Mountain Living

Treatment
2-121. Cool the victim at once, and restore breathing and circulation. If the victim is conscious,
administer water. If possible, submerge the victim in water to reduce his temperature, treat for shock, and
prepare for immediate evacuation.

ACUTE MOUNTAIN SICKNESS
2-122. Acute mountain sickness is a temporary illness that may affect both the beginner and experienced
climber. Soldiers are subject to this sickness in altitudes as low as 5,000 feet. Incidence and severity
increases with altitude, and when quickly transported to high altitudes. Disability and ineffectiveness can
occur in 50 to 80 percent of the troops who are rapidly brought to altitudes above 10,000 feet. At lower
altitudes, or where ascent to altitudes is gradual, most personnel can complete assignments with moderate
effectiveness and little discomfort.

Personnel arriving at moderate elevations (5,000 to 8,000 feet) usually feel well for the first few
hours; a feeling of exhilaration or well-being is not unusual. There may be an initial awareness
of breathlessness upon exertion and a need for frequent pauses to rest. Irregular breathing can
occur, mainly during sleep; these changes may cause apprehension. Severe symptoms may begin
4 to 12 hours after arrival at higher altitudes with symptoms of nausea, sluggishness, fatigue,
headache, dizziness, insomnia, depression, uncaring attitude, rapid and labored breathing,
weakness, and loss of appetite.

A headache is the most noticeable symptom and may be severe. Even when a headache is not
present, some loss of appetite and a decrease in tolerance for food occurs. Nausea, even without
food intake, occurs and leads to less food intake. Vomiting may occur and contribute to
dehydration. Despite fatigue, personnel are unable to sleep. The symptoms usually develop and
increase to a peak by the second day. They gradually subside over the next several days so that
the total course of AMS may extend from five to seven days. In some instances, the headache
may become incapacitating and the Soldier should be evacuated to a lower elevation.

Treatment for AMS includes the following:
—
Oral pain medications such as ibuprofen or aspirin.
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Rest.
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Frequent consumption of liquids and light foods in small amounts.
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Movement to lower altitudes (at least 1,000 feet lower) to alleviate symptoms, which
provides for a more gradual acclimatization.
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Realization of physical limitations and slow progression.
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Practice of deep-breathing exercises.
—
Use of acetazolamide in the first 24 hours for mild to moderate cases.

AMS is nonfatal, although if left untreated or further ascent is attempted, development of
high-altitude pulmonary edema (HAPE) and or high-altitude cerebral edema (HACE) can be
seen. A severe persistence of symptoms may identify Soldiers who acclimatize poorly and, thus,
are more prone to other types of mountain sickness.

CHRONIC MOUNTAIN SICKNESS
2-123.Although not commonly seen in mountaineers, chronic mountain sickness (CMS) (or Monge’s
Disease) can been seen in people who live at sufficiently high altitudes (usually at or above 10,000 feet)
over a period of several years. CMS is a right-sided heart failure characterized by chronic pulmonary
edema that is caused by years of strain on the right ventricle.

UNDERSTANDING HIGH-ALTITUDE ILLNESSES
2-124. As altitude increases, the overall atmospheric pressure decreases. Decreased pressure is the
underlying source of altitude illnesses. Whether at sea level or 20,000 feet, the surrounding atmosphere has
the same percentage of oxygen. As pressure decreases the body has a much more difficult time passing
oxygen from the lungs to the red blood cells and thus to the tissues of the body. This lower pressure means
lower oxygen levels in the blood and increased carbon dioxide levels. Increased carbon dioxide levels in

26 July 2012

TC 3-97.61

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