Acute mountain sickness or altitude sickness is a serious concern when climbing Kilimanjaro. Kilimanjaro’s permit system, where the national park charges per day rather than per climb, encourages operators to offer shorter routes to be competitive on price. This means that full acclimatization is not possible on shorter routes, and even on longer routes, most Kilimanjaro climbers suffer from mild symptoms of acute mountain sickness. If you have a medical condition that you believe may make you more susceptible to AMS, we recommend that you consult your doctor before booking your trip.
There are a number of practical steps that you can take to minimize the chances of having to abandon your climb of Kilimanjaro due to the effects of altitude sickness:
All including the physically fit can get acute mountain sickness during rapid ascent if staying more than 12 hours above 2500m. The altitude difference undergone in 24 hours is the determining factor. From 3000 metres and higher, the risk increases when the altitude difference between encampments exceeds 300 metres.
Many climbers on Kilimanjaro will experience the early symptoms of Altitude Sickness which include headaches, nausea, dizziness, breathlessness, loss of appetite and possibly palpitations. DO NOT ASCEND IF YOUR SYMPTOMS FAIL TO IMPROVE. DESCEND IF SYMPTOMS GET WORSE AT THE SAME ALTITUDE. If vertigo, vomiting, apathy, staggering and breathlessness occur, immediate accompanied descent is essential. Failing to descend may be fatal.
Avoid ascents of greater than 300 metres per day if starting from above 3000 metres (these are the guidelines for trekking in high mountain areas and this is normally impossible to achieve on Kilimanjaro). If early signs of mountain sickness appear, rest for a day at the same altitude. If they persist or increase, descend at least 500 metres. Acetazolamide (Diamox) can be used to help prevent mountain sickness when a gradual ascent cannot be guaranteed. It should NOT be used as an alternative to a gradual ascent. It acts on acid-base balance and stimulates respiration. It should be combined with a good fluid intake. It should not normally be used in young children except under close medical supervision. Dose: 125 mg to 250mg twice daily for adults. It should be started 24 hours before ascent and continued only for the first 2 days at high altitude while acclimatization occurs.
Initially simple analgesia (e.g. ibuprofen) for headaches. Sleeping pills should be avoided if possible. Acute Mountain Sickness with Cerebral Oedema – Immediate evacuation or descent at least 1000 metres; oxygen if available. Dexamethasone (12-20 mg daily) or Prednisolone (40 mg daily). Acetazolamide 250 mg orally within 24 hours of onset of symptoms and 250mg orally 8 hours later. High Altitude Pulmonary Oedema – Immediate evacuation or descent. If symptoms are acute and/or descent is impossible or delayed consider Nifedipine (20mg tds).
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