is Adapted From Our New Book:

2nd Book

To learn more about altitude illness and treatments with medications like Prednisone (Deltasone) and Diamox, please click on the book image above.

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