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Altitude Sickness

One of the main sicknesses during the time of peak climbing or trekking is Altitude sickness which is caused by high altitude. Altitude Sickness, often known as Actuate Mountain Sickness (AMS) is particularly an important medical consideration while trekking in Nepal. Altitude Sickness means the effect of altitude in those who ascend too rapidly to elevations above 3,000 meters. The initial symptoms of AMS are as following:

  • Nausea, vomiting
  • Loss of appetite
  • Insomnia/ sleeplessness
  • Persistent headache
  • Persistent rapid pulse
  • Dizziness, light headedness, confusion
  • Disorientation, drunken gait
  • Weakness, fatigue, lassitude, heavy legs
  • Slight swelling of hands, feet and face
  • Breathlessness and breathing irregularity
  • Reduced urine output

On all trekking and exploratory trips our staff has been trained to strict hygiene standards. We carry extensive medical kits and, if the need should ever arise, we are able to evacuate seriously ill group members by helicopter. In Nepal we run regular first aid courses for all trek leaders, Sirdar, Trekking guide.

Precaution and Cure

Altitude illness can be prevented by acclimatization; that is, by a graduate rate of ascent (not more than 400 – 500 meters), allowing sufficient rest at various intermediate altitudes. The dry air of the mountains tends to dehydrate you so an increased fluid intake is necessary. Try to drink at least four liters of water a day. On the trail you can drink hot garlic soup that will help you to some extent. When we reach to our destination it is better to make some hiking up to a bit higher point and come down to the camp or hotel. This is a really good way to get acclimatization. You may take a Diamox 250mg tablet the night before flying / going to altitude. After the symptoms will often disappear and the trek can be resumed.

If you feel obviously suffering from the serious symptoms of AMS then descent should not be delayed even if it means going down in dark. In such case, should an emergency situation arise, horse, or porter will be arranged; or I myself carry you and run to lower (descend) altitudes. There are 3 radios in Namche Bazaar, Doctors at Khunde hospital in the Everest Area and HRA Clinics and in some trekking areas also has the Gamow Bag. The hospital or the clinic will take fees or charges for such services. I can arrange for immediate evacuation, by horse or helicopter, depending on the severity of the case.

First Aid Medical Kit: Medical Considerations

On most treks, you will always be within a few days of medical help. If you are on a group trek, the leader should have the medical knowledge necessary to deal with emergencies and evacuation. If you are on your own, you will have to shoulder most of the responsibility for medical problems yourself. The Sherpa who will accompany you are not doctors, nor are they first aid practitioners. It is essential that you bring your own first aid kit and be prepared to take care of your own blisters, cuts and scrapes. In the event of a real emergency, the Sherpa Sridhar will do his best to get you transported quickly to a qualified physician or an airstrip from which you may be evacuated to Kathmandu.

Medical Supplies

The supplies listed here are recommended for any trek. Since some of them are prescription drugs, you should visit your doctor and discuss the trip with them and obtain prescriptions. If your doctor makes recommendations contrary to the suggestions here, follow your doctor’s advice, and obtain substitutes for these items. It is not necessary to burden yourself with a lot of medicines for the trek, though you should carry enough to take care of minor problems. The ones listed here are sufficient for most situations. You should be sure to provide your supply of own aspirin, band aids, etc.

Basic first aid supplies

  • Suntan lotion or sun blocking cream
  • Lip salve (Chopstick, Blister, or Glacier Cream)
  • Foot powder
  • Band-Aids (plasters) and tape
  • Moleskin or other blister pads
  • Elastic (Ace) bandage
  • Antiseptic cream
  • Aspirin
  • Throat lozenges or cough drops
  • Decongestant tablets
  • Iodine – small bottle for water purification
  • Toilet paper & matches or a cigarette lighter to burn used TP
  • Bactrim, Norbactin or other diarrhoea remedy

Immunizations

Your own physician and your local Public Health Service are the best sources of information about immunizations necessary for Nepal. The list of recommended injections here includes immunizations usually recommended for trekkers in Nepal. Hepatitis and Meningitis protection is also strongly recommended. It is a good practice to have your jabs recorded in a yellow international health certificate.

Recommended Injections

  • Cholera
  • Typhoid-paratyphoid
  • Tetanus
  • Polio (oral)
  • Malaria (only if you will be visiting a jungle lodge)
  • Typhus
  • Hepatitis
  • Meningitis Meningococcal A/C vaccine

Some Advice about Food and Water

In Nepal you should drink only treated water and eat only freshly cooked food. You should always wash your hands before eating, especially if you eat things like biscuits and bread with your fingers. If you follow these simple rules, you should not experience any severe stomach problems. Be forewarned, however, that it is not unusual to have some mild diarrhoea in Nepal while your system adapts to a new environment. If, however, you have diarrhoea accompanied by severe cramps, high fever and chills, you may have a bacterial or parasitic infection that requires additional medication.

The food in most hotels in Kathmandu should pose no health problem. Some conservative physicians recommend that you yourself see any water you drink boiled or treat the water yourself with iodine. The bottled mineral water available in Kathmandu is the safest water to drink. Do not drink tap water under any circumstances. If you eat in restaurants outside the hotel, you should follow the cooked foods rule. Salads and fruits that cannot be peeled should be regarded with suspicion. Open air sweets, dried fruits, local chant, candy colored soda pop in the bazaar, and the wares of small pie shops are all tempting, but can harbor germs and parasites that can upset your stomach and ruin your trek. During the trek, the Sherpa cook and kitchen crew thoroughly cook all food and wash dishes in boiling water. You should have no stomach problems if you eat only the food served by the sherpas. The most important consideration for staying healthy is to take extra care with your own personal hygiene. Keep your hands clean by washing them frequently in the washing water that the sherpas provide.

Equipments : Sphygmomanometer (Blood pressure Instrument) / Stethoscope / Scissors
Syringes (20 ml, 10 ml) / Thermometer / Tongue blades / Hot water bottle / Matchbox /Pen light / Pen and writing pad / Splints / cervical collar
Bandages & Dressings : Sterile gauge pads (large and small) / Band aids / Triangular / Bandages / Elastic Bandages (3, 4 and 6 inches) / Adhesive Tapes / Eye pads / Cotton roll (large and small) / Q-tips / Safety pins / Medications
For pain: Paracetamol (500mgs tablet and 125 mgs in 5 ml syrup)
Aspirin (300mgs tablet)
For Allergy: Avil (25 mgs tablet)
Benadryl Syrup
Trexyl – (60mgs tablet, 30 mgs in 5 ml syrup)
For Infections:
Eye: Neosporin Ophthalmic Cream
Throat and Lung: Amoxicillin (125mg per 5 ml syrup, 250 mgs and 500 mgs tablets)
For Abdomen:
Metronidazole (200mgs, 400mgs tablets)
Tinidazole (500 mgs tablets)
Antacid
Oral Rehydration powder
Loperamide (2 mgs tablets)
For open wounds: Cloxacillion and Cephalexin (125 mgs in 5 ml 250 mgs and 500 mgs tablets)
For urinary infections
Narfloxacin (200 mgs, 400 mgs tablets)
Disinfectants:
Betadine (Solution and cream)|
Miconazole Cream (for fungal infection)
Silver sulphadiazine (for burn injury)

Note: We have trained guides who were very experienced in dealing with the effects of higher altitudes. As they are natives of Nepal, they easily acclimatize and therefore can care for their clients. They are equipped with necessary medical supplies and will assist you with basic first aid treatment. We design our tours to ensure clients are ready for high altitude, and arrange alternative itineraries for those at risk.