Mountain medicine divides altitude into three categories:

• 4,900 to 11,500 feet above sea level (1,500 to 3,500 m)
• Extremely high elevation: 11,500 to 18,000 feet (3,500 to 5,500 m)
• 18,000 feet and above is considered extreme altitude (5,500 m and above)

Reduced performance is prevalent in the first category, high altitude, AMS. Reduced performance is expected in the second category, very high altitude, AMS. Humans can only function for brief periods of time at high altitudes after acclimatization. Mount Kilimanjaro’s summit is 19,340 feet above sea level, making it a high-altitude mountain.

At elevations exceeding 10,000 feet (3,000 meters), more than 75% of climbers will get mild AMS.

There are four elements that play a role in AMS:

1. High Altitude
2. Fast Rate of Ascent
3. High Degree of Extertion
4. Dehydration

Going too high (altitude) too fast is the main cause of altitude sickness (rate of ascent). Your body will adjust to the decrease in oxygen at a specific altitude given enough time. Acclimatization is the name for this procedure, which takes one to three days at any particular altitude. Several changes occur in the body that allow it to cope with low oxygen levels:

• The depth of breathing deepens.
• To transport oxygen, the body makes additional red blood cells.
• When the pressure in pulmonary capillaries rises, blood is forced into sections of the lung that aren’t ordinarily used when breathing at sea level.

The body creates more of a specific enzyme that causes hemoglobin to deliver oxygen to bodily tissues.

At high altitudes, AMS is fairly frequent. Because there are no clear factors that correlate with vulnerability to altitude sickness, such as age, sex, or physical condition, it is difficult to predict who would be affected. During the acclimatization process, many people will develop mild AMS. Symptoms typically emerge 12 to 24 hours after arriving at altitude and subside within 48 hours. Mild AMS symptoms include the following:

• Headache
• Nausea and vertigo
• Appetite loss.
• Fatigue
• Breathing problems
• Sleep disturbances
• A general sense of dread

The symptoms are more severe at night and when respiratory drive is low. Mild AMS has no effect on daily activities, and symptoms usually fade as the body adjusts. As long as the symptoms are minor and simply an annoyance, the rise can proceed at a steady pace.

It is critical to notify others on your hiking excursion promptly if you have any symptoms of illness.

The following are some of the indications and symptoms of Moderate AMS:

• Medication does not relieve a severe headache.
• Nausea and vomiting, as well as a growing sense of tiredness and exhaustion
• Breathing problems
• Coordination issues (ataxia)

Normal exercise is difficult, yet the individual may still be able to walk independently. Only advanced drugs or descent can reverse the condition at this point. It’s critical to bring the person down before their ataxia progresses to the point where they can no longer walk on their own (which would necessitate a stretcher evacuation). Even descending 1,000 feet (300 meters) will result in some improvement, and staying at the lower altitude for 24 hours will result in a major improvement.

Continuing to ascend to greater elevations while suffering from mild AMS can result in mortality.

Severe AMS causes an increase in the severity of the symptoms listed above, such as:

• At rest, shortness of breath
• Being unable to walk
• Mental health is deteriorating
• Inflammation of the lungs due to a build-up of fluid

Severe AMS necessitates a rapid descent of around 2,000 feet (600 meters) to a lower elevation. High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE) are two dangerous diseases linked to severe altitude sickness (HAPE). Both occur less frequently, especially in people who have been fully acclimatized. When they do occur, though, it is mainly in people who get too high too quickly or who become very high and stay there. The absence of oxygen causes fluid to seep through the capillary walls into the lungs or the brain in both circumstances.

Pulmonary Edema at High Altitude (HAPE)

HAPE is caused by a build-up of fluid in the lungs. This fluid obstructs proper oxygen exchange. The amount of oxygen in the bloodstream diminishes as the illness worsens, resulting in cyanosis, reduced cerebral function, and death. The following are some of the signs and symptoms of HAPE:

• At rest, shortness of breath
• Chest constrictions
• Coughing up white, watery, or foamy fluid on a regular basis
• Excessive tiredness and weakness
• At night, a sense of approaching asphyxia
• Irrational behavior and confusion
• Insufficient oxygen reaching the brain causes confusion and erratic conduct. In situations of HAPE, a rapid fall of roughly 2,000 feet (600 meters) is required to save lives. Anyone who has HAPE should be airlifted to a medical center for further treatment.

Cerebral Edema at High Altitude (HACE)

The enlargement of brain tissue caused by fluid leaking causes HACE. HACE symptoms include:

• Headache\sWeakness
• Disorientation
• Coordination problems
• Consciousness levels are diminishing.
• Memory lapses
• Psychotic conduct and hallucinations
• Coma

Unless the afflicted person descends quickly, this condition is rapidly lethal. Anyone who has been diagnosed with HACE should be airlifted to a medical center for treatment.