Altitude sickness medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

The classification of patients with acute mountain sickness as mild or moderate is based on the severity of headache and presence of other manifestation such as nausea, dizziness, fatigue or insomnia.

The management of mild acute mountain sickness includes:

1. Discontinuation of ascent.
2. Treatment with acetazolamide (250 mg q12h).
3. Descent: The patient should descend below the point at which the symptoms occured.

Similarly, following steps are recommended for management of moderate acute mountain sickness:

1. Immediate descent.
2. Administration of oxygen (2-4 L/min).
3. Treatment with dexamethasone (8 mg PO/IM/IV, then, 4 mg q6h).
4. Hyperbaric therapy: The patient is place in a portable altitude chamber or bag.

Treatment of chronic mountain sickness involves descent from altitude, where the symptoms will diminish and the hematocrit return to normal slowly. Acute treatment at altitude involves bleeding, removal of circulating blood, to reduce the hematocrit; however this is not ideal of extended periods.