Clinical Reference Systems: Pediatric Advisor 10.0

DESCRIPTION

• headache, fatigue, dizziness, nausea
• shortness of breath and rapid heartbeat on exertion
• insomnia or restless sleep
• onset at 8000 feet above sea level or higher
• onset within 6 to 8 hours of arrival at higher altitude.

CAUSE

Altitude sickness is caused by the lower amount of oxygen in the air at higher altitudes. Many people travel to mountainous areas to hike or ski. Symptoms occur in 50% of nonacclimated people who go abruptly from sea level to 10,000 feet above sea level. The likelihood of symptoms increases as the altitude gets higher.

EXPECTED COURSE

Most people with acute mountain sickness (the most common type of altitude sickness) feel normal in 2 or 3 days. If someone overexerts himself and climbs 10,000 feet above sea level, it is possible to develop life-threatening complications such as pulmonary edema (lung failure) or cerebral edema (swelling of the brain).

HOME CARE

1. First aid for severe symptoms

   Quickly take your child to a lower altitude. Descend at least 2000 feet, and always go below 10,000 feet elevation. If your child cannot walk, carry him or her in a sitting position. Give the child oxygen as soon as it becomes available.

2. Rest for mild symptoms

   Symptoms usually respond to 2 or 3 days of rest, fluids, and a light diet. Acetaminophen can be given for the headache (aspirin may make it worse). The dizziness and headache can usually be improved by deliberately breathing more slowly. Skiing, hiking, or any other type of exercise should be postponed. Once your child feels healthy again, activity should be resumed gradually. Breathing from an oxygen tank can improve symptoms temporarily but is generally unnecessary when the symptoms are not severe.

3. Prevention
   • Try to stage your mountain visit. Spend a few days at 5000 to 7000 feet before journeying to the high country.
   • Take it easy on the day of arrival. Some exercise (like short walks) is important, but take rest breaks. Gradually increase the amount of exertion during the second and third days.
   • Avoid dehydration by drinking a lot of fluids.
   • While mountain climbing, gain only 1000 feet per day.
   • If your child has experienced severe altitude sickness before, talk to your physician about taking Diamox tablets (a prescription medicine) for prevention in the future.

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

• Your child becomes confused.
• Breathing becomes labored or fast.
• A headache becomes severe.
• Vomiting has occurred three or more times.
• Your child starts acting very sick.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• The symptoms last more than 3 days.
• You have other questions or concerns.